Cornell Vet Equine Seminar Series – September 2019
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Cornell Vet Equine Seminar Series – September 2019

October 21, 2019

For the first time we’re livestreaming on YouTube rather than on Zoom. I have to stand in a very specific location! So my name’s Lindsay. Believe it or not, I’m the classmate to our speaker tonight, Dr. Julia Miller. We both graduated from vet school at the same time. Since then, though, she has gone on to greater things. She’s now a professor in dermatology for the vet school, and she’s also a secret horse person. So we’re very glad to have her tonight. She’s going to talk tonight about a couple common skin conditions in horses that, unfortunately, if you’re around horses long enough you’ll deal with. So scratches and hives, but I’m sure she’d be happy to answer a lot of other questions. She’s a very entertaining speaker. Thanks, Julia. Dr. Julia Miller: Okay, all right, cool.
Thank you, Lindsay. I’ll stand over here but I might move around because I feel
so far away. Everybody said on that side of the room which is fair. So today we’ll talk about two topics that we see a lot: scratches or distalim
dermatitis for the fancy folks, and then we’ll also talk a lot about hives at the
very end, but first we’ll kind of hit up scratches – talk about how we see that. So
I found this picture on the internet and I quite appreciate it because I have no
idea what mild horse soap is, but apparently on wikiHow that’s what you
use when you’re cleaning a horse leg. Also, what I like to point out – ooh, does this [remote] work? Kind of, I’ll go over here – is this person’s wearing gloves. I mean what kind of horse person wears gloves! So, we’re going to talk first about scratches, and scratches is really just a general colloquial term, and it only describes a
reaction pattern on the skin. It doesn’t tell you what’s wrong with the horse, it
doesn’t give you their diagnosis, it just told you what’s the clinical picture of
the horse’s leg. Other things that people call it: pastern dermatitis, dew poisoning,
mud fever, grease heel. You’ve heard lots of different names for it, but scratches kind of compasses it all. So what are the clinical signs? What does it look like?
Scabs and crusts is the number one thing that we tend to see. That’s what most
owners recognize. We can also notice some hair tufting, and the tufts of hair,
because there is a scab or a crust underneath there, so just look closer. Hair loss,
sometimes you can see that. That’s usually a little bit further down the line. We also can see some oozing underneath the crust. That’s always very fun. I enjoy a good ooze. They can be painful when you touch them, particularly the redhead mares – they don’t like to be touched period. And sometimes you can
see that the legs can get swollen as well. So lots of different presentations
of scratches. But normally it’s a very similar look. You can see in this picture
we’ve got a horse with some notable scabs and bumps and also some areas of hair
loss, and this is affecting most of the cannon bones down to the pasture,
and then sometimes we just see it on the caudal team here on the back. Either way you cut it, scratches is what we call it. The three P’s are where like to start with scratches. We all get excited about how to treat it, but the real truth is to know how
to treat something you’ve got to know what caused it. If you don’t know what caused it, you can’t figure out how to treat it. And the three
P’s of scratches are very important. First we need to think about the
predisposing factors. I’m going to argue that these are the most important.
Environment where the horse lives. How many of us have dry pastures here in
upstate New York. We see negative 20 days – nobody does – it could be negative
20 degrees, so you never know. Humans: what are we doing to our horse? We are guilty as all get-out. And also the coat color. Is this a chestnut horse or a light horse? Next we think about the primary factors,
and primary factors are things like the physical irritants. Again, what are we
putting on our horse? Ectoparasites, we’ll talk more about those later –
different mites and things of that nature. And then certain immunemediated conditions can be primary factors. And then finally the place are we all get really excited are the perpetuating factors – so bacteria, fungi, is this staf, is this ringworm, we want to know. But the real truth is, it’s these predisposing factors that I’m going to harp on more
and more, as I don’t care what you do to treat it down here, if you didn’t treat it
upstream, you will never be successful. So, there are many causes of
scratches, and we want to get into our technical terms. I like to write here that there’s
usually an initial wound, some form of trauma, or even wet skin. We’ll go a
little more into that later, but that’s usually what perpetuates scratches. All
of these other things are kind of secondary problems for most horses. Rain rot over here, most of us are very familiar. Ringworm. Bacterial infections can happen. Allergies, including culicoides hypersensitivity. Environmental allergies is my most favorite. Corioptic mange. Photosensitization. Vasculitis. Contact irritants. Chronic progressive lymphadema, and there are
others. This is not an exhaustive list, so that’s just to get your brain thinking
about all of the different things that can cause those scabs that you’re seeing
on your horse’s leg. There really are a lot of causes and most of us just get focused on the treatment. So now we’re going to go through a few of the different
