Keeping Horses Sound as They Age - Ask The Horse

0:00Hi, everyone, and welcome to Ask the Horses Live. I'm your host, Haley Pepper, Digital Managing Editor at the horse.com. As horse's age, managing their soundness using a multimodal approach becomes increasingly important. Experts emphasize proactive joint care, appropriate exercise, and routine veterinary evaluations. Regular low impact work helps maintain joint mobility and muscle support, while avoiding long periods of employment, which can worsen stiffness. Strategic health balance, body condition management, and early intervention for mild lameness or key. With thoughtful management and early attention to subtle changes, many senior horses can remain comfortable and active for years. This event is sponsored by American Region Animal Health. To answer your questions, we are joined by expert panelists, Dr. Lauren Trigger from the Virginia Maryland College of Veterinary Medicine, and Dr. Helen Mansfield from American Region. Welcome to the view. Thanks, Haley.

1:00Hi. Good evening. Dr. Trigger, can you start by telling us a little bit about your background? Sure. And thank you so much for having me. I've been looking forward to doing this, so a little about me, I've been a lifelong lover of horses. I grew up in Pony Club and with area two of venting. And so going to vet school to be an equine vet just seemed like the logical next step for me. So I love working with performance horses, both young and old. I really love the challenge of working on complex performance issues, whether they're related to lameness or not. And lots of reasons why a horse could be performing poorly, not necessarily orthopedic. So I really love that kind of like puzzle challenge. So I also love anything to do with imaging, particularly ultrasound, and briefly thought about becoming a radiologist, but thought I'd miss the patients too much.

2:05So currently I'm on faculty at the Virginia Maryland College of Veterinary Medicine. I'm boarded through the American College of Veterinary Sports Medicine in rehab. So my focus is on sports medicine and keeping our horses performing at their best. At England University, I'm always with students, both in the classroom and on clinics. I really enjoy teaching students in addition to seeing patients. And then my husband and I, we have two little girls. We have a small farm in Blacksburg, and I love being able to have my horses in my backyard. Very fortunate. You know, we have a couple of horses here in their 20s who are still working and doing their jobs. I'll be at a slightly lower level. So this topic really resonates with me, keeping them found and healthy is, it can be a bit of a challenge, but it's very rewarding. Awesome. Thank you. And Dr. Mansfield, can you tell us a little bit about your background and your role with

3:09America? Absolutely. And thanks for having me here tonight. So I was born and raised in Charleston, South Carolina, where I was also involved in my local pony club. I competed in Hunter, Drumper, and Eventine, and was kind of that all around the forced crazy kid. At 14 years old, I got to watch my horse's college surgery, and from that moment on, that's when I decided I was going to be an equine vet. From there, I went on to University of Georgia, from my undergraduate degree, and to TV for vet school. I did two internships, one in general equine medicine and surgery, and then one in advanced reproduction. I spent almost 15 years in equine private practice working on pretty much every type of horse from your backyard pleasure horse to Amish workhorses, to Olympic level show jumpers. I even spent a couple of months in Germany working on sport horses. Along all those travels, I also became certified in active puncture and veterinary medical manipulation or chiropractic. Now I'm the senior manager of the Professional Services Vets at American Region Animal

4:13Health, and I've been here about two and a half years. In my job, I now provide education for veterinarians and horse owners nationwide. I work on educational programs, as well as a bunch of other modes of educating horse owners, practitioners, and student slash future practitioners. Thank you. Before I begin answering questions, I want to remind everyone of our Ask the Horse Sly Format. We're starting with questions submitted during registration. If you're listening live and would like to submit a question, please do so via the chat window. We'll do our best to get to as many of your questions as possible. If you're listening to the podcast reporting of this event and would like to join us live in the future, please visit overs.com slash Ask the Horse Sly to register for notifications. And with that, we're going to jump in. So our first question is for you, Dr. Trayer, and it's from Robert in Rhode Island who wants to know if you can explain the most common causes of lateness you see in aging horses. Yeah. Yeah.

5:14So this is a great question. And, you know, while every horse is different, there are a couple of things that come to mind with this. The first is osteoarthritis, really, of any joint. Osteoarthritis is a degenerative condition. So as the horse's horse ages, it has the tendency to get more complicated to get worse for them. And so really, any joint is at risk. With older horses, though, in particular, there's the cervical facettes kind of come to mind. So osteoarthritis of the neck, which can often result in neck stiffness or neck pain sometimes is actually translate into forelimelainness, depending on where the pathology is. We see a lot of muscle wasting due to kind of disuse of the neck in conjunction with that. And sometimes even neurologic signs in conjunction, depending on what part of the neck is affected and note the disease process.

