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 | 14712 Franklin Ave St K. Tustin CA 92780. Phone: 714-665-2211. Fax: 714-665-2212 | |
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Caring for the Geriatric Horse Owing to better health management, more horses than ever before are living well into their 20's and 30's. With this increase in older horses in the equine population, geriatric medicine, including preventative medicine, has been sought out in recent years by many owners to keep their equine companions healthy into their golden years. When a veterinarian performs a routine exam on a geriatric patient, one of the most important aspects of the exam is discussing with the owner the horse's history, including vaccinations, deworming, previous and current medications, nutrition and eating habits, housing, exercise, and previous and current lamenesses. This initial information will help the veterinarian start to diagnose potential health problems. It is important to tell the veterinarian even subtle changes that are noted by the owner, such as lethargy or increased drinking and urination, which may not be apparent during the physical examination. The next step in evaluating a geriatric patient is to perform a complete physical examination. Typically, the veterinarian will start with the “big picture,” the overall weight of the horse and the body condition score (BCS, a system of scoring body condition based on fat deposits in six different areas on the horse). Ideally, the BCS of a geriatric patient should be 4-6, on a 9 point scale. The skin and hair coat will be evaluated for lumps and bumps, evidence of external parasites or skin infections, hair loss, and excessive or poor hair coat. The circulatory system will be evaluated by ausculting the heart, assessing hydration and capillary refill time on mucous membranes, evaluating jugular vein refill time and arterial pulse pressure, and observing edema of unknown cause. The respiratory system will be evaluated by ausculting the lungs and trachea and noting any nasal discharge or coughing. The gastrointestinal system will be evaluated by ausculting the intestinal sounds, called borborygmi; ausculting for sand in the ventral abdomen; and evaluating the manure for consistency, courseness, or undigested grains. The eyes will be evaluated with an ophthalmoscope looking for corneal scarring, evidence of chronic or acute inflammation within the eye, and changes in the structures of the eye including the lens, retina, and optic disc. Horses have hypsodont teeth, meaning they continue to erupt from the gum after forming. This makes them prone to dental problems later in life. During the examination the teeth will be evaluated for dental abnormalities such as sharp enamel points, hooks due to misalignment of the arcades, wave and step mouth due to slowing of tooth eruption or tooth loss, fractured teeth, and tooth root abscesses. The musculoskeletal system will be evaluated by palpating the limbs including all joints and examining the horse moving at the walk and trot. Lamenesses attributed to arthritis are common in the older horse. Lastly, the hooves will be evaluated for abnormalities including laminitis rings, hoof cracks, poor angles (long toe, low heel and upright or club feet), flat soles, and thrush. If the horse is shod, the shoeing will also be evaluated. Another important step in evaluating a geriatric patient is to perform routine bloodwork, including a complete blood count (CBC) and a serum chemistry panel including thyroid parameters. The veterinarian will take approximately 5ml of blood from the jugular vein and have it evaluated by a local laboratory. The CBC can help diagnose decreased red blood cells (anemia), as well as changes in white blood cells (chronic infection/inflammation and some types of cancers to name a few). The serum chemistry panel gives the veterinarian insights into kidney, liver, thyroid, and muscle function, as well as protein ratios and electrolyte balances. It can be invaluable to have bloodwork done when the animal was healthy to compare to if the animal become ill. Subtle changes in bloodwork can be noted with serial values to compare, potentially making a diagnosis earlier in the course of a disease. Certain diseases are seen more commonly in older horses compared to their younger counterparts. One of the most important diseases of older horses is Cushing's disease, or pituitary dysfunction caused by a benign tumor. The classic signs of Cushing's disease in horses are excessively long hair coat or delay in shedding, muscle wasting, cresty neck, pot-bellied appearance, chronic laminitis, increased thirst and urination, increased sweating, and decreased immune function leading to infections in the skin, mouth, hooves, and respiratory tract. Not all horses exhibit all these signs. If the veterinarian suspects Cushing's disease, additional blood tests may be necessary to diagnose the disease. Another relatively common disease in the older patient is colic. A horse of any age can experience signs of colic, but older horses are more prone to certain types of colic. Colonic impactions seen in older horses can be due to inadequate chewing of hay and inadequate hydration. Having the teeth evaluated regularly, changing the diet if necessary, providing clean water at all times, and supplementing with electrolytes to encourage drinking are all ways of lessening the risk of impaction colics. Geriatric patients in California are also at risk for intestinal stone development, called enteroliths. Although they are more common in Arabians, enteroliths are seen in all breeds of horses, especially those horses on an all alfalfa diet. If colic due to enteroliths is suspected, abdominal radiographs (x-rays) are taken at a referral hospital to diagnose them. Surgery is required in most cases to remove the stones. Another cause of colic typically seen in older horses is strangulating lipomas. These lipomas, sometimes on a long stalk, are slow-growing tumors in the abdomen that can wrap around segments of the small intestine, causing a blockage and loss of nerve and blood supply. Typically, emergency surgery is needed to remove that segment of intestine. Another common finding on physical exam of an older horse is a heart murmur which is due to one or more valvular dysfunctions. For the most part, older horses are able to compensate well and they do not affect the animal's performance. Melanomas, or skin tumors, are a very common finding on gray horses. It has been noted that approximately 80% of gray horses 15 years or older will have melanomas. They are usually found under the tail and around the anus, but can be found anywhere on the horse's body. Melanomas are slow-growing and usually benign in nature. Treatment is usually not necessary or recommended due to the difficulty in removing the whole tumor.Owning geriatric horses can be a difficult prospect, due to their ailing conditions, but they can also be very rewarding. With a little extra TLC and a proper health care maintenance program, the older horse can live a longer, more comfortable life. Written by Dr. Karina Cox
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General signs of aging in the horse include the following:
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