causes. This is just a picture to show all most of our pastures do look like in April in upstate New York. So here we have, I’m not sure if that’s a pond or pasture, very difficult to tell, but that’s what we deal with. Lovely horses, but what’s
going on with their distal limbs? They are immersed at all periods of time, right,
very hard to get them out of there. I bet you there’s a hay feeder right here, so all
the horses are going to hang out around it as much as possible. By the way, whenever I was in practice and
people said, “Look at my pasture. It’s so dry.” I walk around the corner and I
see where their hay feeder was, and let me tell you, nine-point-nine times out of 10 it was a
mud pit right around their hay feeder. And I’d say, “Excuse me, the pasture’s not that dry,” and then we could all take a walk around. “Oh, you’re right. I understand now.” So pay attention to the whole pasture. That’s really important. This is my beautiful new drawing, so let me know if it’s terrible. I wanted to talk about what water does to
skin because wet skin really can predispose a lot of horses to scratches. This is supposed to be, in a nice drawing, the normal skin cells – the keratinocytes
that are right here, and these are awful purple bacteria on the outside of the skin. When
you have normal skin, this purple bacteria have no way of getting through to the inside of the skin where they worry us and can cause infection. Now, this macerated skin is when you’ve got the water that happens. Anybody been in the shower and you see that nice little prune that’s on your fingers? Right? That’s kind of what this looks like. So these are the skin cells, right here, that happen and they spread apart when your
skin is exposed to that much water. Now when the skin cell spread apart, that
bacteria that’s happening on the outside is now very happy to go on the inside and
can set up shop and create an infection. So that wet, macerated skin is what
allows the bacteria, from being on the outside where it’s fine and doesn’t cause any trouble, it can now get inside where it can cause lots of trouble. Next we’ll go into some specific causes. So rain rot, or fancy word: dermatophilus congolensis. Does anybody know what it is? It is a bug? Bacteria? Fungus? Even my vet students don’t know. It’s a bacteria. Very nice. So this is a picture of rain rot, and this is to show you the little dots. These are each a
single bacteria, and they create sort of a railroad track-like appearance, so
that’s the classic appearance for rain rot. Because it is a bacteria that’s how
we can diagnose this. We can actually look at it under the microscope and say: Cool, that’s what that is. Now there is a seasonality to this
particular condition, right? You tend to see it a lot more in the spring and then
also in the fall. Why do you guys think we can see it more in those seasons? Our horses have long coats and it’s in
theory raining more. You can certainly see this in July in upstate New York, or if you live in a tropical place, you can see this year round. The big thing is, the hair coat on the horse is longer in the spring usually, and longer in the fall, right, and it’s that long hair coat that when it rains, now the hair coat gets wet, matted down on the horse’s back, the back can’t dry, that skin gets macerated – like a picture we just showed
you – and then that normal bacteria is hanging on the surface not causing a
problem, is prone to causing a lot of problems. The reason it’s important to think about that is one of the key features of treating rain rot, or any condition where a horse gets wet
first, is clipping. Clipping can help tremendously, keeping our horses dry and that’s a good thing. Normally we think about rain rot at the common location at the topline,
right? It has it was really nice big crusts you peel off and it’s very
satisfying. Again, most horses do not appreciate that
you do that. And also, fun fact, this is zoonotic, which means that you can get rain rot, so do be careful. It’s not very pretty; you usually get it on your finger, but
that is a possible thing. The other fun thing to remember about rain rot is, the crusts are contagious, so unless you really hate your next-door neighbor, you don’t want to sweep those crusts to the next pony’s stall. Take those, put them in the trash, whatever you need to do. Middle figure: We talked about the legs. So we can see rain rot on the distal limb. People don’t think about it. They only
think about rain rot on the back of a horse. But the reality is rain rot can be in
many other places, which includes the distal limb. And that includes scratches. Then the third presentation, people don’t think about very
often, is actually called dew poisoning. How many of you’ve seen the white muzzle ponies, but then end up looking very pink and having some crusties and scales around the muzzle. So what happens to those ponies is they’re out
eating in the grass. It’s very wet in dewey grass, right, and you get that macerated
skin and they can get the rain rot. Those are the three presentations. Next we’re going to talk about staph
infection. This looks pretty similar, right? It looks bad, but it looks pretty similar. It’s crusty and scaley on the back of the leg. I can’t tell you if this is rain rot or if this is staph. And I’m pretty good at that. I can’t tell you, so what I can do is an impression cytology, try to figure it out. It’s
just very dry regions and that’s not even very rewarding. The point I
want to make on this is it looks quite similar to rain rot. The seasonality for
