special considerations for the senior horse · ppid horses. 36% are ir. •equine metabolic...
TRANSCRIPT
Special Considerations for the Senior Horse
Ocean State Equine Associates
What is a “Senior” Horse? • 15 years to 20 years?
• 20 year old horse = 57 year old person
• 25 year old horse = 71 year old person
• 1 horse year = 2.85 human years
• “Seem” to be living longer
• Ponies live longer (>30 years). Why? – Part of world they came from?
– Smaller size?
– Physiological differences – better wound healing
Long Duration of Life
• Enhanced bond with owners
• Older horses can live very healthy lives into their 30’s, sometimes early 40’s.
• Address problems as soon as they are recognized.
• Quality of Life - Vet plays a role with owner.
• Biannual Geriatric Assessments to identify correctable problems
Biannual Geriatric Assessments
• Thorough Physical Exam • Body Condition Scoring (BCS) • Oral/Dental Examination • Fecal Examination – parasites, presence of long hay fibers or whole grain in manure • Hair coat abnormalities • Respiratory evaluation • Musculoskeletal stiffness or lameness • Ophthalmic abnormalities • Cardiac murmurs • Blood work for CBC, chemistry profile, ACTH and insulin
levels
Dental Care for Seniors
• Changes in dental anatomy with age = reduction in reserve crown and occlusal enamel, finite tooth length
• Goals = ensure oral comfort & maximize chewing ability
• Signs : – Quidding feed “making hay
or grass balls”
– Losing weight/topline musculature
– Finding long fibers in manure
Dental Care for Seniors
• Short remaining reserve crown meals achieving major changes is not possible.
• Missing teeth • Overgrown teeth • Wave mouth • Smooth mouth • Fractured or displaced teeth • Loose teeth • Diastemata • Periodontal disease • Sinus infections
Decreased enamel thickness as the teeth wear results in weaker
teeth.
Equine odontoclastic tooth resoprtion and hypercementosis
(EOTRH) : Progressive inflammatory
disease of incisors and canines
Senile Diastemata (spaces): As teeth age, they narrow toward the root, reducing
contact between teeth.
Specialized Diets for Seniors
• Fresh pasture • Chopped forages - denji,
totally timothy, hay cubes, (caution with diastemata)
• Pelleted forages – high quality complete Equine Senior diets
• Fiber fillers – hay stretcher, beet pulp, hay pellets
• Additional fat calories in the form of oil instead of carbohydrates
Ebby Gladys Jaynes August 2012
Ebby Gladys Jaynes October 2012
Pituitary Pars Intermedia Dysfunction (PPID) aka “Cushing’s Disease”
• Associated with old age • Most common endocrine disease • 10-25% of horses >20 yrs have PPID (avg. age 20 yrs, youngest 7 yrs) • Signs:
– Long, sometimes curly coat – Laminitis – Excessive sweating – Excessive drinking and urination – Muscle wasting – Increased susceptibility to infections – Blindness or seizures (rare)
PPID - Diagnosis • ACTH (with insulin and glucose levels -
overnight fast prior to test)
– Seasonal variations
– Nov. to July < 35 pg/ml
– Aug. to Oct. <47 pg/ml ** Now a BETTER time to test, esp. for borderline patient
• Overnight Dexamethasone Suppression Test
• TRH (Thyrotropin-Releasing Hormone) Stimulation Test
PPID and Insulin Resistance • Insulin is often higher in
PPID horses. 36% are IR. • Equine Metabolic Syndrome
(EMS) = regional adiposity (fat), IR and laminitis
• EMS affects all ages. • IR increases probability of
laminitis in PPID horses. • Therefore, PPID horses
should be fed a diet low in non-structural carbohydrates (NSC’s) and get regular exercise.
Treatment of PPID
• Pergolide (Prascend) = USDA approved drug
• Recheck ACTH 30 days later and adjust dose as needed.
• Whole body clipping
• Aggressive treatment of injuries or infections
• Good dental prophylaxis
• More frequent fecal monitoring
Respiratory Problems in Seniors
• Recurrent Airway Obstruction (RAO) – not restricted to older horses, but age is a risk factor.
• Inflammatory airway disease similar to asthma
• Signs – Increased respiratory rate
and effort – Cough – Development of a “heave
line” – Exercise intolerance – Crackles and wheezes on
auscultation
Recurrent Airway Obstruction
• Treatment = decrease inflammation and open airways
– Environmental reduction of allergens
– 24 hour turn out
– Elimination of hay from diet
– Oral or inhaled medications
– Anti-inflammatories (steroids)
– Bronchodilators
Musculoskeletal Disorders
• 37% laminitis (related to PPID)
• 55% degenerative joint or soft tissue disease
• Earlier life injuries lead to degenerative changes – loss of shock absorption due to chronic inflammatory changes in synovial fluid, cartilage defects
• Progressive degenerative suspensory ligaments in hind limbs – straight hocks, progressive sinking of fetlocks
Management of Chronic Orthopedic Issues
• Long term medications – NSAID’s (Bute, Equioxx/Previcoxx, Surpass)
• Chondroprotective agents – Legend, Adequan
• Increase mobility – avoid stall rest
• If still in work, may alter training program. Continuous low level work is the best.
• Acupuncture, chiropractic & massage may be helpful
Ophthalmic Care for Seniors
• Senile cataracts – increased lens opacity, relatively common in older horses, usually slowly progressive, bilateral
• Senile retinopathy- very common condition in seniors, causes visual impairment, bilateral
Cardiac Problems in Seniors
• Not common
• More frequent in seniors
• 2-3% of horses >20 years will develop a murmur – (holodiastolic murmur from aortic insufficiency)
• Most do not have a performance problem.
Colic in Seniors
• Large colon impactions
• Small intestinal lesions (44% are strangulating lipomas)
• Colic surgery in seniors? – Humane considerations
– Emotional
– Financial
– Survival was based more on nature of colic signs than anesthetic risk.
Neoplasia in Seniors
• Cancer in general horse population = 1-3% incidence
• 10% in seniors (including pituitary adenomas and lipomas jumps to 27%)
• Squamous cell carcinoma of the eye and external genitalia is most common type.
• Melanomas (80% of older gray horses)
• Lymphosarcomas
When is it right to say goodbye?
• “Old age” is most frequent reason for euthanasia in horses >30 years.
• “Hopeless” prognosis, veterinary advice, poor quality of life
• Sometimes a very obvious choice, but often times, the most difficult decision you will ever face
Humane Euthanasia
• Horse is often sedated first.
• An overdose of a barbiturate (pentobarbital) drug is given intravenously to stop the animal’s heart and breathing.
• 100% painless, much like being put under anesthesia.
• Horse will go down (if not already down) and may breathe, vocalize or have small muscle movements for 30 seconds to 1 minute after injection.
Burial & Cremation
• Burial on private property • Renderers • Burial or cremation services
– Angel View Pet Cemetery in Middleboro, MA – Final Gift Pet Cremation Services in Cranston, RI
Shayne at age 51