Alta Equine Sports Medicine

04/01/2025

Unlike humans, horses don’t have collarbones. Instead, their shoulders are attached to the rest of their skeleton by a network of muscles and ligaments, referred to as the “thoracic sling.”

Why does this matter? We often ask our equine athletes to perform complex movements that require tremendous strength and coordination, and horses carry the majority of their weight in their front end. Therefore, it is imperative that the bulk of the muscles that support the front end are kept healthy and conditioned, and the horse is trained to engage the large hind end muscles as much as possible to avoid excessive weight bearing on the front end.

If the front end of the horse is consistently overweighted or not at an appropriate level of fitness, repetitive biomechanical stresses get transferred down the leg to the smaller ligaments and tendons that were not designed to bear this weight. Over time, this can increase the risk of injury.

📸: AAEP Horse Owner Education Committee.

03/31/2025

After exercise, measure your horse’s heart rate at 2, 5, and 10 minutes post-exertion. A well-conditioned horse will have a faster recovery rate, with heart rate returning toward baseline within this period. Delayed recovery or an elevated post-exercise heart rate, especially when compared to previous patterns, may indicate pain, dehydration, metabolic stress, or insufficient conditioning for the workload.

For more precise monitoring, equine heart rate monitors can be incorporated into tack to track exertion levels in real time, providing valuable data on training intensity and recovery trends. Monitoring heart rate alongside respiratory rate and other parameters can help optimize conditioning programs and reduce injury risk.

03/28/2025

This infographic from the AAEP Horse Owner Education Committee provides a great quick-reference overview of what we’ve been discussing this week.

Because the clinical signs of PPID and EMS overlap, a proper veterinary evaluation is crucial to ensure the correct diagnosis and treatment plan. PPID often requires medication like Pergolide, while EMS is primarily managed through diet and exercise changes.

03/27/2025

If your horse is showing clinical signs of PPID (Cushing’s disease), it’s time to test.
A blood sample will be taken to measure resting adrenocorticotropic hormone (ACTH) levels. ACTH naturally fluctuates with the season, and reference ranges account for these variations. However, stress, illness, or exercise can also influence results, so testing in a low-stress, familiar environment is ideal.

For early or borderline cases, or when resting ACTH results are inconclusive, a thyrotropin-releasing hormone (TRH) stimulation test may be recommended as it provides a more sensitive assessment of pituitary function.

PPID and Equine Metabolic Syndrome (EMS) can coexist, but not all horses with PPID develop insulin dysregulation. Additional testing for insulin and glucose regulation may be recommended, as insulin dysregulation is a key risk factor for hyperinsulinemia-associated laminitis.

03/26/2025

Pituitary Pars Intermedia Dysfunction (PPID), also known as Cushing’s disease, is one of the most common endocrine disorders in horses. It results from dysfunction of the pituitary gland, leading to excessive hormone production that affects metabolism, immune function, and overall health.

How is PPID Different from EMS?
PPID and Equine Metabolic Syndrome (EMS) share some clinical signs, but their underlying biology is different. While EMS primarily involves insulin dysregulation and obesity-related laminitis, PPID causes the pituitary gland to overproduce hormones, leading to:

🩺 Delayed coat shedding or a long, curly coat (hirsutism)
🩺 Muscle loss, especially along the topline
🩺 Increased drinking and urination
🩺 Chronic infections, abscesses, or delayed wound healing
🩺 Unexplained laminitis or abnormal fat deposits
🩺 Lethargy or decreased performance

Who is at Risk?
PPID can affect any breed, both male and female horses, and has been diagnosed in horses as young as 7 years old. Studies suggest that 15-30% of horses over 15 years old have PPID, making early awareness and testing crucial.

While PPID cannot be cured, it can be managed with proper diagnosis, medication, and supportive care.

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03/25/2025

Lush spring grass can challenge even the healthiest equine digestive systems. A gradual transition to pasture is ideal—starting with short, controlled grazing sessions and slowly increasing duration. This allows the digestive tract to adapt while reducing the risk of metabolic disturbances.

Other management strategies include:

Using a grazing muzzle to slow intake without fully restricting grazing.

Providing hay alongside pasture to maintain fiber intake and reduce overconsumption.

Limiting turnout when environmental conditions favor high fructan accumulation, such as after frost or during drought stress.

Monitoring pasture conditions—fructan levels tend to be lower in early morning but vary based on sunlight, temperature, and plant stress.

Some horses may benefit from hindgut buffers to support digestive stability.

