Important information for Owners, vets and practitioners. There has been a clarification regarding consent from vets for animal osteopaths, animal chiropractors and animal physiotherapists to treat animals. The update from RCVS can be found on their website here:
The following update has come from The Register of Animal Musculoskeletal Practitioners (RAMP) whose website can be found here.
RCVS Guidance clarification for MSK Practitioners. The following Guidance has been passed by the RCVS Standards Committee and will be circulated among the veterinary profession:
a) Musculoskeletal therapists are part of the vet-led team. Animals cared for or treated by musculoskeletal therapists must be registered with a veterinary surgeon. Musculoskeletal therapists carry out a range of manipulative therapies, including physiotherapy, osteopathy and chiropractic therapy.
b) As per the Veterinary Surgery (Exemptions) Order 2015, remedial treatment by ‘physiotherapy’ requires delegation by a veterinary surgeon who has first examined the animal. ‘Physiotherapy’ is interpreted as including all kinds of manipulative therapy. It therefore includes osteopathy and chiropractic but would not, for example, include acupuncture or aromatherapy. It is up to the professional judgment of the veterinary surgeon to determine whether and when a clinical examination should be repeated before musculoskeletal treatment is continued.
c) The delegating veterinary surgeon should ensure, before delegation, that they are confident that the musculoskeletal therapist is appropriately qualified and competent; indicators can include membership of a voluntary register with associated standards of education and conduct, supported by a disciplinary process. As the RCVS does not regulate musculoskeletal therapists it cannot recommend specific voluntary registers.
d) Musculoskeletal maintenance care for a healthy animal, for instance massage, does not require delegation by a veterinary surgeon. However, the animal must still be registered with a veterinary surgeon. Maintenance should cease and the owner of the animal should be asked to take their animal to a veterinary surgeon for clinical examination at the first sign that there may be any underlying injury, disease or pathology. Alternatively, the musculoskeletal therapist may ask the client for formal consent to disclose any concerns to the veterinary surgeon that has their animal under their care.
This has come about as a result of RAMP Council consultation with DEFRA and the RCVS around clarification for veterinary consent for Competition and Maintenance Care.
To reiterate, the only difference to current practice is in point d). An animal declared healthy by the owner, in cases where care is given to maintain good health and optimise competition performance, can be seen without specific Veterinary referral with the caveats stated. This covers the areas of Maintenance care and Competition care ONLY.
This clarification will ease the current legal grey area and hope it will improve communication between MSK Practitioners and the Veterinary Profession. ANY pathology must be reported back to the animals registered vet immediately.
This post is the last in this Laminitis series and looks at diagnosis, treatment, management and prevention of Laminitis
Diagnosing Laminitis
Laminitis is usually diagnosed using the clinical signs however x-rays may be taken to confirm whether there has been and rotation of the pedal (coffin) bone. Blood tests may also be undertaken to assess whether there is any underlying endocrine disease (1).
If you suspect your horse may have Laminitis, it is important to contact your vet as soon as possible (2) as laminitis should always be considered an emergency.
Treatment and Management of Laminitis
Horses will need to be treated by the vet as soon s possible. Pain relief is likely to be requried.
Horses should not be forced to walk if they are resistant as they are likely in a lot of pain and you may further damage the laminae (4).
Vets often will prescribe non-steroidal anti-inflammatory drugs (NSAIDs) e.g. Bute and potentially opiates e.g. Morphine. (1)
It is essential to work with your farrier/trimmer in order to support the foot and limit the rotation of the pedal bone. Corrective and supportive farriery/trimming should form a staple part of your management (5)
Soft/deep bedding will help to soften things for your horse, box rest may be highly beneficial (5)
Ice may help to cool the feet initially but do not continue this long term as this can cause problems (3)
Dietary changes are a must, poor quality hay and no (or minimal) concentrates are more beneficial. High roughage based foods which work the hindgut but are not high in water soluble carbohydrates. Do not ‘starve’ your pony unless under veterinary guidance as this can cause additional problems due to the predisposition of hyperlipaemia in obese ponies (3).
Treatment of any underlying endocrine disorder is fundamental
In serious cases of laminitis prognosis may be poor and euthanasia may be suggested by your vet in order to prevent further suffering (4)
Ensure your horse is in the least stressful position possible as stress can exacerbate the symptoms of laminitis, therefore ensure your horse is in an environment they are comfortable with and that they have company during their confinement. (2,3).
