Alex Knott MA VetMB MRCVS
It's that time of year again....the shoes are off and the hunters are out in the field enjoying their holidays. For injury recovery a long holiday may be advantageous. But for those horses with arthritic changes, staying in light work is better for joint health and the overall well-being of the horse.
Osteoarthritis (damaged cartilage) occurs due to trauma. The joints become swollen and painful which often manifests itself as lameness. In more severe cases there may be a reduced range of movement of the joints making the horse more vulnerable to injury.
From a veterinary perspective we have an extensive armoury of treatments; from targeting specific joints with intra-articular injections, to treating multiple joints with systemic medications. Intra-articular steroids are relatively cheap and still the most effective treatment for reducing inflammation within a joint. More elegant and expensive therapeutics have recently come to the market, from biological products (PRP and IRAP), to shock absorbing plastics (Arthramid). Which particular treatment is appropriate for your horse depends on a multitude of factors and should be discussed with your vet.
Atypical Myopathy is a frequently fatal condition caused by severe muscle damage. The condition, thought to be caused by ingestion of sycamore seeds seems to be associated with specific weather conditions particularly found in autumn.
Horses suffering from atypical myopathy have been found to have high levels of the toxin Hypoglycin A, found in the seeds of sycamore trees. The toxin prevents the normal use of fats as energy by muscle cells, causing build up within the cells and destruction of the normal muscle function resutling in complete dependence on carbohydrates as an energy source.
Unfortunately, once clinical signs are evident the disease is usually in the advanced stages and there is no curative treatment at present. Survival rates are between 20-30% with intensive care which usually requires transport to a hospital facility. However, in some cases transport is not recommended or possible due to the degree of muscle damage and you should be guided by your vet's advice in this instance.
Please see the attached fact sheet for more information on symptoms, treatment and preventative measures.
A new technique that uses ultrasound to predict a racehorse’s likelihood of a return to racing after a tendon injury has been developed by researchers at the University of Nottingham, Oakham Veterinary Hospital Equine and the world-famous Hong Kong Jockey Club.
In this unique collaboration, the team has created a scoring system for grading tendon injuries in racehorses when they first occur and used this in a large study to determine which ultrasound features will predict whether or not the horse will successfully race again after rehabilitation.
The new system will significantly improve racehorse welfare in both the short and long term. It will enable vets and racehorse trainers to make early and informed decisions on a horse’s future – whether to prescribe rest and recovery before racing again, rehabilitation for another career or immediate retirement.
The researchers have also been working with a leading veterinary ultrasound company, BCF Technology, to develop an App vets can use to record their ultrasound findings using the new scoring system.
Horse racing is an ancient and global sport with thoroughbred racing a multi-million pound industry that has been dubbed ‘the Sport of Kings’. There are around 14,000 horses currently in training in the UK alone1. Not all will end up competing on the 60 racecourses throughout Britain but of those who do a relatively small percentage will suffer a tendon injury. A high proportion of these will not be fit to race again and will have to be retrained for an alternative career.
Standard treatment for tendon injury in a racehorse is the 3 ‘Equine Rs’ – Rest (until able to race again), Rehabilitation (toward an alternative career) or Retirement. In the new study, published in TBC, researchers from Oakham Equine Hospital in the East Midlands, the Hong Kong Jockey Club and the Nottingham Veterinary School developed a statistical model which related ultrasound changes in 469 racehorses when the tendon injury first occurred to the likelihood of that horse making a successful return to racing (defined as completing at least 5 races after rehabilitation).
The data used in the study are unique in that the Hong Kong Jockey Club has standardised recording of clinical records for all racehorses over many years. All racehorses train and race on the same track, live together in the same racing yard and are attended to by the same vets. These characteristics enabled the researchers to perform a large-scale cohort study with long-term follow up of each injured racehorse. Their predictive model found that clinicians should concentrate on two main characteristics of the tendon injury, each easily assessed by ultrasound at first presentation; the cross-sectional area of the lesion and the extent of disruption to the normally highly-ordered pattern of tendon fibres.
Dr Rafael Alzola, equine surgery resident at the Nottingham Veterinary School and Oakham Veterinary Hospital, said: “Ultrasound is a quick and easy method of assessing tendon injuries, widely available across veterinary practices. The scoring system makes evidence-based decision making on long term outcomes feasible and accessible to equine veterinary practitioners.”
Professor Chris Riggs, Head Vet at the Hong Kong Jockey Club added: “Decisions on future careers for racehorses have to be carefully considered by the horse’s owner, trainer and vet, working together. This study is important from a welfare perspective, as it provides the information to help them make decisions which are best for the horse’s long term welfare, as soon as the injury occurs.”