For horses prone to laminitis or metabolic conditions, close management of grazing is essential. Consult with your Dr. Natalie for pasture strategies tailored to your horse’s needs.

ker.com/equinews/tips-healthy-spring-grazing/

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03/24/2025

Equine Metabolic Syndrome (EMS) is a collection of endocrine and metabolic abnormalities that often accompany obesity and increase the risk of laminitis. Affected horses may develop abnormal fat deposits, struggle with weight loss despite a controlled diet, and exhibit signs such as a cresty neck or an increased body condition score.

EMS is most commonly diagnosed in middle-aged horses (8–18 years old) and is frequently observed in “easy keeper” breeds such as ponies, Morgans, gaited horses, Arabians, and Warmbloods. Laminitis is a major concern, often triggered by insulin dysregulation, where the body either produces excessive insulin in response to dietary sugars or maintains persistently high insulin levels. Proper metabolic management is critical to reducing this risk.

Horses at risk should be evaluated by a veterinarian to determine whether diagnostic testing is warranted. Once diagnosed, a tailored treatment, dietary, and management plan can be implemented to support long-term health. These conditions are treatable and largely preventable with proper management, a healthy body condition, and a balanced diet. For horses requiring a low-NSC diet, hay should always be tested to ensure it meets their nutritional requirements.

03/21/2025

Many studies have demonstrated the adverse health effects of equine obesity, making weight management a crucial part of equine care.

The Henneke body condition score (BCS) is the industry standard for assessing a horse’s condition. Generally, horses rated 1 through 3 are considered poor to thin. A 4 to 6 horse, described as moderately thin to moderately fleshy, is typically classified as healthy, while a 7 to 9 horse, characterized as fleshy to extremely fat, is considered overweight or obese.

However, BCS alone may not fully determine a horse’s condition. Dr. Natalie starts with BCS and then evaluates the horse’s overall lifestyle, exercise, and underlying conditions. Schedule an evaluation with Alta Equine to determine your horse’s BCS and receive tailored recommendations to support their long-term well-being.

03/20/2025

Seasonal skin allergies and coat quality can be influenced by diet. Adding Omega-3 fatty acids, MSM, and other antioxidants can help support a healthy immune response and reduce inflammation.

MSM promotes the formation of enzymes, hormones, and immune cells, which help support healthy skin and coat. While MSM helps strengthen your horse’s immune response to allergens, Omega-3 fatty acids provide anti-inflammatory relief. Flaxseed and flaxseed oil are palatable choices for adding Omega-3 fatty acids to a diet. We also recommend the skin and coat supplements by Platinum Performance and SmartPak.

Want to learn more? Reach out to discuss your equine athlete’s nutritional needs!

03/19/2025

Pollen, dust, fungal spores, and insects are impossible to remove from the environment, but there are ways to help reduce these factors and improve the quality of your horse’s environment. Fly masks and fly sheets, combined with insect repellents, provide a good first line of defense against biting insects. However, if your horse continues to struggle with insect-related skin allergies, additional measures may be necessary.

Environmentally friendly solutions like Fly Predators help control fly populations naturally by targeting fly pupae before they emerge—without the use of pesticides or harsh chemicals. Mosquito Magnets offer another effective tool for insect control. Concentrating on facility management strategies, such as manure removal and ventilation, can also help reduce environmental allergens and insect breeding grounds. Reviewing management protocols with your veterinarian can provide additional strategies for minimizing insect-related irritation in horses.

03/18/2025

Always a treat to see our patients in action! Thanks for tagging us in this shot of Gio 🫎and of

03/17/2025

🍀 Rusty, Duke and Gus looked very festive this weekend for the St. Patrick’s Day parade 🍀

03/14/2025

Grooming and bathing play a critical role in skin and coat health. When bathing a horse experiencing skin irritation, cold water can help soothe the skin and even offer anti-inflammatory relief. However, using shampoos containing soap will strip away the protective oils in a horse’s coat, making them more susceptible to skin irritation and secondary skin infections, so it is important to choose a shampoo that will address the problems your horse is having without causing further harm.

Some products that we recommend are the KineticVet shampoos. They offer a variety of medicated and anti-itch shampoos, as well as fly repellent, skin and coat supplements, and sunblock!

Ceraven (formerly known as Phytovet) offers shampoos and sprays that are similar to KineticVet products, but they also offer antiseptic/antimicrobial and anti-itch protection in the form of leave-on mousse (which can be helpful with horses that aren’t a fan of spray bottles), or easy-to-use wipes.