Preventing Laminitis
Prevention is always better than cure especially as laminitis can cause extreme pain, lameness, permanent damage to the hooves and can increase the risk of future episodes (1)
Regularly cooling your horse’s feet to help reduce inflammation in laminitis associated with inflammation.
Treatment of any underlying endocrine disorders and reducing water soluble carbohydrate sources.
The use of frog/sole supports in horses predisposed to laminitis associated with mechanical overload.
Regular exercise, gradual fitness programmes, consistency is the key, this helps with insulin regulation (4)
Maintain your horse’s weight at a sensible level (you will want to keep a regular eye on their weight using a weigh machine or weight tape and carry out regular hands-on body condition scoring).
Regularly check your horse’s feet for heat and their digital pulses
Watch your horse’s food intake. Recommendations are approximately 2% of the horse’s bodyweight per 24 hours. (never go below 1.5%)
Get your foodstuffs analysed (forage under 10-12% sugar content is safer)
Avoid rye grass hay or haylage as these increase the risk of laminitis
Restrict grass intake (this may be by strip grazing, wearing a grazing muzzle, using a track system etc.)
Don’t over-rug your horse during winter – allow them to shift some weight by working to keep warm.
Keep your shoeing/trimming appointments regular and under 8 week intervals.
Limit fast work on hard ground
Sometimes turning a horse out at night and bringing it in during the day can help as there are less water soluble carbohydrates in the grass at night.
Use a laminitis app to help you determine whether it is safe to turn your horse out.
If your horse has colic, is showing signs of severe diarrhoea or you mare has recently given birth and you are concerned she has retained her placenta – call the vet immediately (12 hours is too long) (2).
Watch out for the subtle signs of laminitis, catch it early!
The above TEDEd video helps us to understand how our dogs ‘see the world’
Dog’s don’t have the same vision as us, they don’t see the world the way we do. In fact their noses do a lot of the ‘seeing’ for them.
Their damp noses enable them to catch particles of smell on the breeze or on objects around them.
Did you know that they can smell individually with each nostril then enable them to determine the direction of the smell.
Dog’s noses have a separate areas for ‘smell’ which is different to the breathing channel, this allows them to focus some of the particles which ‘smell’ into this area where there are a high number of ‘olfactory receptors’ which register the odour and send it to the brain for processing.
Dogs have approximately 300 million of these olfactory receptors, compared to the 5 million we have as humans. (that’s 60 times more than us!).
Did you know that dogs exhale through slits at the side of their nose, rather than back out of the main channel through which they inhale, this allows them to continually inhale and build up the concentration of ‘smell particles’ by not pushing them back out as they exhale which is what humans do.
The olfactory system takes up much more room in a dog’s brain than it does in our brains, in fact up to 40 times more, which allows dogs to remember and differentiate many more smells than us, even if the concentration of the odour up to 100 million times less than we can even detect.
Every thing around dogs will have a unique smell; people, trees, rubbish bins, birds, insects etc. each will have an individual smell and also the dog will be able to tell which direction it is going in.
Dogs have a second olfactory system called the vomeronasal organ, it sits just above the roof of the mouth and enables them to detect hormones being released by animals (including us). It helps them to detect friendly or hostile animals and they can also ‘read’ our emotional state.
Dogs can smell things that were there in the past not just in the now they can recreate a ‘story’ through their noses.
We’ve all watched our dogs as they undertake the process of “doggie peemail”, sending messages to each other on structures such as trees and lamp posts. This really is how dogs share messages, emotions and understand what is happening in the world.
We need to remember that whatever state we are in, the dog will be able to smell this and they will react accordingly.
Stressed? Your dog will know. Sad? your dog will have read this and may well ‘comfort’ you.
With training, they are able to detect smells that we could never imagine to, which is how dogs can detect cancer, drugs, landmines etc.
So the next time your dog is wanting to stop and sniff, remember that to your dog this is their life line, their sight, their understanding, it is what brings life and colour to their world and just stop and let them tap into their olfactory abilities and understand what is going on in the world around them, a world beyond our eyes that we can only dream to experience.
This post looks at the term laminitis and the causes and clinical signs the next post will look at diagnosis,treatment and management and prevention
What is Laminitis?
Laminitis is inflammation of the laminae of the foot.
The Laminae is the soft tissue structure attaching the pedal (coffin) bone to the hoof wall.
During laminitis, the blood flow to the laminae is affected, leading to inflammation, swelling and severe pain in the hoof. This ischaemic event causes the cells to become damaged and the laminae to die unless immediate intervention is undertaken. The death of the laminae leads to the pedal bone becoming unstable and if things go untreated, it can separate from the hoof wall and rotate within the capsule. If the pedal bone rotates too far it may protrude from the sole of the foot. In severe cases, this can lead to horses having to be euthanised.