Professor of Veterinary Surgery at the Nottingham Veterinary School, Sarah Freeman, said: “We have worked with leading ultrasound company BCF to develop an App based on the scoring system. This will help develop future research studies so similar work can be done for injuries in horses competing in other disciplines.”
The Visits ToDo App produced by BCF Technology gives veterinary surgeons and technicians the tool to record animal health and diagnostics in one place while they are out in the field. More details are available here.
Full research paper: Ultrasonographic-based predictive factors influencing successful return to racing after superficial digital flexor tendon injuries in flat racehorses: A retrospective cohort study in 469 Thoroughbred racehorses in Hong Kong.
R. Alzola, C. Easter C.M. Riggs, D.S. Gardner and S.L. Freeman
1British Horse Racing Authority.
Thorn penetration by blackthorn is a common injury in horses hunting over country with fields separated by hedges containing blackthorn (Prunus spinosa) bushes. This type of injury is treated at Oakham Veterinary Hospital on a regular basis throughout the hunting season due to our proximity to the Leicestershire packs. As a result, we have developed a huge amount of experience and a high level of expertise in the treatment of these injuries.
A huge thank you to everyone who attended the REACT to Colic evening with Professor Sarah Freeman held here at OVH recently. The BHS and University of Nottingham have combined forces to help horse owners combat the life-threatening condition of colic. Colic accounts for one in three emergency call outs to horses with at least one in ten of these cases being critical. The campaign aims to educate horse owners on how to identify the more subtle, early signs of colic.
Wednesday 30th September saw Oakham Veterinary Hospital hold a CPD day for referring vets at the George Hotel business centre in Stamford.
The day focused on updates regarding new techniques, interesting cases and clinical research from our caseload. The subjects covered included surgery, medicine, imaging, neurology, and sports medicine. Speakers included our own vets and our colleagues from the University of Nottingham School of Veterinary Medicine.
The programme included:
BADMINTON HORSE TRIALS - MAIN ARENA AT THE CONCLUSION OF THE DRESSAGE ON FRIDAY 5TH MAY
(1) JAGUAR MAIL by HAND IN GLOVE xx ex ELVIRA MAIL by LAUDANUM xx
(2) BRITANNIA’S MAIL by JAGUAR MAIL ex HEADLEY BRITANNIA by JUMBO
(3) LANGALLER STARRING ROLE by CATHERSTON DAZZLER ex LOUBEG MARIE by I’M A STAR xx
(4) LEPRINCE DE BOIS by YARLANDS SUMMERSONG ex ESCALE DE BIOS by QUANDY DU MAYNE
(5) SIR SHUTTERFLY by SILVIO I ex FAMM by FORREST
(6) KL MAC by LARDUC ex GRATINA by GRAF QUIDAM
(7) GLENCARRIG DOLPHIN by COOSHEEN STORMBOY ex MOUNTROSS COLLEEN by CORAL STAR
(8) CORRINDON DANCER by CROSSTOWN DANCER ex MOYLOUGH HOLLY by MERRY MATE
(9) WISH UPON A STAR by GRIBALDI ex PASMIEK by HOUSTON
(10) TIMOLIN by TOTILAS ex SAMIRA by SION
(11) PARTY TRICK by CHILLI MORNING ex DHI PARTY PIECE by TOLAN R
(12) CHILLI MORNING by PHANTOMIC xx ex KORALLE by KOLIBRI
Oakham Equine Hospital veterinary staff will be attending two major veterinary conferences (the European College of Veterinary Surgeon's Congress in July and the British Equine Veterinary Association Congress in September) to present the results of clinical studies and new techniques developed through collaborative research with the University of Nottingham. Dr Rafa Azola will be presenting the outcomes of a study which looked at ultrasound changes that predicted successful return to work following tendon injuries in racehorses. Hospital intern, Dr Daniel Castillo, and undergraduate student, Lucy Chapman, will present results from a study looking at a novel technique for repairing deep flexor tendon injuries, which was designed and supervised by Dr Neal Ashton. The research abstracts will also be published in the Equine Veterinary Journal after the conference in September.
Equine vets and horse-owners will have access to the latest research and resources on common emergency conditions in horses thanks to a new website launched today.
VetReact has been set up by an equine research group at The University of Nottingham’s School of Veterinary Medicine and Science. The team hopes the new site will be the ‘go-to’ resource for the latest evidence-based advice and information on clinical best practice in horse medicine.