this is spring. Spring is most common time we see staph infections. Spring is when we start to ride our horses again. Maybe we didn’t wash our tack all winter. The horses have a long hair coat, they’re sweating a lot under that hair
coat. That can predispose them to rain rot but also to staph infections, so
that tends to be that seasonality. But I have seen staph present all throughout
the summer, all throughout the year, so this one doesn’t as much seasonality as others. Chorioptes mites. Fungal dudes (or dudettes), here it is. This is the chorioptes mite. When we’re thinking about these, we’re thinking about draft horses first and foremost. Do you know why draft horses? What’s unique about them? They’re hairy; they have feathers. They like the feather breeds. So this could certainly be a Fresian, a shire, this could be a draft cross that’s
heavily feathered. Every now and again it happens on a non-feathered horse. That’s
usually not a common presentation. These tend to be very itchy. How do you think
the draft horse tells you that it’s itchy and it’s backwards? What are you
gonna see and call me about? Biting! They’re remarkably agile. It’s incredible what they can do. They can turn right around and bite at those back ends, even these huge 2,500-pound horses. They can rub, yeah. They can also stomp; they’ll stomp a lot. So if you ever go to a farm and you’re watching all of their Clydesdales or Belgians stomping, it’s going to be chorioptes mites. That’s a pretty common thing to see. This is contagious to other animals, including you if it really
had to be. It does not prefer to stay on people; it prefers the animals. But if you have a goat in the
area – by the way it’s always the goat’s fault – if you have a goat in the area
it can be contagious to that, it can be contagious to your donkey, to the other horses. These mites also have a really
good off-host survival. They can live in the debris. They can also live in
your wet shaving. How long do you think they live? Ballpark? Some 90 days. That’s crazy. So you treat the horse, and you don’t get rid of the shavings, and those little buggers are living off-host for
90 days. That’s scary, right? But that also makes getting rid of them a bit difficult. We do see the seasonality on these to be more winter time, and at winter time it’s because everybody’s inside
at those quarters. That being said if you have a herd of fell ponies or herd of
gypsy banners they just self-perpetuate and you’re going to see chorioptes mites
at all times. But this is always on my list of things to think about with a draft horse. They are surface feeders but they can even, when the horses itch themselves, you can have severe infections. Photosensitivity is another thing that
can cause some issues on the distal of your horse. Now there’s two different kinds. Primary
photosensitivity is where the plant touches the horse’s leg and it’s actually
that contact that sensitize the skin. Secondary photosensitivity is where the horse ingests the plant or has another piece of liver damage. The liver itself
doesn’t function well and then they can’t excrete the right plant parts and
then you get sort of a systemic photosensitivity. Now what that means for us is that if you see a horse that you think it’s photosensitivity, the first
thing I do is I check its liver values. Because if that horse has liver disease, I need to know about it and I need to treat it right now. It can be very hard to say
whether something is primary or secondary, but I’m always thinking about
secondary first and being sure that that’s not it. And there are different plants in
different parts of the world. These are some plants that are local to us. Things
to think about: you do not want to see these in your pasture. When we see photosensitivity in the horse it tends to be the white haired skin. It doesn’t like the colored skin. It
really only likes the white hair, and that’s an important part to see. Seasonality,
well they’d have to have plant exposure, so the good news is you’d only have to worry about that two months out of the year in upstate New York. Here are some photos of a photosensitivity horse. So this horse has a nice chestnut before the socks. Perfect skin. I couldn’t ask for
prettier skin. You get to the white part of the skin and holy moly that looks
terrible, right? It’s oozy, it’s red, it’s very severe. Another thing here, the
chestnut part of this horse is not affected at all, and then you get to the
white hair part and it’s very affected. So I always ask that question, if someone says, “Hey, my horse has scratches on one leg.” I always say, “What color is that leg?” And if it’s got three chestnut limbs and one stocking or sock, and it’s the sock that’s affected, then I’m worried about photosensitivity. Vasculitis is something that stinks to be honest with you. But this is one of the more common causes that scratches that just won’t go
away. And the reason you can’t get rid of it
is that there can be a sort of underlying condition there. These tend to be very well demarcated. See how sharp this is? Very sharply demarcated lesions. They can also go deeper. You can see the
skin almost peeling off of this horse here. The limb can get swollen. These tend to be
a bit more severe in nature. But I will throw this out as a
differential for that pesky scratches that you just can’t clear up,
it could be vasculitis. Now I say call your vet, because this is going to require
steroids, whether they do topically or if you put them in the horse’s mouth, that’s fine, too, but you’re going to want a vet to look at this to decide that that’s what you