Laminitis cannot be cured but it can be managed so prevention is the key to your horse living a long and happy life.
Causes of Laminitis
Whilst the exact process that leads to laminitis is unclear, there is an understanding that laminitis can arise in three general situations (1):
1) Diseases associated with inflammation – during these, inflammatory processes within the body are thought to lead to lamellar inflammation and trigger a failure of the adhesion between cells leading to laminitis e.g. certain types of colic, diarrhoea, retained placenta, severe pneumonia
2) Endocrine (hormone) disease – during these situations, it is thought to be the hormone Insulin which is of high importance e.g. Equine Cushing’s disease (pituitary pars intermedia dysfunction; PPID), equine, metabolic syndrome, excessive pasture consumption
3) Mechanical overload (supporting limb laminitis; SLL) – during mechanical overload situations, it is thought that in the leg undergoing excessive and continuous weight-bearing, blood supply to the lamellar tissue becomes inadequate. e.g. associated with a fracture or infected joint the other leg which is bearing all of the weight is at risk of laminitis
Over feeding (grass and concentrates) (especially already overweight ponies) is one of the most common causes. especially in spring and autumn when daylight hours are lower but rain levels mean that the the soluble carbohydrate content in grasses and clovers is increased and when ingested, this causes metabolic changes that result in altered blood flow to the laminae of the foot.
Clinical signs of Laminitis
Acute:
Lameness affecting most commonly at least two limbs (most commonly the forelimbs are affected and more severely but all 4 can be)
The horse leans back onto its heels and is reluctant to move
The lameness is worse when the horse walks on hard ground or turns
Shifting weight between feet when resting
Increased digital pulses in the fetlock area (strong, rapid)
Laying down more to offload the hooves
Difficulty picking up a foot (as loads the other hoof to much)
Pain with use of hoof testers at the point of frog on the foot or the toe
Warm hoof wall/ coronet
Changes in behaviour/temperament
Chronic
structural changes:
Laminitic “rings” on the surface of affected hooves corresponding to previous episodes of laminitis
The hoof wall takes on a dish/slipper shape with long toes
A bulge in the sole of the hoof where the pedal bone has rotated
Restricted forelimb movement with increased weight-bearing on the hindlimbs in a ‘table-top’ or ‘laminitic’ stance. (4)
This post introduces you to the topic of Equine Laminits. Over the next couple of blog posts, we shall look more closely at its, causes, clinical signs, diagnostics and treatment.
Did you know that 1 in 10 horses/ponies develop Laminitis each year and that 45% of owners do not recognise their horse’s symptoms as Laminitis (1)
These stark figures provided by animal health trust suggest the difficulty owners have with Laminitis and how easily it can become a more serious situation.
Once a horse or pony has had laminitis once, they are at greater risk of getting it again.
The most common clinical signs reported by vets and owners are linked with changes in gait and stance, including a stilted/pottery or lame walk. However once these signs have been seen, suggesting pain in the feet, damage to the foot has already taken place which can lead to permanent changes in the feet. Therefore prevention really is vital to helping to stop the manifestation of these effects. (1)
Often owners report that they mistook Laminitis for general lameness, a foot abscess, colic or joint / muscle stiffness before Veterinary diagnosis takes place
The Royal Veterinary College (RVC) has been working with Anglia Ruskin University and equine feed companies Spillers and Waltham to seek to investigate horse carers’ current knowledge of laminitis to understand factors influencing what horse carers’ do to prevent and manage the condition and to understand the decision making process surrounding caring for horses, to improve equine welfare (2)
A recent study by the RVC, Animal Health Trust (AHT) and Rossdales Equine Hospital, found horses and ponies that gain weight are more than twice as likely to develop laminitis than if they lose or maintain their weight and revealed that the groups particularly at risk of contracting laminitis were native pony breeds and their crosses, as well as horses and ponies with a history of laminitis and those with lameness or soreness after routine hoof care (3), Researchers found a high risk of laminitis present in horses shod/trimmed at greater than 8 week intervals with these individuals also taking longer to return to soundness post laminitis.
Other findings included that diet, grazing management and health were factors closely associated with the development of laminitis and that weight gain often occurred unintentionally even when owners were aiming for weight maintenance or loss in their animals, highlighting the importance of keeping a regular check on your horse’s weight.
