About Cheryl L. Detamore, DVM

Cheryl L. Detamore, DVM, has practiced equine medicine for over 14 years, including a stint specializing in Thoroughbred horses in the heart of Kentucky’s horse country. A graduate of the Tuskegee University School of Veterinary Medicine, Dr. Detamore now practices in Virginia and West Virginia, where she developed and produces MeliHeal All Purpose Healing Salve™ for horses.

Boo-Boos and Uh-Ohs

Knowing when to call your veterinarian is one of the greatest challenges of horse ownership. What one horse owner considers an emergency might seem minor to another. And no one wants to gain a reputation for “crying wolf” when no real medical crisis exists. To prepare yourself for unexpected emergencies, use this step-by-step guide to safely manage wounds.

Preparation

Because preparation is often the best medicine, it’s critical that every horse owner becomes familiar with basic equine anatomy. It’s also important to have an emergency first-aid kit convenient at all times. Keep one centrally located in your barn, another in your trailer and a portable kit for trail rides. Keep kits stocked with items to stabilize and treat wounds, including a tourniquet, hemostat (clamp-like instrument used to stop bleeding), bandage scissors, antimicrobial solution, gauze pads and rolls, adhesive wrap, cotton rolls and antibacterial ointment. Also, keep an extra tetanus-toxoid shot in the refrigerator in case of an emergency.

Treatment

The first step in treating a laceration is to control the bleeding. The amount of bleeding depends on the duration, severity and location of the injury. Simple lacerations involving skin capillaries usually seep slowly and clot with compression. Severed veins, however, bleed moderately to severly. Arterial bleeding pulsates and squirts in rhythm with the pumping heart.

1. Apply pressure to bleeding areas immediately. If you suspect that a major vessel has been damaged, notify your veterinarian immediately. In the meantime, hold gauze or some type of bandaging material with your hand on affected areas of the body, or apply pressure wraps to the legs. When applying pressure, wait at least 20 minutes to evaluate your clotting progress. Doing so prematurely disrupts clotting and might necessitate starting over.

2. Inspect the wound. Once the bleeding has subsided, remove your compression and thoroughly inspect the wound. If you’re unsure whether the wound requires sutures, avoid the wait-and-see approach.  All wounds have a “golden time of healing.” During this period of time, usually the first three hours after injury, treatment is most effective.

3. Clip around the wound. If you’re confident that you can handle the injury yourself, begin by clipping the hair along the hair along the wound margins. Take care to protect the wound, and sweep away loose hair; clipped hair sticks to exposed tissue and is difficult to remove later.

4. Clean the wound. The wound is already contaminated, so tap water, as opposed to sterile water and liquids, is acceptable. Rinse well with moderate pressure, resisting the urge to scrub. Abrasive treatment disrupts clots and inflicts trauma.

5. Flush with antimicrobial solution. Once visible contamination and debris are washed away, gently clean the wound with antimicrobial solution. Avoid peroxide, as it can increase bleeding and damage delicate tissues.

6. Apply antibacterial ointment. Minor cuts don’t require extensive aftercare. In fact, overdoctoring actually can impair natural healing. Apply an antibacterial salve, such as MeliHeal, twice daily for several days.

7. Apply insect repellent. During warm months, apply insect repellent to surrounding areas, but avoid spraying directly on the wound.

8. Monitor the wound. Keep the horse in a clean area, such as a stall or small pen, where you can observe the animal until risk has passed. Check the affected area daily for delayed healing and signs of infection, such as oozing, swelling and warmth.

9. Administer tetanus-toxoid booster. Last, but certainly not least, give the injured horse a tetanus-toxoid booster if more than three months have lapsed since his last immunization. If the horse wasn’t previously vaccinated for the disease, or the status is unknown, administer both the toxoid and antitoxin (the antitoxin offers temporary protection until the toxoid booster takes full effect), along with a toxoid booster in two weeks. Early signs of tetanus include difficulty swallowing, prolapsed third eyelid and overall stiffness. Additionally, affected horses are often sensitive to light and sound.

If you only take one thing away from this post, please stop using peroxide. It’s my mission to inform the horse public that peroxide is the devil (smile).

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Winter Water Worry

Gipper StoneyDid you know the average equine requires half a gallon to a gallon of water for every 100 pounds of body weight each day to maintain proper hydration? This includes equines of all sizes, regardless of species or breed – from donkeys and mules to miniatures and drafts, the formula remains the same.

However, during cold weather, water consumption naturally declines, predisposing to dehydration colic. Without a doubt, lukewarm water encourages intake during winter months, lowering the risk of constipation and impaction. Water between 45 and 65 degrees Fahrenheit is ideal.

While buckets and tanks with heaters are efficient in almost any situation, ensure they pose no electrical hazard; indoor automatic water sources are another alternative. But, whatever method you choose, make sure you can approximate how much water your companion is drinking every day.