need to do for treatment. A biopsy of the area is certainly something is
recommended before your treatment because this is a cause that is often forgotten. Progressive
lymphedema it’s just fun to see, but it’s really not fun for the draft horse. Poor
draft horses. They’ve got it hard. Here they are again. This is really a
condition that’s only affecting the draft horses local to us. Often the shire breeds, the Belgians do, too, and what happens is, the lymphatics of the leg are supposed to drain the lymphatics down
here, and then we pump them back up and shoot them out. But what happens in these
draft forces is they lose the ability to shoot all of that fluid out of the leg. So it
gets trapped in the leg. When the fluid gets trapped in the leg, you end up with
this very sort of corrugated cardboard appearance. Did you guys ever hear the term grapes? These horses will get what’s called grapes. So this is a long
progressive process. As you can see it’s very nasty. This is a horse in Georgia. When it gets to this point, I can do zero things for this horse. there is no treatment, unfortunately, for
this condition, and it goes missed for a lot of years usually, and why is that? There is feathering covering those legs. If you are an owner, breeder, lover of the draft horse I highly encourage you
palpate back there and check the legs and make sure they feel normal. Catching this early is helpful because diligent management is
critical. They’re very prone to secondary
infections – chorioptes might crop up – so if you can treat those things and get on them ahead of time, you actually stand a better chance of prolonging that horse’s life. This can be a euthanizeable offense, honestly, in a draft horse unfortunately. So what are we going to do about scratches? We saw these really cool causes. The nice thing is we have a lot of treatments that are going to work to treat any of these causes. I just wanted to make you aware there are a number of different things that do predispose them. But the good news is you guys can treat with a lot of the same stuff. Environmental management is critical. This is
everything. I don’t care what you slather on a horse’s leg. I don’t care what antibiotic you pump into their body. If you are not controlling the environment and
management of that horse, you are doing didly squat. You are never going to have success. Pastures are the biggest thing, and this is likely the hardest, right? It’s really easy to get a shot of penicillin, but it’s real hard to get a dry pasture in May in upstate New York. But that’s what’s really important. You want to avoid mud. I’d like to tell my students that this is poop water. Mud
in a horse pasture is poop water. I don’t care what you say about it. And that horse is now standing in poop water. How good does that sound? No to me, them or anybody. So that certainly predisposes them, just
like with the wet skin, now there’s wet skin and bacteria, and they’re standing in this. So you want to try to avoid the mud if at all possible. That can be very difficult. If you have a horse that’s predisposed to scratches, it doesn’t go out in springtime. I’m sorry that sucks but that may be what happens. Or you just may be even in the battle of the scratches. Avoiding standing water is super important, too, if you’ve got that nice big river in the middle of your pastures. If there’s anything you can do – cordon off a certain section to keep your horses away, that can really help. Mowing the grass is something we don’t think about. This is a pony here, first of all, ponies don’t eat that much grass. One of the things we think about, have you guys ever walked out into the grass early morning in the summertime and you look down and your pants are all wet? That dew is pretty cold. There’s a lot of water in the dew. We love to let our horses out in
the morning and in the evening when the dew point’s up. So if you really got tall grass, they’re essentially bathing their distal limb in the entire time they’re out mowing the grass down for you, and that can actually predispose them, too. So keeping your grass nice and short so
that the dew is not all over the legs can make a big difference. Plus it’s good because most horses don’t eat the actual grass, right? And then removing manure. That’s nobody’s
favorite thing to do, but it really is a useful thing, not only for the distal limb issues but also for your strong [inaudible], your other intestinal parasites, right,
and keeps your pastures healthier. Moving manure is a big deal. And then stalls are really important, too. One of the things: I’ve gone into a number of barns and they say look how clean my stall is, and on the surface it’s beautiful, but I look underneath the straw, and it’s just an ammonia wet bath under there. So remember that you have to clean that stall early and to the base and keep it clean regularly, because if you have a horse that’s digging out of a mud pit, but then into a nasty thick straw stall, that’s not actually help that horse much very much. And you don’t want to bed them too deeply. Air is your friend. You want
the horse’s limb to get exposed to air. So by doing the bedding a little
bit more shallow, that really helps us get the air in there. And then now: Clean and Dry. This is a mantra for all things of distal limb issues with a horse. And this is the most
important thing. If you do not get this step, I don’t care what you do next. It’s not going to help anything. Horse management – also super important.