6:17So certainly, osteoarthritis of the neck and of any joint comes to mind. The whole thing that comes to mind is DSLDE, which is degenerative suspensory ligament does minus. It's a condition of the suspensory ligament, particularly of the branches of the suspensory ligament. And while you can have DSLD, unfortunately, in younger horses, it really kind of resonates with me as like an older horse as they age kind of issue. And the issue with that is that the suspensory ligament is critical for keeping the fat lock suspended. And so with this disease, the suspensory ligament can kind of lose its elasticity and the fat lock can drop to the ground or hyper extended to the ground. And that is very painful for the horse. It can cause changes to their confirmation behind hope issues and conjunction with that.

7:19So, and unfortunately, is a disease that we hope we never see, but unfortunately, see quite often. And then another thing, too, is, you know, as horses change, their confirmation can change as well, particularly the confirmation of the back. Some horses will get quite luredotic in their spine, which is like a sway back type appearance. And that can really impact the joints in the back, the muscles of the back, so particularly the epaxial muscles as well as their core strength. And so, you know, loss of epaxial muscles or loss of core strength, secondary to back pain, whether it's due to confirmation or due to pathology and the joints or soft tissues of the back can certainly be a big issue for horses as they age, can have implications for tack fitting appropriately, you know, for their ability to do their job.

8:21So, fortunately, there's lots of things we can do to help keep the back in good working order. So, I think those are really kind of the top three. I mean, there's other things to soft tissue injuries, particularly those that arise from chronic wear and tear, and not necessarily a cause of lameness, but other causes of poor performance in aging horses, like development of cardiac murmurs or arrhythmias or changes in vision or susceptibility to asthma, those kinds of things can all impact performance. But yeah, I think that's probably the things that come to mind for me. Awesome. Thank you. Dr. Mansfield, McKaylen, California wants to know what a horse is considered aging and why? Yeah, absolutely. So, I think when it comes to aging, one of the most common questions we get asked is, like, what horse, what age is my horse a senior?

9:22And I think it kind of really depends on the horse. Horses, just like people, they age differently, and there's no really hard fast rule about when a horse is officially a senior. You know, some horses may exhibit visible signs of aging or loss of performance earlier than others, which can be affected by, you know, their previous job, genetics, or hack a bunch of even environmental factors. But there's really no set age where a horse is considered to be a senior. There was actually a survey back in 2023 from horse owners and most indicated to first consider their horse old at the age of either 20 or 25 years old. You know, horses are living a lot longer now than they used to be because of all the advances in medicine we have now to keep them happier, healthier, and more sound. And interestingly, actually, in that study, the top three reasons that they consider their horses old were reduced ability to work or exercise. Then they started to show signs of age-related disease or disorder.

10:25And then the third one was an increase in gray hair. But, you know, like I said, it depends on how your horse acts, depends on how they behave, depends on how they perform. So there's not really a set age for a senior horse. Dr. Trigger, Kristen in Washington asked what the best type frequency and duration of exercises for senior horses? Yeah, so I would say, honestly, just keep them moving as much as possible. I love turnout for aging horses. And you know, it certainly depends on how comfortable your horse is and if they have any confounding issues, lameness or otherwise or, you know, some horses as they age due to other metabolic issues can't be turned out on pasture, for example. So it certainly depends on the horse, but, you know, getting them out and moving as much as possible is really beneficial for them.

11:29And you may have to modify, you know, the turnout conditions as your horse ages. For example, if they typically even turn out on pasture, that's very hilly and that's not quite what they need anymore, that's a lot of stress on their joints. For example, then, you know, modifying that to a smaller, flatter area that they can maneuver a little bit more easily might be the best option for them. But, you know, horses as natural grazers, they're going to move around constantly throughout the day. In the winter, you can kind of encourage them to move around by sort of spreading out their hay or, you know, having them walk from their hay to their water and not just have it right next to each other, that kind of thing. So you can get kind of creative with how to keep them moving. Certainly, like the degree of work ultimately is going to depend on the comfort of your horse, as well. But I would say that the best type and frequency and duration of exercise for senior horses

12:33is consistent work, low intensity, and then modifying that intensity level, you know, related specifically to the animal and what they can, they can handle durations, certainly variable depending on the horse as well. But you'd be surprised how fit a horse will stay just with walking. And so walking over varying terrain can challenge them. You know, they don't necessarily need to go out and do trots, that's their sprint or anything like that. Just keeping them moving and, you know, keeping it consistent is the big thing. For some horses, as they age, if they're having a hard time carrying a rider, they're having issues. In their back, for example, that preclude them from carrying a rider, there's a lot you can do with groundwork. You can consider ponying them off of another horse. So, you know, really just like anything you can do to keep them moving, I think, keeps

