17 minute read
Health and Welfare
Vet Watch THEM BONES:
WHEN A FRACTURE OCCURS
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Presented by
By Matthew Coleridge BVMS, MS, Dip ACVS-LA, MRCVS
ROSSDALES EQUINE HOSPITAL
Cotton End Road, Exning, Newmarket CB8 7NN. T: 01638 577754 E: hospital@rossdales.com
www.rossdales.com
Most horse owners associate the word ‘fracture’ with a sense of dread, fearing the worstcase scenario is inevitable. Whilst this sadly is the case with some types of fracture, and euthanasia is the only or the kindest option, many fracture types can be managed successfully, provided that there is early and appropriate veterinary intervention.
What is a fracture? A fracture is a partial or complete break in a bone. Bone is one of the hardest substances in the body and is subjected to a multitude of forces on a day-today basis. Fractures occur when a bone is subjected to forces that exceed what it is able to withstand. They can come in all sorts of degrees of severity ranging from small fissure fractures and small chip fractures in joints to large, complex and comminuted fractures of the long bones. What causes a fracture? Fractures in horses normally come about in one of two ways. Either the bone is subjected to a very high amount of stress very quickly, leading to an acute fracture, or it is repeatedly loaded, eventually fracturing due to cumulative fatigue of the bone. Fatigue fractures in horses, just
Main: An elbow (ulna) fracture in a young warmblood repaired using a bone plate. Below: A frontal fracture of the long pastern in a showjumper
like human athletes tend to occur more commonly in highlevel equine athletes and are related to the intense, repetitive training they undertake. Pleasure horses are more likely to suffer an acute fracture due to a misplaced step or from an external trauma, such as a kick from another horse or collision with a gate or fence.
A horse with a lateral condylar fracture has a large swelling of the left fetlock joint.
How do we diagnose a fracture? If you suspect your horse has sustained a fracture, call your vet immediately. Fractures do not all present in the same way and clinical signs can vary from lowgrade lameness to the horse appearing very sore - in some cases, there will be severe nonweight bearing lameness of the affected limb. Within seconds of the fracture occurring, the area will start to swell and, left unbandaged, the swelling can become large, quickly, indicating the need to take an x-ray. Fractures are generally confirmed using digital x-rays, where a clear break in the bone will be apparent. Fractures can be ‘open’ or ‘closed’. An ‘open’ fracture is one where the skin and soft tissues have been broken or cut, so the fractured bone has been exposed to the environment. These are commonly caused by kicks or collisions with hard objects such as gates and fences. These carry a poor prognosis as they are almost certainly infected. A ‘closed’ fracture is one in which the skin has remained intact. Once the horse has been transported to a referral hospital, diagnostic imaging of the suspected area will be carried out to diagnose the fracture. This will start with digital x-rays of the area and depending on these findings, further threedimensional imaging may be necessary with either computed tomography (CT) or magnetic resonance imaging (MRI). Technology in this area is improving rapidly and a lot of advanced imaging can now be undertaken with the horse standing and given mild sedation.
First aid/splinting Horses with fractures are usually treated at equine hospitals and before transporting the horse, the fracture will be stabilised by the attending vet, using a bandage alone or in combination with splints. The goal of the attending vet is to immobilise the joint above and the joint below the fractured bone. For example, a pastern fracture would have a stiff bandage placed from the foot to the top of the cannon bone. By immobilising the fractured bone in this way, further propagation of a fracture or damage to the soft tissues around the bone, is minimised. Horses sustaining fractures are in a lot of pain and can become quite distressed.
A B
C D
A comminuted pastern fracture. X-rays (a) were taken indicating the need for further imaging. CT imaging (b) allows for a clear understanding of the fracture. The surgeon used fluoroscopy imaging (real time moving images) to guide the repair (c) and (d). Continued overleaf...
VET PROFILE
MATTHEW COLERIDGE
BVMS, MS, DIP ACVS-LA, MRCVS
Matt is a specialist in equine surgery and joined the team at Rossdales Equine Hospital in 2020, having spent the previous three years as a surgeon at Fethard Equine Hospital in Ireland. He qualified from Glasgow Veterinary school in 2012 before spending a number of years in the USA, where he undertook a Surgical Residency at Auburn University College of Veterinary Medicine in a combined program with Hagyard Equine Medical Institute, Kentucky. He completed a Masters in Veterinary Science (MS) in 2017 and the following year he became a diplomate of the American College of Veterinary Surgeons (ACVS). Matt is experienced in all aspects of equine surgery, particularly orthopaedics. He is interested in all aspects of the Thoroughbred breeding and racing industry and his surgical interests include juvenile and adult orthopaedic surgery, as well as broodmare reproductive and abdominal surgery.