Clipping the affected areas can make a big difference. The thing is, don’t go hog wild with your clippers and cause bunch of razor burn, right, if you go the next day
and horse is all swollen. You just need to clip the big hair off, that’s the big thing, right. But clipping the area can make a big difference so you don’t get all that wet hair and macerated skin. You want to clean and dry skin any time the horse gets wet. Who likes
to bathe their horse? It’s like one of my favorite sports. I did it all the time. Now, when we sweat scrape a horse, where do we sweat scrape a horse? The body. How many of you sweat scrape the distal limb? Good for you – not many of us do a very good job of that, right? Especially when you have those metal scrapers. A lot of horses don’t like that. Most people that bathe their horses pay attention down to the knee down and then stop paying attention. And then they put that horse out on the grass and say oh you’ll dry off eventually. Well in upstate New York or in tropical location, they’ll dry off – four hours later. But that four hours is enough time for that skin to get damaged enough to predispose them to a bacterial infection. So don’t forget
those distal limbs when you bathe a horse. It’s really important that you dry them
off. This is not every horse at a time; these are the horses they’re predisposed
to scratches. Do pay close attention to them. You also have a nice clean boots intact. That’s really important,
right, our boots they don’t wash all that well. We know that, but it is
important to wash them because if you just went through all the poop water, and now you’re putting the nice muddy boots back on a horse’s leg that’s already kind of irritated, it’s not going to help. And I also say here, and I mean this very thoroughly, do not share. You do not know what that neighbor’s pony has, okay. Don’t share. It could have ring worm. It could have rain rot. It could have everything. There’s always one. Don’t share, that’s a life lesson. The other thing I like to show everybody is don’t scratch scratches. Who is a picker here? It’s so bad! Don’t be a picker. I know that it’s very hard but in
general you should try to let the crust kind of come off on its own. If one’s coming off on its own, that’s fine. But nothing pains me more when I walk around in spring in a barn and I see all the girls
in their boots and britches, and they’re down there with their curry comb just going at the distal limb. And then the next day I see all the horses hobbling out of their stalls, limbs swollen up, and they say oh it’s just the scratches he gets every year. Breaks my heart. What you’ve done is taken that bacteria that was on the outside,
not so happy, you shoved it deep into the leg. And those swollen legs are
what’s called cellulitis. They’re bacteria and inflammation deeper in the
skin. You’ve only got one person to blame for that and that’s yourself, so don’t
scratch scratches. I don’t want you to go crazy with the curry comb. If the crusts want to fall off perfectly fine, don’t get in there and go too crazy. Now we’re going to talk a little bit about shampooing. And we’ll talk about the challenges with these. Everyone has a shampoo they like for their horse with scratches. I’m open to whatever works for you. But
there is a challenge when it comes to shampoo so what are our principles first
we ran a clip the hair coat you know second you should pre-big to get rid of
some of those precedents without scrubbing but try to get rid of a little
bit of but in general nobody maids for this period of time the truth is if you
squirt a bunch of medicated shampoo on the horse leg rinse it off on a minute
later you might as well just rinse it yourself so the contact time I think is
probably the biggest problem with shampoos and our only treatment you have
to also dry well afterward important thing and then for really need to be
affected you have to do it once a day at least for the first week when it is
April in upstate New York could be twenty five degrees one never knows
right how keen are we on letting something sit on our horse like on 50
minutes on speak that’s wet you’re so fond of it you’re not fond of it I’m not
fond of it so it can be difficult to do shampooing appropriately and I see a lot
of treatment failures when it comes to shampooing and I think it’s just because
it’s a great treatment it’s just hard to do it right I will say this selsun blue
if you want something cheap in the written pattern something blue this
ranch is an anti-dandruff shampoo it works really nicely it is actually
antibacterial and it’s one of my favorite peak rosters
if you will as I people reading color we feel like so that’s a cheap one you can
and I really like the kinetic that line they have a lot of any shampoo you like
that works is cool and evens up or actually my language
mumbles a lot of treatments and the betadine so I see a lot of people use
betadine okay that works okay it’s just sometimes with the white horses it
sounds good but you like it my cabin my projection news
absolutely this so is my magic so – all the day who’s heard but do the medical one this truly is
today it’s a wonderful wonderful product and it does it all I call it LST because
it’s trippy how it works it smells like rotten eggs it will
tarnish your jewelry I have gloves but it’s still worth it
I’m on a whole high-tech stiff to do it Phoebe because it does do it all this is
going to treat bacterial industry bring arms and feet oh they’re coming back
they’re actually gonna treat feels disgusting pour out these mics all the
hate this stuff it’s and remove your crust and it can actually reduce
inflammation and itch in the legs to what is like the most bang for your buck
you can’t get anything else and it’s dirt cheap as my on the grease up dirt
cheap this bottle this little guy usually only
eight bucks you can get like that I mean that is what is better now the smell is but there is an important thing with the
technique here by the way tell the best I told you that’s the pre washing the
area can help you don’t have to but getting awesome of those needles and
fast enough I put here dilute to three and four percent that’s critical I love
course people they say hey if a little is good a lot of setter not the case
from higher sulfur if you put it on the full concentration
of this about 99% you can strip the skin off so it’s a serious thing you do not
want to put it on the whole spring but when you dilute it pretty close then
fantastic the other nice thing is on the bottle of