13:35them like Dr. Mansfield is saying, living a lot longer than maybe they used to. I can't really agree with you, Dr. Traeger. I'm a firm believer that motion is lotion for the joint. Yeah. Dr. Mansfield, Nancy and Arizona wants to know what physical and behavioral changes she might see into her horse as is osteoarthritis progresses. That's a great question, Nancy. Horses can often show subtle clinical and behavioral signs as that OA progresses, things like stiffness at the start of a ride. Your horse may feel stiff or a little sticky in his movement during the warm-up, but then they sort of loosen up as you go. Now, some stiffness can be totally normal, but if you have consistent or worsening stiffness, that can be kind of a red flag that your OA may be progressing. They also can have like a shortened or uneven stride because of joint issues and because that can affect their ability to like fully extend their joints. So, if you notice like shortened choppy strides or they feel uneven anytime, that could also

14:41signal some joint discomfort. Now, obviously, sometimes you're not going to see obvious limping, but something may just feel kind of off to you. Now, we all know our horse is and a slight head bob or dragonito or just that feel and he's got a little hitch in his giddy up. It may be a little more noticeable to you because you're keyed into your horse's movement a little more. You know, I always tell people, trust your instincts because those subtle signs are often some of the first clues we actually see. Now, behaviorally, they can have some reluctance to move forward or turn or perform even just every day task. You know, if they resist forward movement, you know, or balking at some of your transitions or struggling through turns, especially if it's on one side, you know, OA can be causing joint pain and reducing some of the range of motion. Some of the other signs of discomfort or irritability can be, you know, pendi or tail swishing or resistance when asked to work, you know, I had a client who, you know, she knew her mayor well enough that she started putting her leg on and that mayor started

15:45counting her ears. She knew it was time to get her checked out, you know, these behavioral changes, especially if new or increasing, may point to some pain because if your horse is like Mr. Steady Eddie and it's suddenly crow hopping around, you know, the arena, that's definitely a red flag to look for pain. But I always told my clients, you know your horse best, listen to them and if you notice they're feeling off or reluctant to work or giving you some weird new behavior, you've never seen before, call your vet because early detection by you and your vet is really critical to managing these symptoms and implementing that early treatment because the earlier we treat any pain in these horses, the better the outcome is going to be. Dr. Trigger, John and Kelow in Canada wants to know the best way to bring an age horse back into work after some time off. Yeah, so I think that this might depend on, you know, what that time off was for.

16:50So that might, that might kind of modify the, the answer to this question a little bit. But, you know, if this horse, like let's say, for example, this horse just had the winter off and, you know, it was a bad winter and it just was not really doing much, but you know, spring has arrived and we're ready to start getting back into work. I might approach that a little differently versus if it's a horse that had a significant period of time off due to an injury, you know, those, those carry certain implications with them separately. But I would say that probably the first thing is to just make sure all systems are go, right? So, you know, having your horse evaluated by your vet to make sure that heart, lungs, everything sounds good. The horse's baseline sound, everything checks out to, to say that that horse is ready

17:54to start back into work. That would be an excellent first step. I'd also check your tack and make sure, depending on how much time the horse had off, you know, a lot of things can change about their back, even about their mouth too, we'd be surprised how many performance issues and older horses stem from the mouth. It was kind of wild to me to see, you know, causes of performance issues that all boil down to the mouth, but having those checked out and making sure that your tack is still fitting appropriately, kind of setting yourself up for success, we're getting back into work. And then really, you know, I think about it as like preparing yourself to go train for a marathon after you've had a significant amount of time off, right? So long, consistent fitness work is, I think, really the safest way to bring a horse back into work after a variable amount of time off. So lots and lots of walking, and that might mean like a month of just walking, or a couple

18:59of weeks of walking, or a couple of months of walking, right? It just kind of depends on the fitness status of your horse. And then as they get fitter, adding in trot and or can or work, if that, you know, is what your goal is, in intervals, so I'll often say, like, set your watch to beep on every 30 seconds, and every 30 seconds, you change from trot to walk, right? Or trot the long side of your arena, walk the short side, or that kind of thing. Interval work really builds up fitness, and that's important because horses that aren't fit will fatigue, and they're more likely to injure themselves. Signs of fatigue that you might witness or see as you're bringing the horse back into the work are things like tripping, you know, paying close attention to the recovery rates both during and after exercise. So, you know, it's my horse breathing particularly hard while we're working, and it's a pretty

19:59cool day, and that doesn't quite make sense, or, you know, do they take a long time to recover post-work, do they need to, you know, cool down for a long period of time? That could, that could single that, maybe they're not quite fit enough for the level of work that they're doing currently, and just take a step back, and you can go back to focusing on more, more walk really. And then, you know, a lot of, a lot of the work that we, or the progress that we make in the saddle can also be started just on the ground, and so, you know, horses, we're very, we're very kind of proactive about conditioning their core, conditioning their back, conditioning their pelvis, because those are the major stabilizing muscles that are going to help, help with their fitness, but also help keep them safe for riding, and so we have mobilization exercises, carrot stretches, you know, your pelvic tux, your general lifts, those kinds of things you can be doing on the ground, as you're grooming or tacking up,