Fracture repair taking place with the horse under general anaesthesia. Fluoroscopy is being used to guide the repair.
Continued from previous page...
Injectable pain-relieving and anti-inflammatory drugs as well as mild sedation are regularly used to help horses through the journey to the hospital. Can/how do we fix them Equine orthopaedic surgery has progressed enormously in the last 50 years. Many of the more common fractures are now treatable and can be surgically repaired by specialist veterinary surgeons. Surgeons working in areas such as Newmarket where there are a large number of racehorses in training can be fixing fractures on a near daily basis. Fractures are generally repaired using steel or steel alloy surgical screws and bone plates. The type and conformation of the fracture will determine what is used and in what combination. These implants also have been developed hugely over recent decades, to become stronger and more resilient. A significant number of fractures can now be repaired without having to place the horse under general anaesthesia. What is known as ‘standing fracture repair’ is now commonplace for horses sustaining simple fractures to the cannon bone and pastern. The horse is sedated and local anaesthetic is then used to numb the area to be operated. More complex fractures or those occurring in bones higher up the leg require general anaesthesia. These may also need arthroscopic alignment of the fracture fragments to ensure a smooth articulation remains once the fracture has healed. Following surgery, the fracture can be stabilised using a bandage or cast to provide support to the surgical repair and aid the soft tissue healing. Complications Contra-lateral limb laminitis is perhaps the most well-known complication associated with fracture repair. This occurs due to excess stress being placed on the foot of the ‘good’ or unfractured limb as a result of the horse being too sore to weight bear through its repaired limb. Implant infection is rare, but is another nasty complication. Once infection sets in around the plate and screws used to repair the fracture, the only way to resolve it is to remove the metalwork. Modern implants are able to maintain their strength in the face of infection for long periods of time and so improve the chance of fracture healing before implant removal. Prognosis following a fracture Whether a horse will be able to return to their previous level of performance will depend heavily on the type of fracture that has occurred, but if a good and timely repair is initiated then, yes, it is possible for horses to return to their previous level. If a good repair is achieved, fractures take approximately 3 months to heal and during this time horses are confined to varying degrees of restriction/box rest. Depending on the type of fracture, some horses may be able to start walking exercise 30 days after surgery.
Common fractures In racehorses, the most common long bone fractures include pastern fractures and condylar fractures of the cannon bones. These are seen and fixed routinely at equine referral hospitals, often with the horses standing and sedated. Common fractures seen in pleasure horses include pastern, pedal bone and elbow (ulna) fractures.
Lateral condylar fracture, before and after surgery. This fracture was repaired using local anaesthesia, with the horse standing and sedated.
In summary If welfare is seriously compromised, euthanasia may be the only or the kindest option. However, in many cases limb fractures can be managed successfully, depending on type and classification, and taking into consideration other factors such as the age, size, value, temperament and welfare of the horse. The cost of initial treatment, surgery and rehabilitation programme will also be a major factor when owners are decision-making. Some horses will be able to resume their previous athletic careers, whereas others will have a career change – possibly a breeding career, or competing at a lower level, becoming a hack, or retiring to live out their days in a paddock.
RECESSION MAY BE STARTING TO IMPACT HORSES
WARNS BLUE CROSS
The latest figures from national pet charity, Blue Cross, indicate that an increased number of horse carers may be struggling financially to keep their horse.