I have been working with Olivia Turner B.Sc Hons, Animal Behaviour Consultant & Equine Bitting Specialist since 2015, where has the time gone? Our discussions are always interesting and it’s worth having a read of her guest post on Dr David Marlin’s FB page. As with everything it is how things are used and the ability of the person on the end of the leadrope that is key. It is so very easy to train the wrong behaviour into your horse or dog without realising it due to just a minute delay in response time from you. Ensure you stay well informed and well prepared. Seek a professional to assist you and regularly review your timing. Olivia teaches for us at Animal Osteopathy International, find more about us and our courses at Animal Osteopathy International or online at www.animalosteopathyinternational.com
Here is her post below:
TRAINING HEADCOLLARS AND THEIR EFFECT ON HORSE BEHAVIOUR – OLIVIA TURNER
Handling issues are very common in the horse world and there are many gadgets and training aids available which claim to fix the problem, but what effect do these have on equine emotional state and behaviour? The gadgets utilise pressure, the more pressure you apply, the more uncomfortable it becomes for the horse. The goal being that the pressure motivates the horse to perform the right behaviour, then the handler releases that pressure.
This method of pressure and release is called negative reinforcement. A stimulus is removed to increase the performance of a behaviour, e.g. applying pressure on a headcollar (HC) for a horse to stop, then releasing the pressure the second the horse stops. The horse will learn on the release of that pressure, so if your timing isn’t accurate the horse will find it harder to learn what you intend it to. Techniques (such as pressure and release) are only deemed ethical if they are proportionate to the desired response, are predictable for the horse and are released immediately upon the correct response (McLean and McGreevy, 2010). The context of the situation is very important when we’re thinking about using aversive stimuli. In a fearful situation what we really want is for the horse to relax, listen and learn something positive about what’s frightening them. Applying increasing amounts of pressure that is magnified by a training HC might get the job done, but at what cost to the emotional welfare of your horse? If you’re frightened and someone puts pressure on you, what’s your first response and how does it make you feel?
There is a level where pressure becomes a punisher and it’s something I see a lot of when watching people train in training HC’s. The horse doesn’t offer the right behaviour, so they ramp up the pressure very quickly or hold it for a longer duration. What they fail to notice are the early indicators given by the horse that it wasn’t coping in that situation. Now the pressure has been escalated and they’ve made the horse feel worse about what’s going on, rather than teaching it the desired response in a more ethical way. So, the horse might perform the desired behaviour, but is experiencing emotional conflict, stress and discomfort while doing so. For example: your horse is frightened of the trailer, forcing it on by increasing aversive pressure will eventually work. However, you haven’t made the experience positive or enjoyable. Your horse is ‘behaving’ as a result of active punishment and discomfort, not because it’s truly happy at walking onto the trailer.
There are a number of training HC’s on the market, perhaps the most common is the Dually Headcollar, designed by Monty Roberts. This magnifies the pressure a handler can apply in a normal headcollar and concentrates it on the nose and subsequently will create some poll pressure. Research by Iijichi et al, 2018 looked at the effects on compliance, discomfort and stress in naïve horses trained with a Dually and a normal HC in 2 novel handling tests. Their results showed that the Dually didn’t increase compliance compared to a standard HC and it caused an increase in discomfort as measured by the Horse Grimace Scale (HGS).
Other similar HC’s on the market are the Ezy Loader, the Eskadron Control Headcollar and the Be Nice Halter. All give the handler a mechanical advantage and apply escalating pressure to the horse. Research has already proven that high pressures on the nose and poll caused by tight bridles and nosebands increase stress, handler avoidance, tissue damage and head shyness (Doherty et al, 2016; Fenner et al, 2016; Hockenhull and Creighton, 2013 and McGreevy et al, 2012). All things we want to avoid when teaching horses to be safe and relaxed when being handled by us on the ground. It would be interesting to see what pressures on the facial tissues are actually being exerted by these HC’s and to assess the consequences on equine emotional state and welfare.
Once we understand why a horse isn’t doing a behaviour that we want, we can see things from their perspective and know which area of training needs more practice. All horses are individuals and will respond differently to various training methods, just make sure your timing is correct and you’re rewarding your horse for the behaviours you want!