21:03and we actually have the evidence-based research to support that it does increase the muscle mass of the epaxial muscles in the back, and those are very important. So, you know, utilizing a combination of groundwork, and then lots of long fitness work, and making sure that your horse is ready to go before you start any of that, I feel like those are kind of the keys for success for bringing them back into work. Dr. Mansfield, Alex in Georgia wants to know how veterinarians monitor osteoporitis progression horses as they age, and how often should they be re-evaluated? So, I love this question. I think one of the best ways to monitor the progression of osteoarthritis is regular performance exams, which in my opinion really aren't done enough in the equine space. You know, one of the reasons for these regular exams is early detection of health problems, and the earlier we detect things, we have significantly increased in the likelihood of positive

22:08outcomes. The earlier we catch these issues, often mean treatments can be less invasive, less costly, and more likely to result in recovery, because I truly believe in a proactive approach to management of health issues, rather than that reactive response to problems, which really could be the difference between a little minor step back and maybe a serious injury. So, for horses in regular work, whether they're in competitive sports or just recreational riding, you know, these exams can be crucial for maintaining their health and ensuring when we get their best performance. And that preventive performance exams can be an all-encompassing evaluation of your horse. You know, it's going to differ from veterinary to veterinarian as for what they're looking at. But the main focus is often that muscular skeletal exam, but it's also a really good opportunity to look at the other important aspects of your horse's health, like checking out their vaccination program, you know, as, you know, checking in their mouth, just like Dr. Trigger just said, you know, reviewing their shoeing and even their diet.

23:11When I was performing performance exams, I, you know, I separated them into a static and dynamic portion. That static exam involved observation, palpation, passive flexion of all the major joints, and that's all done while the horse is standing in place. And then we do that dynamic portion of the exam when I watch the horse move at a walk, trot, and canner, you know, in hands, lunch, you know, even I'd watch them being ridden. And for horses that are in consistent year round training programs, I would say once to twice a year exams make the most sense, especially as these horses age, or they're going into a harder training portions of their career. Yeah, I think you two are worries right out of my mouth. I feel like I need a shirt that says be proactive instead of reactive. I mean, you're 100% correct, right? Like getting on top of the, getting on top of something before it is a problem, I think is, is the, is the only way to go.

24:12So I'm glad somebody else feels that way too. Absolutely. Every presentation I give, we talk about proactive versus reactive. Dr. Trigger, Irina and Alberta wants to know how to keep a high level performance horse comfortable in competitive, even in two years later years. Yeah, so I, you know, I think that this is completely doable with taking like a comprehensive whole horse approach. And I mean, I personally, I think horses just get better as they age like at this stage in my life. I would much rather take the 18 year old bin there, done that than like the four year old wild feral thing, right? So particularly horses that have had a career, I think that they just, I don't know, they kind of like, they kind of lose, I think they kind of lose like a lot of that, what makes them, gives them a personality and kind of what makes them a horse when they're like slated

25:15for retirement, right? And so I think that even if you have a high level performance horse and you're taking it, you know, backing down the step or maybe not showing quite as frequently, but like keeping them in a program is, I think the best way to keep them, you know, happy and healthy like as they age. And so in a kind of what exactly what Dr. Ramesh was saying in the previous question with these taking that proactive instead of reactive approach is super important. And so for these older horses, I will probably, I often see them more frequently throughout the year than I might be younger horses, right? And these are, these are just regular kind of like all systems go wellness checks, right? And so making sure they're staying sound and flexing well, they're back in their neck and their pelvis are palpating well, everything else is looking good, they're not developing

26:16any signs of metabolic issues or, you know, because those, those things are cushings and older horses or PPID or equimetabolic syndrome with insulin dysregulation can absolutely wreak havoc on them and really have implications for who are staying sound as they age. I think that these horses really benefit from, you know, obviously regular, regular ferreary, but paying close attention to making sure they're maintaining, you know, a much faster access and appropriate palmar angle. And so for these older horses, as their confirmation kind of higher up changes, often we see those issues or those changes reflected in their feet as well. And so regular pediatry evaluations, including, you know, taking radiographs to assess for balance and the heat and everything is looking good, I think is very important, you know,

27:17if, if your horse does have musculoskeletal issues that were previously addressed, you know, do you have kind of a complete picture of what's going on? Do you have an updated picture of what's going on and is there a plan in place? And so we've got lots, lots and lots of things that we can do to help support horses and their joints and their musculoskeletal system as they age, you know, from like a variety of standpoints. And so, you know, considering those ancillary supports such as joint supplements, for example, or specific rehabilitation techniques to make sure their core is staying strong, that they're back, is staying strong, that their appropriate section is staying conditioned, you know, all those things, I think, can really be valuable to keep a horse performing well into their 20s, you know, and beyond, so. I'm coming in to field, Lydia and North Carolina wants to know if there's a point where joint