So far this year the charity has received 144 requests from people asking for the charity to take in or help rehome their horse or pony and more than 70% of these cited personal or financial circumstances as the reason. In comparison for the full year of 2021 just 43 (around 15%) of a total of 277 intake and rehoming requests specified financial reasons and in 2020 a total of 32 (nearly 14%) out of 231 requests stated financial reasons. The charity, which rehomes horses from its centres in Burford, Oxfordshire and Rolleston, Staffordshire as well as through its Home Direct scheme, is urging horse owners to get in touch if they are struggling, rather than let problems escalate to potentially cause health and welfare problems for their horses. Annabelle Taylor, Rehoming Coordinator at Blue Cross, said: “We are acutely aware that as the cost of living continues to increase, many people may be unavoidably presented with making difficult choices for their beloved horses. “We encourage them approach us whilst their horses are still healthy rather than risk them being passed from pillar to post, potentially ending up in a welfare compromised situation. We are here to listen and help, not to judge, and with Home Direct we a can help people as much as we are helping horses.” Blue Cross Home Direct has proved to be highly effective, with over 150 horses helped since it was launched back in 2015. Every horse is assessed thoroughly by a member of the Blue Cross horse unit team and then advertised on the charity’s website. Once a potential new owner has been found Blue Cross will arrange and oversee initial visits. If it’s a good match, the horse will then be rehomed directly from the old home to the new one. All the home visits and checks
“It is distressing will be completed as if the to see that the horse was from a Blue Cross number of people centre. seeking rehoming Blue Cross also offers their Home Direct service to other support because of equine welfare charities that financial reasons is don’t specialise in rehoming. already more than Any horse can be considered double last year’s for Home Direct, as long as annual total and they pass a health check and we still have a third are not on any long-term medication. of the year to go” If you need support, advice or guidance about giving up your horse please email helpmyhorse@bluecross. org.uk
www.bluecross.org.uk/ rehome/horse
The British Equine Veterinary Association (BEVA), British Equestrian (BEF) and the British Horseracing Authority (BHA) are collaborating to monitor the potential impact of a shortage of doses of vaccines for Equine Influenza.
The three bodies have been aware of minor interruptions to the supply of such vaccines throughout 2022. However, a significant, pan-European logistical problem being experienced by Boehringer Ingelheim has raised the prospect of a further reduction in supplies in the coming months. BEVA is liaising with the three vaccine manufacturers to quantify the impact of the shortage and to consider solutions, not only to minimise the threat to equine health and welfare but also to prevent disruption to equestrian competition. David Rendle, Chair of BEVA’s Health and Medicines Committee, said: “We remind all horse owners of the importance of maintaining vaccination for equine influenza but would advise they wait until as close a time as possible until their horse’s next dose is due to minimise current demand.”
#TheWeighToWin
HICKSTEAD SHOWING PRODUCERS ARE ‘WEIGHT AWARE’
The Horse Trust has ramped up their Healthy Body Condition Awards with many showing shows signing up to be ‘WeightAware'. This included the Derby Meeting, Hickstead, 23rd to 26th June.
These coveted Healthy Body Condition Awards recognise and reward horses in the best condition as well as providing support and advice. The Sussex Equine Hospital supported and carried out the assessments alongside the showing Judges. The Horse Trust delights in sharing the success stories of professionals and amateurs alike in their quest to see more healthy-weight horses. Lynn Russell, a leading Show Cob producer, came a very close second with Talos for the Award having previously received it at Herts County Show in May. Speaking at Hickstead, Lynn said, “The Awards are a good idea and horses should carry less condition. Some of the Judges may need some adjustment on how they take this into account when judging.” Lynn’s regime is to keep the horses out 24/7 and to harrow their fields regularly. “They seem to regulate their intake of forage and consequently their condition. For feeding, I use straights, rather than mixes and cubes.” Dream On Harry, owned and exhibited by Siobhan Dalloway, won the Award in the Maxi Cob class and was delighted by the recognition. Siobhan wasn’t previously aware of it, but thought it was a very nice incentive. “Harry was a rescue case from Ireland, taking nine months to get fit for today. We let him be a horse and have a natural lifestyle with regular exercise to keep him in today’s good condition.” Starting the day with the Lightweight Cobs, Bankers Draught won The Horse Trust’s Award. Known as Todd, his body condition score was 30% better than the top placed horses in the class. Exhibited by Hannah Horton she explained that Todd goes hunting all winter which keeps him very fit and obviously in a great condition. Master Of The House, or Big Tom, won on a score of almost 20% better than the others in the Heavyweight Cob class. Ridden and owned by Kate Barber-Lomax, it’s Kate’s mother who does the day-to-day care and oversees Big Tom's 4-days a week exercise regime. They were thrilled to be placed second in the class and be first for the Healthiest Body Condition. They’re new to the Awards and think they’re a brilliant idea. “Tom is now sixteen and has had a successful showing career and it looks like he’ll continue to do so. He’s pretty good at regulating his own weight in that he isn’t greedy - in fact he gets four small feeds a day whilst at grass.” Although not so susceptible to being overweight, the Large Riding Horse class was assessed, giving the rosette to Legend In Manhattan exhibited by a clearly delighted Victoria Hersford. Owned by James Woodington, Legend was placed second in the class out of six. Well-known showing producer Val Sheehan was presented with the Award at Herts County for 6year-old Heavyweight Hunter Red Rumour. Val hadn’t heard of the Awards before winning but agrees enthusiastically with the concept. Val’s horses are all fed for the work done. Val acknowledges that, “You can’t feed to build fitness.”