Body Conditon Score, Dissected

Weight has forever served as an assessment of overall health in the horse world, and has been a controversial issue for just as long. Numbers can be misleading and opinions vary – what seems desirable to one, can have the air of neglect to another. There is no such thing as a body mass index for horses and weight tapes can only offer a vague estimate of weight, as they do not compensate for differences in breed, age, or sex.

However, the Body Condition Score is an objective assessment of general health and is considered the industry standard for determining appropriate level of condition for horses. The system assigns a numerical value, or score, according to fat deposition on various places on the body. This is done by assessing fat both visually and by touch in each of six areas – loin, ribs, tailhead, withers, neck, and shoulder. Horses accumulate fat in these areas in a set order, and the order is the same regardless of breed, age, or sex. Scores range from one to nine – most consider five to be “ideal”, with one classified as “emaciated” and nine as “obese”. It will not indicate how fit your horse is for training or performance, since it does not measure muscle.

This system was developed to eliminate subjective opinions that have different meanings to different individuals. It is considered a scientific form of evaluating condition and is accepted in a court of law. References on body condition score are readily available and easy to interpret with a bit of practice.

Adequan and Legend, Apples and Oranges

steeplechaseAdequan or Legend, which is better? I get this question all the time. Even though both products have been around forever, rumors of their merit continue  – including a misconception that one is just a cheaper version of the other. Let’s explore the differences, so you can decide if your horse is a candidate for either formulation, or both.

While both products are great options for treatment of moderate to severe arthritis, Adequan and Legend are completely different formulations, with entirely different applications. So much, in fact, that I sometimes use both products at the same time on the same horse. Even though both pharmaceuticals are effective for the management of arthritis, I cannot say which is better – it’s like comparing apples and oranges.

Adequan is polysulfated glycosaminoglycan, a substance that stimulates cartilage to repair itself. It can be administered intramuscularily (Adequan IM) or intra-articular (Adequan IA). Adequan IM treatment consists of a series of intramuscular injections every four days for a month, while Adequan IA treatment consists of a series of five weekly intra-articular injections. It may take as long as two months to see results.

Legend is hyaluronic sodium, a substance naturally found in synovial fluid. It comes available in intravenous (Legend IV) or intra-articular (Legend IA) formulations. Either route consists of three consecutive weekly treatments. Legend works quickly to reduce inflammation within the joint capsule, with improvement as early as two days.

The manufacturers of Adequan and Legend agree that intra-articular injection of their products is most effective, but it does pose greater risk of complications. However, intramuscular or intravenous administration sometimes offers better overall results because it acts systemically and can alleviate joint abnormalities throughout the body. There are pros and cons to both products: Adequan acts more slowly, but it has a more profound effect on joint repair; meanwhile Legend acts more quickly to improve lubrication and reduce pain, but it works for a shorter period.

These Adequan and Legend treatment protocols can be repeated at regular intervals, or the two products can be combined for optimal results. There are no metabolic or behavior changes associated with either product, and both are permitted in competition.

Click, Tick, Tock

beau mistAnother year has come and gone. I guess the old saying is true:  time flies when you’re having fun. And that other thing about the older we get, the quicker it goes – Mom was right, but that’s another story…

As for me, 2012 brought lots of changes, both personal and professional. After nearly 15 years of day-to-day practice, I now focus on writing, teaching, and product development.

And, what a year in the horse world – from changes in slaughter laws to controversy surrounding show regulations. And, of course, record drought throughout much of the country.

I look forward to discussing these topics, and much more. But, since cold weather is upon us, I want to address a common question:

What causes a horse’s joint to ‘click’?

Joints are enclosed in a capsule, and bathed in a slippery liquid called synovial fluid. This substance, along with articular cartilage, allows a joint to move with ease. Without adequate lubrication, joints become rough – a product of age, wear, or conformation. If not addressed, articular cartilage begins to erode, followed by inflammation of underlying bone surfaces and, ultimately, arthritis.

Once you hear noise coming from a joint, avoid taking the wait-and-see approach – pain and lameness may be close behind. When it comes to joint degeneration, it’s easier to prevent a process, or slow it down, than to correct it once established.

Joint supplements provide the body with natural components that have been lost with time and use, and are a good option to prevent dryness or replace viscosity in the early stages of degenerative joint disease.

Look for a product that contains at least MSM and vitamin C (ascorbic acid); added glucosamine is a plus, but something with hyaluronate is superior. And, since nutraceuticals are not closely regulated, purchase a reputable brand to ensure quality and consistency. Most products recommend an initial loading dose, followed by a maintenance dose. It may take a month or more to see results, but most supplements become more effective over time.

Happy New Year !