28:24injections are no longer beneficial for a horse. How would you know when the horse has reached that point and what are some other options? Let's say the joint decks are failing if you see no improvement inliness within a couple weeks of injections or that rapid return of the symptoms you had before injection, like two months or less, you know, other indicators to be like persistent, unexplained, like bad performance, you know, reluctance to work, stiffness, behavioral changes, you know, sort of quote-unquote the norm for joint injections usually includes steroid and hyaluronic acid. But one of my new favorite, one of my favorite things about equine medicine is how it's constantly changing and improving and we're finding other ways to treat these horses. You know, there's an alternative now to those traditional corticose steroid injections that could be things like regenerative medicine and try to take your hydrodale system as joint support. You know, some of the regenerative options out there, which I used to use a lot of times

29:26when horses were no longer responding to the normal corticose steroid injections for things like, you know, platelet-rich plasma, atologist protein solution, iraps, thin cells, alpha 2. And then you've got some of the systemic OA therapies out there, like polysulfide glycosmenoglycan intravenous sodium hyaluronic and pentacan polyphilipinjection, which all have disease-monifying effects and they actually treat all the synovial joints versus just the specific joints for joint injections. I'm also a strong believer in that whole multi-modal approach to OA management. There's never going to be one silver bullet to treat OA. So I'm going to take multiple modalities for like that effective long-term management. And you know, as we said, there's adjunct therapies out there too, acupuncture, chiropractic massage, laser, PMF, you know, vibration, controlled exercises, you know. We have so many tools in our toolbox, as you say, and equine rehabilitation facilities are also an excellent resource to offer, you know, exercise programs and so many other

30:31modalities to reach whatever goals you need for your horse. And if I could just add one other comment to that, I think that it's important to do a little investigation if, you know, like for example, your horse has gotten its hawks injected on an annual basis for the last X number of years and you know, he's always felt really good after that and it seems to have maintained him for nine to 12 months. You know, if that suddenly stops working, be a little critical of like, you know, do we have a different problem here, right? And so, you know, for example, a lot of horses that typically respond really well to hawk injections and then suddenly stop, I'm a little worried about the health of their proximal suspensory, right? Because like those can, the hawk and the proximal suspensory pain can emanate from both,

31:31one or both of those areas and look very similar clinically, but you know, if the horse has stopped responding to a hawk injection, I'm going to be a little worried about this ispensory and kind of maybe investigate that a little bit more too. So you know, there are certainly like, I feel like there's never, it's never as black and white as we want to make it, right? There's like horses, there are lots of little things that can kind of be smaller problems and then get to the point where, you know, suddenly they're too big to ignore type thing for the horse. And so, you know, if the joint injections have stopped working, you could have a separate problem going on as well. Is there a way to trigger Cynthia asked there are any stretching or groundwork exercises that can help prevent or slow the progression of joint disease and keep an aging horse comfortable? Yeah, so I'm not sure, oh gosh, if there was something we could do to completely prevent

32:34joint disease, that would be amazing, right? I think that, like whoever can figure that out, it like wins, right? So, but I will say that stretching and groundwork exercises are fantastic from the standpoint of keeping joints moving in an appropriate range of motion. And so for example, what I mean by that is like, if you watch a horse gallop and you kind of freeze frame the second where there one like four limb is, is an impact phase of stride and you see that fatlock just hyper extend and disappear down into the, into the ground, right? Like that is putting that joint through extreme range of motion and that is not the best thing for the joint, but I mean, it's, it's what we ask our horses to do for a living, right?

33:35And so on, on the other hand, what we can do with stretching and groundwork is take, take those joints through passive range of motion exercises, which are control of range of motion exercises that are not going to push the joint kind of past its limit and is also a great tool for, for helping you kind of discern whether they're painful on passive range of motion, they shouldn't be painful on passive range of motion, but that, you know, if they're reluctant to do those exercises, that might suggest that, you know, there's a problem brewing. So stretching, you know, mobilizing like micro motions to mobilize the joints and kind of isolating each joint and doing each joint separately, as well as kind of like manipulating the muscle tendon units that support those joints, certainly very, very proactive approach. You know, joints are, joints are pretty incredible.

34:35They have a lot of proprioceptive receptors in the joint capsule that need to be conditioned just like any other part of the body. And so the more we can keep them moving under like appropriate loads, the healthier they'll be and the more willing, or the more likely they are to undergo extreme loads like when we're asked them to work. You know, I always think it's a good idea to do, to consider, you know, what the horse has done or is doing prior to doing passive range of motion exercises or stretching your groundwork exercises, meaning like, you know, joints that are already kind of warmed up, I think go through those rehabilitated exercises a bit better. So warming the horse up could be, for example, just taking them for, you know, a brisk like five to ten minute hand walk or if you have like a treadmill or something putting or hot

35:39walker, putting them in the walker for a few minutes and then performing those exercises or using some sort of like therapeutic heat source to kind of warm the body up beforehand. I feel like we always get a little bit better quality of exercise after that. And you know, not everyone has access to this, but aquatic therapy is also excellent for joints. So, you know, an underwater treadmill or I probably would say not necessarily swimming the horse because that there are a lot of uncontrolled variables of swimming the horse. Underwater treadmill therapy can adjust the height of the water and kind of target specific joints like the fat lock versus the hawk, for example, the nice thing about underwater therapy as well is that depending on the height of the water, you can unweight the horse quite a bit.