Contact Alta Equine to discuss symptoms and the best approach to management solutions for your equine athlete.

03/13/2025

If your horse suffers from persistent itching, recurrent hives, or other allergy-related symptoms, allergy testing may help identify potential triggers and guide management strategies.

Veterinarians have two main testing options:
🔹 Serum (blood) testing – A simple blood test that measures allergen-specific antibodies. Results take about a week but can have false positives/negatives.
🔹 Intradermal skin testing – Small amounts of allergens are injected into the skin to assess reactions in real time. This method provides immediate results but requires shaving and possible sedation.

Because allergy tests are typically performed after a horse has already shown signs of an allergic reaction, the immune system is often in a heightened state. This can increase the likelihood of identifying reactive triggers that may not cause issues when the horse is in homeostasis. For this reason, results should be viewed as a guide rather than a definitive diagnosis.

Many dermatologists believe the best use of allergy testing is to help guide allergen-specific immunotherapy (allergy shots), a treatment proven effective in many cases. This therapy involves gradually introducing allergenic substances in increasing amounts to help the body recognize them as non-threatening, reducing hypersensitivity over time.

Wondering if allergy testing is right for your equine athlete? Contact Alta Equine to discuss the best approach to managing allergies.

📸 Platinum Performance

03/12/2025

Spring and summer bring allergy challenges for many horses as pollen, mold, and insects increase. A balanced diet with targeted nutrients can help support immune function and reduce allergic responses. Starting supplementation 4-6 weeks before symptoms typically appear may help maintain skin, coat, and immune health.

Platinum Skin & Allergy provides key ingredients like Quercetin, a naturally occurring antioxidant that helps support normal histamine levels.

🔗 Learn more: bit.ly/37pxbcL
Use code "ALQ" when ordering Platinum Products to keep your profile up to date.

For competing horses: Platinum Skin & Allergy contains a small amount of rosemary extract to stabilize omega-3 fatty acids. While the DHA flake used in this formula is tested to confirm no detectable levels of camphor (

Platinum Skin & Allergy supplements for horses help maintain normal histamine levels and provide support for respiratory and horse skin allergies. Order now.

03/11/2025

For our horses who suffer from seasonal skin allergies; spring can be an itchy and uncomfortable time. There are many forms of seasonal and allergic dermatitis, such as hives, sweet itch, pruritus, or photodermatitis, and they tend to be difficult to resolve or control.

Allergies can appear in the skin and respiratory airways. Allergens may include grasses, molds, spores, or insect bites. Signs your horse may have an allergic response include watery eyes, hives, itching, or hair loss.

Traditionally, steroids were the go-to treatment for a quick resolution of skin allergies. However, steroids may not always be an option for some horses, like those in competition and laminitis-prone horses. Many other options are available, and a multifaceted approach tends to be the most effective. Topical treatment, systemic treatment, environmental control, and dietary changes may all be required to bring relief.

Contact our office to develop an allergy plan customized to your equine athlete's needs. Do you have questions about equine allergies? You're probably not the only one! Comment below, and the Alta Equine Team will work to answer them in a future post.

03/07/2025

There is a wealth of published clinical research showing the efficacy of shock wave therapy used for sports medicine indications in the horse (as well as in dogs and humans). At Alta Equine, we use shock wave therapy on a wide variety of cases to:

✔️ Improve healing for tendon & ligament injuries
✔️ Increase circulation
✔️ Accelerate wound healing
✔️ Arthritis management
✔️ Reduce inflammation
✔️ Treat back conditions like kissing spines and dorsal articular process inflammation
✔️ Support overall musculoskeletal health as part of a maintenance program

The biological response lasts 2-4 weeks, with short-term pain relief lasting up to 4 days. Since competition regulations vary, owners should check rules and inform their veterinarian before scheduling ESWT.

03/04/2025

This image shows the fin-like bony projection from spinal vertebrae called a Dorsal Spinous
Process (DSP).

When these DSPs crowd together, it can result in a painful condition commonly referred to as “kissing spines.” Kissing spines can result from a number of contributing factors, including ill-fitting saddle, training, poor core engagement, conditioning, and others. It is more commonly diagnosed in performance horses and thoroughbreds. Not all horses with radiographic evidence of kissing spines display signs of back pain.

Treatment can include bodywork, rest, medical interventions, and physical therapy. Affected horses should have an assessment for proper saddle fit with modifications to allow more room over sites of kissing
spine lesions.

Check out this article from UC Davis for more information on kissing spines.
https://ceh.vetmed.ucdavis.edu/health-topics/kissing-spines