VetReact adds to the current national campaign by the Nottingham Vet School and British Horse Society – REACT Now to Beat Colic – which is helping horse owners spot the early signs of colic and seek early diagnosis and treatment.
Launching the website, Dr John Burford said: “Colic in horses continues to be one of the most dangerous conditions in the animal. It accounts for a third of veterinary call-outs. At least one in ten of these cases may become critical and up 80% of these end in the death of the horse.
“The VetReact website presents the results of the most recent research as resources for vets, with links to the original sources of information. We have focused on the primary assessment of horses showing signs of colic and how to spot critical cases at this early stage. The website has been developed as a result of interviews and surveys of vets in practice on how they go about finding research-based evidence to help them in their work.”
Dr Alex Knott, a partner at Oakham Veterinary Hospital said: “We see a large number of colic cases both through visits out to owners, and referred into our hospital for surgery. This initiative will help vets in practice by providing resources which are easily accessible for vets out on the road, and helping vets make the decisions to refer critical cases as rapidly as possible, giving them the best chance of survival.”
Resources available on VetReact include information on:
- The most common clinical signs of colic
- The essential components of history-taking and physical examination
- When different diagnostic tests should and shouldn’t be used
- How to differentiate critical cases on the first examination.
Recommendations which have been generated through multi-disciplinary workshops and online surveys with vets and horse owners with experience of colic.
The website places a strong emphasis on safety considerations, and stresses that the information offers ‘recommendations’ not ‘rules’, which should be considered and applied by veterinary practitioners in the context of each individual case.
The Nottingham project group includes Miss Isabella Wild, Dr John Burford, Dr Adelle Bowden, Professor Mark Bowen, Professor Gary England and Professor Sarah Freeman. The VetReact website has been developed based on work done by research student, Isabella Wild, on how vets access evidence in practice, and has been supported by funding from World Horse Welfare.
Dr Roly Owers, Chief Executive of World Horse Welfare, said: “Colic is a really significant equine health and welfare issue and vets play a fundamental role in bringing about a prompt resolution. World Horse Welfare is pleased to support this innovative work to help bring practical advice to practicing vets.”
The website will continue to grow and will include hard-copy resources to download and print, as well as videos and an App in the future.
A good de-worming strategy is an important part of your horse's general healthcare plan. A high worm burden may predispose your horse to ill health, weight loss, poor condition, diarrhoea and most seriously, colic. The traditional approach of treating horses for worms at set intervals every three months is promoting 'resistance' amongst the worm population. There are no new classes of wormer currently under development, so it is important that we update our thinking when it comes to best practice for worm control. Strategic worming uses worm egg counts to assess whether your horse actually needs worming.
Oakham Veterinary Hospital is now able to offer treatment of equine melanoma with Oncept® vaccine.
Melanomas are tumours most commonly seen in mature grey horses on the skin, primarily of the head, prepuce and perineal region, but growths can also develop in internal organs. The majority of melanomas grow slowly causing few problems however in cases where they do become large they can interfere with vital body functions. Surgery to remove melanomas can sometimes be an option but to the proximity to many vital structures.
The Oncept® vaccine was developed to treat melanoma in dogs and offers an effective treatment for melanoma in horses. It is a DNA-based vaccine that stimulates the body to produce an immune response to a protein found in melanoma cells (tyrosinase). It will target all melanoma cells, both internal and external and those not accessible with other treatments. The drug is licensed in the USA for use in dogs, so treatment of horses in the UK is carried out under the veterinary cascade and is only available under the supervision of specially qualified veterinarians. Preliminary results from use of the vaccine suggest that response to the vaccine is positive in some cases but unpredictable; some horses showed cessation of melanoma growth or even tumour shrinkage, however not all horses responded to treatment. Treatment with the vaccine involves an initial assessment followed by administration of the vaccination at two week intervals for four treatments and then six-monthly boosters.
Oakham vet Vicky Marchi has recently returned from two weeks working as a volunteer vet at The Gambia Horse and Donkey Trust in West Africa.
The charity acts to provide veterinary care, equipment and education to owners of working horses and donkeys. The lack of veterinary care and difficult living conditions means injuries and disease are commonplace. This can have a devastating effect as the families rely heavily on their animals for transport and farming.
"The most rewarding days were spent running veterinary clinics at the local markets where queues of horses and donkeys formed for treatment; many had walked for 4 hours to see us. We treated all conditions, including many tropical diseases not seen in the UK with very little equipment other than a stethescope and a thermometer! This presented a very different challenge to working under hospital conditions at Oakham but it was great to see animals improve and return to their families."