36:40And so, you know, that really like that buoyancy factor really takes away a lot of the ground reactive forces that occur when the horse, you know, strikes the ground is walking. And so that can also, you know, be quite beneficial when we're thinking about kind of conditioning joints and bringing the horse back into a program, for example. So yeah, you can get really creative stretching and groundwork exercises. Anything that makes the horse like from a groundwork exercise, walking over raised cavalities or ground poles, backing exercises, even something, you know, as simple as like putting one bell boot on one hind limb, you know, the horse will eventually acclimate to that, but for probably a good three to five minutes, they're going to be like kind of like, you know, kind of goose stepping a little bit on that one bell boot hind limb. And so that can, that can kind of help condition specifically those joints and also translates

37:41well to the, to the large muscle groups in the, in the back and the pelvis too. You know, I totally agree with, you know, everything you said, I also think it's super important as these horses aged that we also need to make sure we're giving them longer warm up and longer cool down points, because I will say I appreciate osteoarthritis for the older I get it. I'm starting to get it as well because I know what I work out. I need a little time, longer time to start and I need a little longer time to cool down these days. Yes. Absolutely. Dr. Meensfield Becky and Illinois asked that there are alternatives to NSAIDs for senior horses with joint pain who also have a history of gastric ulcers. Yeah. So non-steroidal anti-inflammatories are NSAIDs are pretty strictly used in the equine world. Actually, they're only secondary we use to dewormers and we prescribe them for a plethora of reasons, including things like when they were covering from surgery and lameness issues.

38:44You know, these drugs are extremely helpful when we're managing equine pain, but they do have a fairly significant side effect on that equine stomach and GI tract, you know, incendus injury can occur anywhere in the GI tract, but that right dorsal colon and the gastric neocosis can appear to be the most sensitive to our insides. You know, there was a study, I think it was through 2018 where they found some of the COX2 insides still caught gastrointestinal damage even in healthy horses. You know, they said the fiddle buttozone and fear coxib and they both resulted in gastric ulceration. But specifically though, the horses treated, they had similar degrees of ulceration to that squamous portion of the stomach, but those fear coxib, pre-inhorses, had less severe ulceration and the fear coxib resulted less inflammation of that gastrointestinal than the fiddle buttozone. So, you know, we have drugs that are safer for use for the GI tract, but they can still

39:47have effects on the GI tract. But as I said before, we got a lot of tools in our toolbox, or we can help these sources out. Again, we have our systemic osteoarthritis treatments, like polysulfate glycosmetic glycan. Intravenous pilarine sodium and pentaphan polysulfate injection, like I said, that goes to treat all the joints. And if you have a specifically affected joint, you know, you're causing pain. Joint injections can be super helpful, and those include steroids, HA, regenerative therapies or inter-article hydraels, and it all depends on that severity of the disease and what your vet recommends. And then rehabilitation centers can be of great help, which I've served Dr. Traker can speak to you better than I can. Dr. Traker, Lisa and Wisconsin wants to know if there's any way to prevent the vicular disease and horses. How can she and her vet slow its progression in the senior horse? Oh, Lisa, I feel like we could have a whole hour conversation about this.

40:54So what it really all, it all boils down to keeping the components of the vicular apparatus happy, which it's not just the vicular bone, but it's, you know, the bursa, the deep digital flexor tendon, some of the supporting ligaments, such as the empire ligament, the sensory ligament of the vicular bone. I mean, we have to basically be like a therapist to all of those components to have all the stars aligned for vicular pain, not to arise in the horse. And I, I really strongly believe that like the number one thing that we can do to help prevent this is to make sure that horse is appropriately trimmed and shot or appropriately trimmed and as a barefoot horse. And so, you know, the principles of keeping the vicular apparatus happy, really boiled down to making sure that we're not loading that vicular apparatus unnecessarily. And so keeping the hoof, past or an axis in alignment, keeping a positive plum or angle.