us solution instructions he meant to do that
it’s right there for you on the bottle these if you want a spray or sponge onto
the affected areas whatever works for you I’m so blessed and then you do not
miss off this is a dip leave it on the horse now if you have that beautiful
nurse with whiteness and white feathers it will stand up so maybe don’t do it
the day before your big show the standing does go away and I hope you did
it for the first four or five days and then I had 177 days after that now
if the other works its prime distractions
it might just get it once a week glanced off astray or the entire screen and
that’s okay you’re not not causing harm by using this product I really enjoy the
other thing I want to say here is you want to treat it packs resolution don’t
just say oh those a little better I’m gonna stop treating no I want him to get
better and that can take time that can take three four or five and treatments
really depends on the horse so don’t worry that you may need to treat these
guys for over a hominid the two months skip or resolution weapons and creams we all have our
favorite one and they can be useful if you do have to be careful of these the
times you don’t want use joint mints any time that you’ve got a lot of losing on
the line because the wagons are going to hold the moisture in also if you’ve got
a really third leg the last thing you want to do is hold ensure that and I
said anything that’s amusing you want that to stir up the body’s response so
you don’t want to pack desitin on there so who’s actually my mom so there’s it’s
okay to use ointments to protect balloons for some early lesions but in
general why not use use of these things that I see if we use diaper rash cream
and even curl alignment you know if you like it and it works through those okay
and then there are prescription creams silver sulfadiazine and some here is a
lifesaver pretty shirt cases diabetes exactly I don’t even though
and then appearance of the know these are veterinarian over-the-counter treatment center
there’s a variety right so MTG much like lime sulfur it just smells good
greasy when I was in South Korea everybody MTG they took the bacon grease
from my kitchen I knew pretty nicely for a lot of horses I just think I’m told by
the Mexican product this is a really nice color but Tristan has a lot of
over-the-counter products they work very hard they actually use bleach bleach is
fantastic really good at a microbial antiseptic and the skin tolerates it
very nicely and the best and all the different products and then I mostly
always hear people talk about when a miss statuses brew and loose stuff the
purple stuff that green stuff forbids on their favorites lab and I okay we do
have a new favorite slider that being said if you put your favorite size just
getting worse and worse remember that topical reactions are
possible maybe a horse doesn’t like the blue stuff it’s actually not good for
the leg so things are not getting better and you need to stop what you’re doing
you could be causing whether you gonna need to call the
phones it is important to only house obviously this way if anytime it looks
really bad you this is a very deep ulcer equation this is a nasty bastard this
case this was actually lost this book so not something you want to mess around
with you don’t sit on these it looks like this she called that if the man
becomes really swollen you call the bat that could be a number that could also
be other things if you’re also saying they don’t traction rarely causes
weakness right so your silane always this is something you want instead there
and I think then I also say that it’s not improving incentive to Kennedy
that’s a short timing right but if you’ve been doing the always work to the
past and we’re not a week almost two weeks into it it’s not any better just
bigger better but what you’re good at may recommend there is a whole lot we
can do may recommend all of this so its skin straight is what we’re going to do
to find out choreographies like surface psychology is how many telephone about a
bacteria or reunify I reckon that bacterial culture tells me if it’s
bacteria what bacteria is it whatever I kind of use spectral resistance sandbox
real thing you see all the time so they may have to do a culture to suit
everyone culture is something we do in summary very the framework if the dream
arms we want to treat a little bit differently
skip I I’ve seen that vasculitis case it should be earlier you know I have to
biopsy that you might say that you know what’s going on and then they might
recommend it instead of them and all these things it might recommend that you
treat on your best your best first guess and that’s okay oral antibiotics might
be recommended CYFS mg pill works pretty nicely I don’t
think maybe you use it though you don’t need you right so make sure that you
kind of exhausted all the roots you forget about that you have some leftover
in your barn or just tossing it every course that is scratched a little bit
not appropriate they said you should change your top of
planets microbials to something stronger something prescription or they may
recommend topical steroids for those vasculitis cases all these teams with
issue wanna check your veterinarian about they may recommend fantastic
referrals for dermatologists I love seeing the cases that nobody else so if
you’ve got that case we work every bit out 40 times say hey what about ever
notice I’m so happy to see you and then a mantra with a life-long so
right if at first you don’t succeed you’ve messed something up the
definition of insanity is repeating the same thing so if your treatments that
should be working or not working you’ve missed something you need to do more
diagnostics I say exactly this all students it sounds like a really basic
thing but it’s like banging everybody hustle all keep banging a tennis ball next so I wanted to show you all the
mantras right so clean and dry cleanliness is next to governments
important don’t trap scratches very important it was oozing no pointment
unsalted it’s just that’s ever and then if at first you don’t succeed you messed
up call you back okay she didn’t get it right that’s cool we have other
treatment options if we’re going to talk about one of my
favorite subjects which is highest so the fancy word provides is attic area
horses are hygiene my favorite thing to do cats hate making x courses lovely so
what are they they’re right that raised soft ones are usually kind of around an