It’s the Most Wonderful Time of the Year

It’s been a long winter, but an even longer wait for the much-anticipated debut of your new foal. As the arrival approaches, worry often replaces excitement. However, proper planning can alleviate the stress of uncertainty.

Proper Health Care

The average equine gestation period is 345 days, plus or minus 2 weeks, depending on the breed and climate in which the mare resides. Mares foaling in warmer climates or during warmer months tend to deliver early, although those due in colder months or climates are more likely to exceed their expected due date. Maiden mares, or first-time mothers, might deliver prematurely.

Early in pregnancy, or at least 45 days prior to foaling, remove mares from fescue grass to prevent future problems. Fescue toxicity in pregnant mare causes significant problems, including prolonged gestation, retained placenta, absence of milk and delivery of weak foals.

Continue routine vaccinations based on your geographical recommendations. If your barn has several breeding females, heavy horse traffic or a history of abortion, vaccinate pregnant mares at 5, 7 and 9 months of gestation for the abortogenic strain of equine herpes virus, EHV-1, to protect against late-term abortions and birth defects. Don’t confuse this with immunization for rhinopneumonitis, or EHV-4, a different viral strain that causes respiratory and neurological disease in young and adult horses.

Give all mares tetanus toxoid boosters 6 weeks prior to their due dates to protect them during and after delivery, and to ensure that their colostrum contains adequate levels of antibodies to the disease. The organism that causes tetanus is actively secreted in horse manure and lives in the environment where horses are kept, making them extremely susceptible to the disease. Mares are particularly vulnerable at foaling time, especially in cases of prolonged labor, or when partially retained fetal membranes are allowed to contact the ground. Foals, meanwhile, are at risk of contracting tetanus through their navels.

You can safely treat mares for parasites throughout their pregnancies, and it’s recommended that you deworm pregnant mares 6 weeks prior to their expected due dates. This ensures that they’re in good condition at foaling and that their milk is free of parasites.

Mares that have undergone Caslick’s procedures need special attention. In this minor surgical procedure, the upper portion of the vulva is sutured shut following breeding, allowing just enough space for the mare to urinate. It’s performed primarily in older mares with genital conformations that contribute to fecal contamination of their reproductive tracts. Without this procedure, many mares are unable to carry a pregnancy to term. In preparation for foaling, the veterinarian opens the vulva by cutting along the center where the tissue has been sewn together, while using local anesthesia.

It’s also advisable to remove shoes, to prevent mares from injuring themselves during labor and damaging their foals after delivery. Bare feet aren’t nearly as dangerous to delicate newborn flesh or as likely to cause fractures as those that are shod.

Expectant mares should receive moderate exercise to maintain fitness, even in the last weeks of pregnancy. Daily exercise strengthens muscles, promotes circulation and prevents colic. Even though pregnancy and impending lactation increase nutritional demands, don’t allow mares to become sedentary and obese. Mares rarely suffer from obesity-related dystocia (difficult birth), but extra weight causes fatigue during delivery.

Comfortable Accommodations

Mares can safely foal in a variety of locations, but it’s imperative that they become accustomed to their birthing location at least 2 weeks in advance. In mild climates and during warm months, turned-out expectant mares can comfortably foal on grass. However, in extreme weather, move them to an alternate area. Avoid placing late-term mares in expansive areas where they aren’t easily observed. Small paddocks or pastures are ideal. If the mare is pastured but expected to foal inside, bring her in at night for the last few weeks of her pregnancy to introduce her to the new accommodations.

Fencing should consist of some type of flank – avoid mesh and barbed wire. Follow the same fencing guidelines when preparing turnout areas for mothers and their babies. Bear in mind that it’s difficult for foals, with their immature vision, to decipher mesh, even that constructed of small weave. Additionally, young foals might fatigue or injure themselves trying to keep pace with their dams in large areas, so keep them in a more manageable location.

The idea foaling stall is at least 12 by 16 feet, the roomier the better. Mares need enough room to safely turn and roll without injuring themselves or becoming cast during the initial stage of labor. The stall should have sufficient room for attendants or the veterinarian to work in emergency situations. At the same time, a larger stall allows new foals room to romp and play without injuring themselves.

Solid walls with no holes or loose boards are safest. Don’t leave space between planks or under the bottoms of walls or doors. Check carefully for nails or any other protruding objects. Water and feed sources are safest at ground level, as foals can get caught in buckets or tubs hung on walls.

Proper ventilation is necessary to ensure the respiratory health of mothers and their new arrivals. The lower levels of foaling stalls should be draft-free, with adequate air exchange above. Stalls with open tops or constructed from bars are generally well ventilated, but might not offer enough warmth in colder climates. Cold areas might require completely enclosed foaling stalls.

Adequate barn and stall lighting allows you to observe expectant mares. Ideally, provide sufficient light to watch mares, without disturbing their rest. Most importantly, ensure that enough light is available to work in emergency situations.