41:59So we're not, we're unloading the deep digital flexor as it passes along the vicular bone. Those are really important. And so, you know, making sure that you have a good relationship with your failure, that your horse is getting regular, regular trimming and shoeing, and that your vet is also, you know, a part of that conversation too and contributing, you know, from like a radiographic evaluation standpoint and making sure that they're maintaining their soundness. And if they are coming up lame, that it's not, you know, localized to the vicular apparatus. There are other things too, that we know lead to development or progression of vicular pain that are unrelated to poor foot confirmation or trimming and shoeing. And, you know, that is kind of like unreasonable loads on, on otherwise, you know, appropriate

43:06confirmation. And so, like the thing that comes to mind are, you know, kind of the weekend warrior horses who kind of rest all week and then go really hard for a couple of days over the weekend or horses who are consistently written on, you know, footing that is a bit too much impact, right? So, you know, harder footing or footing that's not as forgiving, like those kinds of things can put unreasonable loads on the vicular apparatus in addition to the rest of the horse's body as well. So, you know, giving them like the building box for success from that standpoint can really help alleviate that. If your horse does have vicular pain, there's a lot that we can do to help, to help address that. So, there's a lot we can do from a shoeing standpoint. So, whether it's a combination of a special type of shoe or a special type of pad or packing

44:08material or something that is going to unload the vicular apparatus, we've got, we actually, like with, you know, with our MRI capabilities, we have the ability to tell exactly what's going on with that vicular bone and it's associated soft issue structures, which really changes the game in terms of getting a complete diagnosis and being able to target, you know, the specific, the specific issue that's occurring. So, whether that's bone edema within the vicular bone, which can be quite painful or is it a deep visual flexor tendon issue, which, you know, requires a whole separate host of treatments. So, you know, if your horse has vicular pain, it is not the end of the world. I feel like it used to be, you know, kind of like, almost like taboo, like nobody wanted their horse to ever be diagnosed with any vicular pain, but there's really a lot we can do for it now. So, I think it's just getting a complete diagnosis and then

45:10figuring out, you know, where do we go from there? So, we have a few live questions about supplements. So, let's talk about those for a few minutes. Dr. Mansfield, Alice in Michigan says her 19 year old Arabian is not yet showing any clinical signs of arthritis. Should she start on a joint supplement anyway? So, it's never too early to institute some sort of care for your horse's joints, and I love that owners that are proactive about their horse's health. Now, there's a survey of owners in the U.S. and 84% of horses reported giving supplements to at least one horse and joint supplements were the most popular. You know, despite the high use of supplements, there's not a lot of scientific evidence that back there to back those products claims. And unfortunately, they're not regulated by the FDA, so they're not required to prove safe your efficacy. Also, there have been some independent lab analyses out there that reveal a lot of those products actually fall short of the labeled amounts of their active ingredients they have

46:10on the label. Now, navigating, equine oral joint supplements can be frustrating and super challenging, and there's a billion different supplements out there. And you can always talk to your vet about the supplements available. I think the vet has lost Dr. Mansfield for a minute. So, Dr. Trigger, do you want to jump in and talk a little bit about choosing a high quality joint supplement? Yeah, yeah. So, I think Dr. Mansfield set the stage perfectly, right? The Neutraceuticals are not FDA-regulated. It's the same in the human world, too. And so, you have to kind of look at joint supplements with kind of a critical lens. I think the best thing that you can do to choose a good joint supplement is to look for a product that has evidence-based research behind it. And so, that research is readily available

47:10to you through the manufacturer's website or through even social media platforms. But it will be there, and it's usually like on the front page, right? Because, you know, these manufacturers have, you know, we have this peer-reviewed research that states that, you know, ingredient that is in this joint supplement is actually efficacious. It's doing something that will benefit the horse. And, you know, I would be very wary of manufacturer claims, particularly for supplements that, you know, don't have any kind of evidence-based research behind them. And so, you know, components of joint supplements that we have, good evidence-based research behind include things like glucose and lean, conjoint and sulfate, hyaluronic acid,

48:13MSM, ASU. There's kind of a newer one out there that's getting a lot of attention in the joint supplement world called risk veritrol. It's kind of the new kit on the block, and there's very promising data coming from that. And so, the company is that that produce joint supplements with these ingredients in them will often have, you know, evidence-based research to back it. And I personally would feel safer giving my horse, you know, those versus something that, you know, sounds cool, maybe looks cool, but probably doesn't have a lot of a lot of research behind it yet. So, I would just, yeah, I mean, another thing too is like because it's not an FDA-regulated controlled thing, your quality control is sometimes a little scary too. And so, you know, just, I would just have a look at these joint supplements through critical lens. And if ever in doubt,

49:19you know, reach out to your veterinarian because we get questions about joint supplements all the time. And I can guarantee that you're that we'll have an opinion and we'll help you choose something that's best for your horse. In addition to what Dr. Trigger said, which are excellent points, I always want to make sure that the Manifizness Estabulous and Reputable Company always make sure there's study results and not just testimonials on their label, like not just people say it's great. Clear instructions on dosing. And another thing to look for just because now I work for a pharmaceutical company is if there's a lot number or something that identifies, so if you have a problem and you call into the company, they get that batch. And also a customer service number so you can reach out with questions or concerns on the product. And sorry, I think we could also probably talk about this for the whole hour, right? But the other thing to you is if you're competing your horse at a recognized events, there's a long list of