TAKE HOME POINTS * Increasing aversive pressure will only increase discomfort, stress, fear and pain. You might get the behaviour you want, but your horse was in a negative emotional state and therefore won’t have made a positive memory at performing that behaviour. * Identify why your horse won’t do something and focus on re-training the behaviours needed to do it. * Aim to train your horse to respond to a light aid and proof that behavioural response by practising it in a variety of situations. * Make sure your timing is accurate and reward the ‘try’ if your horse is struggling. * Be predictable for your horse and make it easy for them to get the answer right. * If your horse is struggling with something scary like trailer loading, then be realistic with what they can manage in any one session. That competition you’ve got planned might need to wait! * Don’t rush anything, be relaxed and go at the pace your horse is comfortable with. * Interested in scoring equine facial expressions for yourself? Then download the HGS app: https://awin-project-hgs.en.aptoide.com/
References: Docherty, O., Casey, V., Arkins, S., 2016. An investigation into noseband tightness levels on competition horses. Journal of Veterinary Behaviour. 15,pp.78-95. Fenner, K., Yoon, S., White, P., Starling, M., McGreevy, P., 2016. The Effect of Noseband Tightening on Horses’ Behaviour, Eye Temperature, and Cardiac Responses. PLoS ONE. 1:5,pp. 1-20. Hockenhull, J. and Creighton, E., 2013. Training horses: Positive reinforcement, positive punishment, and ridden behaviour problems. Journal of Veterinary Behaviour. 8,pp. 245-252. Iijchi, C., Tunstall, S., Putt, E., Squibb, K., 2018. Dually Noted: The effects of a pressure headcollar on compliance, discomfort and stress in horses during handling. Applied Animal Behaviour Science. 205,pp.68-73. McGreevy, P., Warren-Smith, A., Gruisard, Y., 2012. The effect of double bridles and jaw-clamping crank nosebands on temperature of eyes and facial skin of horses. Journal of Veterinary Behaviour. 7, pp. 142-148. McLean, A., McGreevy, P., 2010. Ethical equitation: Capping the price horses pay for human glory. Journal of Veterinary Behaviour. 5,pp. 203-209.
Often linked with Autumn and Winter when horses eat the seeds that have fallen onto their pasture, did you know that Atypical myopathy is also prevalent in Spring due to horses eating the germinating seedlings.
Seeds and seedlings contain the toxin hypoglycin A (HGA) which slows or stops energy production in muscle and heart
Make sure you look for these during your field checks and remove any seedlings coming up.
Keep a look out in your horse for the clinical signs:
General weakness : horses struggle to walk, stand and breathe
Many horses develop heart problems.
Horses appear depressed with low hanging heads
Muscle trembling
Signs of severe colic – yet, unlike colic, they still have an appetite
Brown or dark red urine
Severely affected horses become unable to stand
Atypical Myopathy can be fatal so do not delay contacting your vet if you see any of these signs.
For more information click on the link below for a great fact sheet from the RVC
Did you know that the French bulldog is now the UK’s most popular breed.
In their study titled ‘Great expectations, inconvenient truths, and the paradoxes of the dog-owner relationship for owners of brachycephalic dogs.’ in 2019, Packer RMA; O’Neill DG; Fletcher F; Farnworth MJ from the RVC looked at owners of short-muzzled dogs. They revealed the close bonds between them and their pets, especially between pugs and their owners, female owners and their dogs or owners without children in the home.
However, worryingly, the academics found that while one fifth of short muzzled dogs in the study had undergone at least one corrective surgery, only 6.8% of owners consider their dog to be less healthy than average for their breed.
The most common health issues relating to their body shape .Other common diagnoses amongst these breeds included allergies (27%); corneal ulcers (15.4%); skin fold infections (15%) and airway obstruction (11.8%). Owners were to some extent aware of such health problems in their own dog, with 17.9% reporting breathing problems and 36.5% reporting overheating. Yet, 70.9% of owners still considered their dog to be in ‘very good health’ or ‘the best health possible.’
For more information visit the RVC article by clicking on the link below.
RVC have been working in collaboration with other universities to discover more accurate techniques for understanding joint behaviour in osteoarthritis. As an Animal Osteopath, I often work with dogs/horses who have this condition. Treatment, home management and rehabilitation can greatly improve quality of life in these cases.
They state: “Osteoarthritis is a condition that causes joints to become painful and stiff. Joints respond to and absorb loads over a wide range of scales over a lifetime by deforming or straining our soft tissue and bone structures. The level of deformation or strain is measured on the nanometre scale within structures such as collagen fibres, on the micron scale in chondrocytes, and the macroscale in bones. Previously these strains have only been measured at the sub-millimetre scale in whole joints during loading. This latest work measured these strains with an accuracy of better than 100 nanometres – more than 1,000 times more precisely – in mouse knee joints at different stages during the onset of osteoarthritis.”
To read more about what the RVC have been up to click on the link below
New Forest Animal Osteopathy 
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