Victoria Hersford and Legend in Manhattan
Kate Barber Lomax and Master of the House
What is The Weigh To Win Initiative? The Horse Trust's Programme is an important initiative to reward healthy equine body condition and raise awareness of healthy body condition in show horses. Showing in particular is often seen to promote horses who are overweight and the aim is to challenge and educate on what is an ideal body condition. The programme was run at events throughout the showing season providing friendly, supportive advice and guidance to owners, riders and producers, both at the events and during online training sessions.
Hannah Horton on Bankers Draught
THE ROYAL INTERNATIONAL HORSE SHOW (RIHS)
The Horse Trust continued their Healthy Body Condition Awards at The RIHS at Hickstead on the last week of July.
The Awards were given in over twenty classes and over 400 horses were body condition scored by qualified experts Tamzin Furtado PhD, Alison Talbot MRCVS and Dee Pollard from the British Horse Society. Lancer is owned by HM The Queen and produced by Katie Jerram-Hunnable from Great Dunmow, Essex. He was seventh in the Heavyweight Hunter class out of twenty-five registered entries. Lancer is a 7year-old and Katie has had him since he was two. His lovely character means that his next job will involve ceremonial parade duties for the Royal Family. Top showing producer Katie Jerram-Hunnable is no stranger to receiving the Award having recently been given the same rosette for her horse The Imperial Choice at Herts County Show. Katie attributes the horses' excellent condition to a tried and tested regime of daily exercise and correct feeding, plus turnout and grazing. Katie monitors the grass available and accordingly adjusts all the horses’ feeds in line with the quality of forage that grows throughout the year. She also implements a good de-worming programme, but the overriding contributor to her horses’ wellbeing is her drive to build muscle-tone, rather than just putting on weight. “We can’t feed to get fit but we can make sure the horse gets the correct nutrition and exercise”, she says. “The Programme is a very good thing and really goes towards helping people to be aware of healthy body condition and its importance”, says Katie, who was delighted to once again receive the Award. Greenholme Falcon is an 11year-old Dales pony owned by Victoria Oliver and shown by Chantelle Chapman. Dan has travelled from Colchester, Essex and also competes in Working Hunter classes which probably contributes to him keeping a healthy condition. “He’s ridden at least three or four times a week; he’s shod which means he’s easier to work. He comes in at night and has a small feed.” His connections hadn’t heard of the Awards before receiving one today. “Sometimes fat is used to try and cover up problems in showing so it’s good to see these Awards to spread awareness.” Chantelle has recently finished school and would like to work with horses. The RIHS has supported the programme since 2019, and is pleased to raise the profile for the Awards at this year’s event. David Ingle, Director of Showing at the Royal International Horse Show, Hickstead and former Chairman of The Showing Council, said, “Showing is keen to become more educational and we are in an era of great improvement in equine welfare, with increasing scrutiny under social license. This initiative shines a light on this important aspect of showing. We will be making this Award in more classes and highlighting the importance of correct weight to competitors at the RIHS this year,” said David. Jan Rogers, Head of Research and Policy at The Horse Trust, says, “We get very upset by seeing photos of underweight horses in the media, but in reality, far more horses are obese than are underweight. This is worrying for vets who are finding that they have to treat these horses with serious health conditions like Equine Metabolic Syndrome and Laminitis. Peoples’ perceptions of what is a healthy weight have shifted towards the higher body condition scores. We would like to help to reset this balance.”