50:23ingredients that are prohibited, there are a long list of prohibited substances, some of which can be found in these supplements. And so, you know, just making sure that you're playing by, you know, playing ethically and making sure that, you know, your horses is not taking one of these substances is important too. And so, again, those reputable companies that Dr. Mansfield was referring to, like they should not steer you wrong, but, you know, some of the things we can get off of the shelf elsewhere, you could get burned a little bit by those. Dr. Trigger, we have a live question that seems like it's up your alley. It's from Cornelia, who wants to know about balance pads and if they can be used to develop muscles in our senior horses. Can you describe this a little bit? Yeah, absolutely. I love balance pads and so

51:24balance pads are these kind of rectangular or square pads that are made of different densities of materials. So, they're either, they can be quite squishy or they can be quite firm. And it's all about like challenging the horse to maintain their center of balance while standing on these pads. And by maintaining their center of balance, like the horse's center of balance is right behind their elbow. And so, in order to maintain their center of balance, they really have to engage their core and use core stability to avoid kind of trunkless sway and looking like they're kind of like wobbling a little like toxic on the pads. And so, they are fantastic tools for helping condition the core and then as well as the back and kind of just like helping to kind of sort of tune in that horse's proprioception and balance. The squishier the pad, the harder it is. So,

52:29like it's kind of just like, you know, us if we stand in an unstable surface, you really have to engage your core in order to keep your balance versus a stable, stable surface. And so, you know, these, you can make it easy for the horse by just putting, you know, one set of limbs or one limb on the pad or you can make it more challenging by having the horse stand on all four pads at once. And then you can make it even more challenging by asking them to do like carrot stretches while they're standing on the pads, like take their nose to their chest or their nose to their knees or their nose to their fat locks without letting them step off the pads. And so, you know, that, like it is hard work for the horse and a lot of horses take to it really well. Something you can incorporate, you know, during your grooming routine or tacking up or even while the horse is eating. You can, these pads are sold commercially. I've also seen people

53:34make their own pads too from various sort of foam materials as well. And we do have some peer reviewed research that shows that it just, you know, using these stability pads several times a week for 10 to 15 minutes at a time helps increase the cross-sectional area of the major stabilizing muscles in the back. So specifically the multifus, the multifus muscle, which is like the hot rehab muscle that we all love to talk about right now. So yeah, I'm a huge fan of those pads. And so I think, you know, it's one thing that you can easily incorporate into your horse's routine. Absolutely. We're coming to the end of our time tonight. So Dr. Mansfield, our last question is for you. It's from Teresa and Wisconsin who wants to know what it means when a horse

54:35is serviceably sound. Are these horses still happy in their work? Oh, that's an interesting question. So the term serviceably sound, we hear that a lot in practice. You know, it doesn't mean the horses are lame. It means a little something to anyone you ask honestly. To me, it sort of means the horse can still do the job that's being asked of them without any pain or suffering. You know, even if they have some minor blemishes or chronic conditions, or require some routine maintenance. Unlike a quote-unquote perfectly sound horse, a serviceably sound horse may have past injuries or age-related stiffness, but it's not lame or in pain during work. I think gosh, like serviceably sound like Dr. Mansfield was saying can mean it's hard to quantify. It can mean a lot of different things. Like to me, the serviceably sound horse is a horse that

55:40maybe is not doing quite the level of work or quite the job that maybe they used to, but they're still they still have like they still have some some go left at them, right? And so whether that is just doing walking trail rides or toting around like a little kid being like that great first like up downless and pony, you know, teaching teaching somebody how to canner for the first time, but meeting a little extra help in order to maintain their serviceably soundness status. You know, to me, that's that's kind of what that means. And I think that they're I think that there are very few horses that are ready for full retirement. I think I know I feel like I've seen a lot of horses change in their personality and their demeanor when they just stop doing a job. And so, you know, the serviceably sound horse, maybe they can only do something a couple times

56:44a week or a couple times a month, but I think, you know, keeping them keeping them moving, keeping them in motion and then paying close attention to, you know, are there specific parts of their body that need special attention, like their their joints, for example, or their muscle mass or or that kind of thing. You know, I think that that that to me is is sort of what encompasses like a serviceably sound horse. I, you know, there are certainly like there are certainly issues that will arise in horses that do that do kind of defer to full retirement. But I think that, you know, we've talked a lot tonight about all the tools in our toolkit for keeping those horses going long-term and, you know, it's it's a much bigger reality now for us and in our horse population. So that's all the time we have for tonight. Thank you, Dr. Traeger and Dr. Mansfield for joining me.

57:48Thank you. Thank you so much. Thank you to American Region Animal Health for sponsoring this event. And finally, thank you to our audience for listening and sending in these questions. If you're listening to us up to the live event as a podcast episode, please rate, review, subscribe, and recommend us the horse live to a friend. Until next time, from everyone at the horse, have a great night.