Straw is the best bedding for foaling stalls. Avoid sawdust and shavings, because they’re dusty and can lead to respiratory disease in foals. They also tend to stick to moist surfaces, which can contribute to reproductive infections in postpartum mares. Wood bedding also is associated with higher ammonia levels in barns. If mares are ordinarily bedded on shavings or sawdust, change to straw a few weeks in advance to allow time to acclimate. Before switching back after delivery, allow another few weeks for the risk of health-related complications to subside. And remember to provide mares plenty of hay on which to nibble to prevent them from eating their bedding. Don’t bed stalls too deeply, or it might be difficult for wobbly foals to stand. Avoid stall mats when possible because they’re slippery when wet. In permanently installed, cover them with a thin layer of sawdust for traction before covering with straw.

In areas where temperatures fall below freezing, heat lamps are often necessary additions. To optimize their use, place them in stalls with ceilings, which helps prevent the heat from escaping. Focus the light into the corner nearest the lamp rather than trying to scatter it over the entire space. This produces a cozy area for the occupants, while still allowing them to escape the heat. Always exercise caution with any heat source. Specifically, make sure horses can’t chew on the cords.

Foaling Detection

Fortunately, there are a number of devices on the market today aimed at predicting foaling. They include surveillance cameras designed to observe expectant mares in foaling stalls and throughout the barn and paddock areas. The systems consists of closed-circuit video cameras connected to a television or computer that allows horse owners or foaling attendants to watch for signs of impending labor in mares without directly observing them.

Monitors that connect to halters can detect restless movement or whether the mare is lying down, while others respond to changes in skin moisture. Vaginal monitors are inserted directly into the vagina or sewn into the vulva to detect contractions. Exercise caution with these types, though, as they can lead to vaginal and rectal lacerations once the foal’s feet have entered the birth canal. Never rely heavily on any of these devices as primary indicators of foaling, because they’re often misleading and provide a false sense of security. Nothing replaces good, old-fashioned observation.

Calling for Help

One of the most difficult aspects of foaling is knowing when to call the veterinarian, because every birth is ultimately unique. If you feel uncomfortable, or uncertain that you can handle the situation, don’t hesitate to call your veterinarian. Many horse owners experience anxiety about having their veterinarian make “wasted” trips, but any equine practitioner would rather take time out of a busy day to find a healthy mare and foal, than face a situation that’s escalated into a dismal prognosis.

Give your veterinarian a list of foaling dates and potential problems ahead of time. It’s also a good idea to have a competent back-up veterinarian in the event yours is unavailable. Keep phone numbers and contact information convenient at all times. And in case of emergency, be prepared to provide details when the veterinarian arrives.

Normal Foaling Stages

The first stage of labor can last up to 8 hours. During this time, the mare experiences contractions as the foal moves into position for delivery. If this stage lasts longer or seems more violent than expected, call your veterinarian immediately.

The second stage of labor begins when the mare’s water breaks and usually lasts only about a half-hour before the foal is delivered.

After the allantoic fluid escapes, the foals front feet should appear within a few minutes. One foot should be farther forward, with the nose resting on top of the legs. If the foal doesn’t present normally, or if more than 45 minutes has elapsed, seek immediate help.

When they initially appear, the foal’s feet will most likely still be encased in the amniotic membrane, which should rupture as the foal advances. If the membrane appears overly thickened, or if the foal is enclosed in a bright red sac, the sac must be opened immediately with blunt scissors. During a red-bad delivery, the placenta prematurely separates from the uterus before the foal is delivered. If not opened immediately, the foal will suffocate. In this case, there’s no time to wait for your veterinarian to arrive.

Call your veterinarian immediately if you suspect any abnormality. Remember that harm can be inflicted by either action or inaction. Being prepared can’t ensure that foaling will proceed without incident, but it sure helps when circumstances take an unexpected turn.

Salt and Mineral: What’s the Difference?

White blocks generally contain salt only, while colored blocks typically contain both salt and minerals. With so many choices, it is imperative to choose a product made specifically for horses. Never use a product created for cattle or multiple kinds of stock. Indeed, each species has different needs, and what is good for one can be harmful to another.

When choosing salt and minerals for horses, read the labels carefully and choose a supplement that corresponds to the needs of your area. For instance, there are regions of the country that are deficient in selenium and, thus, require additional supplementation. Meanwhile, other regions have excessive selenium in the soil – and adding more to the horse’s diet could result in toxicity.

While blocks are convenient and easy to use, loose salt and mineral are actually better for horses, which, unlike cows, grasp food (or any substance) with their lips rather than their tongues. Although horses that eat a balanced diet don’t generally have salt or mineral deficiencies, make them available throughout the year – not just during the warmer months of spring and summer.