appearance and they kind of flat top when you touch them they’re often kinda
squishy or baggage they can be don’t they’re usually anywhere from half an
inch that they can give me all the way to a tissue anger that’s big it can be issued with the nanometer so
some horses are covered in hives and sitting there in her hay other words are
the five hikes and they’re ripping themselves to pieces it just and they
can be anywhere on the body how do you know if it’s really a high so fantastic
question and the one I always ask everybody the beauty of a hive is that
it needs to disappear in 24-48 hours it’s an immediate allergic reaction and
then it goes away so if you press the pom-pom this works right here I wear
these signs I don’t know but I recommend to do is draw around one of them so the
marker right you go that horse could get rid of one well now be drawn around it
if you go out and that bump is still there after 24-48 hours if you go out
and I love this long even if there’s new boss that was high so just to show you some of my pictures
beautiful another great pie maker this is not it should be my favorite carry
which is very very era and that’s this he sees beautiful little stripes they’re
cool NZ and then other things are bringing out a
lot of horses will after they get high so this actually doesn’t have any highs
left they very very so what caused the pipes this is the big
moment isn’t that nice food bugger drop food did you get a new shipment of hay
right is it a new value ring did you switch scripts is it saying hey but
you’re storing in a different application and it’s going into the
horse’s mouth on food both is it true hypersensitivity to above the
sensitivity isn’t a single mind from a single bug by prepares about that in
reality you can definitely see and then the big of the fine animism to say those
things with my contacts as well and then drug now most of us when we think about
drugs were like oh it’s like an antibiotic or something
this again is a pretty broad subject so this could be supplemented courses on
this could be a joint injection that your workshop this could be from the
Attic bomb that you’re putting in the muscle drug is a very loose thing it
could be to shenmue that you’re putting on top of that bush allowing from the
horse trip it could be a new bug spray I’ve seen much let’s get much from the
bus race so thinking cool above and drug as when do you need to call your vet when
it comes to hikes if it’s just one or two of the horses involved but if
they’re progressing to severe swelling that’s something that you need to pay
attention to particularly if they’re progressing the severe swelling in the
facial area that worries me that horse had an allergic reaction the kinetic
affecting its aerial and that was a gives you need a vet on hand not not
twenty minutes from now you need one now right if they’re recurrent so there’s a
bunch of hives at one way into these every three days later you’ve got a
bunch of knives and then waiting two days okay
four days later you’ve got a bunch of hives again call your bed you’re missing
something you need to do some more diagnostic if the hive if the eyes won’t
go away but certainly they don’t go away you want Gator back there I see y’all go
away 24 48 hours is usually and then if the I forgave the Jews crusts become
painful unfortunately horses will sometimes get such bad hives that they
actually is serum out of the Hinds then that can crust up that’s a great
bacterial mediators like a petri dish and then you can get a secondary staph
infection you got an earlier belt on that so you said they might one side
hikes four days ago and now he’s losing his
hair his scans painful there’s cuts everywhere you want to what are we going to do to treat highs
the biggest thing if you can easy it’s fine and eliminating the under the name
cards and this is where you have to deal with Sherlock is there any new variable
in this horse’s life did you change from SmartPak to fight on
performance sector that really like I said been looking is there a new hey did
you get a new source same sorts of different fields is there anything there
brain new great different great new bag of the brain then if you change your
bedding their turnout is what’s your shampoo
what’s your tack some of them really environment and then of course that we
talked about drugs all of these news the boat will never be is Sherlocks sit
down write things down if you do find effect little helps see if you can
figure out what’s different I know it’s different
great go back to the way it was before hopefully that will get rid of your
hives now let’s say you can’t find anything different or you change that to
the way things work and your horses my feedback that’s when we start thinking
about band H so the band a treatments we have in boo dentist use leads to work on
some horses good old zyrtec here is a pretty nice
one it’s affordable which is good I drop some things another one that works well
try this training when you finally look great stay here
you’re an essential competition let me go silly they say that it’s slower horse
down well they’re banned a treatment treatments we have there’s also a cool
booth on the Internet you know like things I cannot confirm
what I say is it you’ve got the money to spend if you want to try it more power
to you but some of these are very expensive and that bothers me because I
can’t omega-3 fatty acids can help finding performance for example makes of
skin and our review supplement just by you know making freeze that can help in
something but it’s usually not going to be the end-all be-all
smartish all sperm smart and also smart there are also topical anti-itch
infusions products that contain steroids hydrocortisone or sometimes come on team
which is like energy difference that kind of help especially keep that
patient worse and then under veterinary guidance
steroids are granted in treatment for high right I was an allergic reaction
calling immune system down steroids are the best thing you have to do that now
again you want to do this under very inviting steroids can be just anybody
know what a high being said if I’ve got a horse that’s covered in hives and is
progressing to not being able to breathe get it Tara
it also because the other thing that we can do when you’ve got a high V horse
you’ve gone through all those things so Diagnostics or what I can offer you
diaphragm that sounds weird this is something that I’ve done actually
praying that they’re the sat down for the client and we talked about the page
sources we’ve have been a tested so diet right here and then insurance game that
even through Hannah’s cute little mini I here is my my most favorite things to do
in horse something I do a lot for the 3080 course so this is a picture of
mention on the skin test so what we do is we inject the allergen directly under
the skin and these are hives we did that on purpose and we want to see the horse
make the high if I inject me I want to join the horse makes a hive that tells
me cool then works its responding to that it’s allergic to that this is a
very good react or you can see there’s a few bumps over here to do much damage to
a lot of other things what we do with this is I say okay now and we test them
by the way for spear sixteen injections and you might imagine a little sedation
I don’t so a little sedation we do this read the text we actually have you guys
read the text going for hours and 48 hours later you tell me come on showed
up and the enemy say okay here’s a list of
things that you’re working virgin – what do about now the thing is I’m so great
I’m gonna equate with their worst so kind of a boy bracket I should baby I
don’t have everybody just tell me figure that out we can solve any allergies
so unfortunately avoidance can be very very difficult I have a few horses for
example that were alfalfa allergic Pokemon like breath so every now and
again you get something in a horse that’s avoidance but in general
avoidance is not possible so what do we do this information we want to do
immunotherapy or the allergy shot well we do here is the desensitize of course
to what they’re allergic to just like people shot to by injecting into them
what they’re allergic to now God’s in fact it works decently well and I’m sure
it’s really Bob Costas I have great success with this I can see
results in his previous one to three months I’ll be conceited here it really
can take that long horse it is when it works it’s going to work and it’s work
great as far as cost those this is nothing this is a very cheap to do we
cost about $400 for the testing your first my authority immunotherapies and
cost you over 300,000 I of eight months 700 bucks to treat your lawyers when it
comes to worse so you’re talking about things that are cheaper in the long run
they have a really big difference this is something that people like oh I
really enjoy doing I’ve had great success of courses and if totally have
some success with any courses as well we wonder if there is a component of
allergy to me if you can spare a steroid it’s a very easy shot here she’s
actually vaccine we just use a teeny little TV syringe to give it under the
skin I encourage you get my carrot you give it to them and so that’s pretty much all about four
hives and infrastructures this is our cute little mini by the way how open
they actually actually you guys make questions about scratches or classes so
my hair by definition has the scratches it starts out with long and then they
use a little bit in Christ the hair is in its 250 Tufts and I can either touch
it or they fall off and then you’ve got like a little circle maybe a pencil
eraser sides up to a dime-sized of skin and pink skin might almost there’s no
blood but if you write down a flush and then actually heals yes and she decides
a few liner legs your chest fits them and the old throat cancer
yeah so what you’re or probably has talking about sort of like things are
using tops and then you lose a hair in my area and it goes in probably has an
insect bite hydrogen that’s a classic pattern she’s getting bitten by those in
section getting small live in the area the Hayabusas you might get a little
bacterial infection or not you’re just a hair all fine and well they’re not quite
how we did and that’s usually early spring well I think I’m both times makes
a difference good well I think she’d be a great candidate for our neck and chest
fly sheet mask you know the sweetie and he doesn’t get though it was per se
but what I’ve noticed on his legs and they might be similar thing well it
looks like giant Friedrich yes he can he has a call and it was final cost again
you would buy prevention so usually SWAT we pack why there’s like one yes is rarely the dog was in that quarry
Aki’s but it could it was really in close proximity so if you have that calf
muscle that’s going around and the result they could potentially get
parents lutely just not common with the dogs have you so cats are surviving that’s abuse there so it’s undiagnosed all the nonspecific
dermatitis but it has so they’re black black dots on his always Lasher and his
friends its I saw you one yesterday under this neck I examine it very flat
for they a little teeny-weeny black like the head
of a pin and on one of his the cannon boner his hind leg you came
irritated and very pink and that was worrisome and actually it does the inch
he doesn’t bother with it it’s nothing and keep his legs clean I’ve used lime
sulfur gift for weeks it doesn’t go away ever it he has it in the winter he does
grow a thick coat but I can still see these pops and what the heck is it edit
spray and I’m invite up seen have you sent a piece of nice yet and one trailer
and he doesn’t I can’t I don’t have it trailer I don’t you want you yeah there’s a
great question so pictures are helpful to us there are times when even me as
everything I thought would be papilloma let’s be honest with you I got
papillomavirus and that can present an odd ways it does
a lot of weird things there are 19 couple of carcasses in orange that one
holdout of them and we’ve seen them present with little black bumps before
there’s also other weird hair follicle tumors but they can get too so there’s
some odd things out there and I think a biopsy would probably be the best way
for you to know what’s going on I’ve got a little bit picture I just need out
people to do not usually unfortunately now Mary said I might be able to get one
of our ambulatory people out and advise them on how I would collect the sample
so they don’t go we’ve also got a couple of others that are really quite good
seem on a few other ambulatory practitioners that I like a lot a chat
with them I can say here’s a picture of the land when you circle what I want you
to do while walking through how to do it well that’s all you have to do is power
I understand absolute ohm so I company the pictures out pretty to see as far as
the next step and that’s okay you know that’s that’s a great so we’re Sherman is awesome right
Spencer you’re going through

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