Care of the Geriatric Horse

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1 Care of the Geriatric Horse Scott M. Austin, DVM, MS Clinical Assistant Professor Define Geriatric! Greater than 16 years old In an owner survey, average age considered old was 22 years. Geriatric Horses 15% of horse population Shift to companion animals Improved health care Dewormers Nutrition Dental care 1

2 The Aging Horse Gradual, irreversible changes 70% of geriatric horses have some age-associated problem that requires special care Owner Survey of Geriatric Problems Muscle loss Weight loss Change in hair shedding Problems eating Lameness Hoof problems Reduced exercise capacity Weakening of Collagen Sagging skin Slack lower lip Hollow appearance of face Muscle degeneration Sagging of topline 2

3 The Aging Horse Graying of face Cataracts Decline of immune system Exercise tolerance Reduced aerobic exercise capacity Decreased muscle mass Reduced heat tolerance Blue -gray lens Cataracts Ground glass appearance 3

4 Management of Geriatric Horses Recognition of problems Aging change vs. medical problem Adjust routine preventative care Preservation of performance Quality of life Rarely can cure Manage problems COMMON MEDICAL PROBLEMS Body weight Dental Abnormalities Gastrointestinal problems Musculoskeletal problems Respiratory disease Endocrine abnormalities and neoplasia Body Condition Body condition in older horses Should remain in this range BCS: 4 = moderately thin Changes in body shape with Age may make scoring harder BCS: 5 = Ideal BCS: 6 = moderately fleshy 4

5 From Tribute Nutrition From Tribute Nutrition 5

6 OBESITY Expectations Feeding grain Lush pastures Feeding too much forage Lack of winter weight loss Sedentary lifestyle Overfeeding Consequences of Obesity Exercise intolerance Strain on musculoskeletal system Fat cells are metabolically active Increased activity of steroids Increase inflammation Increase clotting Constrict vessels Insulin resistance 6

7 Obesity Equine Metabolic Syndrome Insulin resistance Normal dexamethasone suppression test Active or subclinical laminitis Weight Loss is a greater problem in older horses BCS: 3 = thin Under-feeding Protein-calorie malnutrition Dental problems Loss of appetite Increased nutrient requirements Nutrient loss Management or social dynamics within the herd Encysted Small Strongyles 7

8 Feeding the Geriatric Horse Palatability Easy to chew Improved digestibility Maintain normal intestinal flora Decrease competition at feeding time Dental health Do Not Forget Water Intake Water intake in geriatric horses may be decreased Decreased thirst perception Oral pain due to underlying dental disease Consequences Low grade dehydration Reduced exercise tolerance Renal dysfunction Impaction colic or choke Water accessible Heated source? Dental Health of Older Horses Teeth erupt continuously Check twice yearly Bad teeth contribute to disease Weight loss Choke Colic 8

9 Dysphagia Signs of Dental Disease Dribbling or dropping feed Quidding Packing feed in mouth or teeth Pain when chewing Halitosis, mal-odor Enamel Points Upper jaw wider Upper teeth - outside edge Lower teeth - inner edge Wave Mouth Accentuated undulating pattern Some teeth too long Others ground to gum line 9

10 Step Mouth An abrupt change in the height of one tooth Opposing tooth missing or malpositioned Shear Mouth Accentuation of normal oblique occlusal surface Ground to gum level on inside edge of uppers and outside edge of lowers Limits side to side motion of the jaw Treatment of Abnormal Wear Cut off overly long molars or hooks Rasp off points with dental rasp Powerfloat or Dremel 10

11 Parrot Mouth Overbite, Inferior brachygnathism May cause hook formation Hooks First upper Last lower May be painful Rx - Cut off hooks and rasp teeth Parrot Mouth Sow Mouth Under bite, Monkey mouth, inferior prognathism Uncommon Hooks Last upper First lower 11

12 Abnormal Incisor Wear Tooth Abscess Unilateral nasal discharge Swelling Draining tracts Periodontal Disease 12

13 Choke Choke Colic 13

14 Enteroliths Musculoskeletal Problems A major reason for veterinary evaluation and for reduced athletic capacity in geriatric horses Predisposing causes Cumulative wear-and-tear Athletic history Cartilage degeneration Concurrent disease (PPID) Musculoskeletal Problems Common conditions Osteoarthritis Laminitis Hoof-related problems Tendon injury Common clinical signs Lameness Stiffness Reduced range of motion Difficulty standing 14

15 High Ringbone Spavin Arthritic Mare 15

16 Flexion Tests Annular Ligament Constriction Suspensory Degeneration Dropped fetlock Straight hocks Lameness 16

17 Arthritis Proper foot care Extra bedding Control of weight Controlled exercise Feed supplements Injectable products Feed Supplements Chondroitin sulfate Glucosamine MSM Injectable Products Sodium hyaluronate Polysulfated glycosaminoglycans Glucosamine 17

18 Decline of the Immune System Increased susceptibility to disease Increase in occurrence of allergic diseases Culicoides hypersensitivity Recurrent airway disease Culicoides Hypersensitivity Culicoides Hypersensitivity 18

19 Recurrent Airway Obstruction C.O.P.D. Heaves Broken Wind Emphysema Chronic Bronchiolitis Equine Asthma Causes of Recurrent Airway Obstruction Small airway disease Allergic hypersensitivity Molds Dust Straw Hay Viral Genetic? 19

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21 Risk Factors of RAO Middle aged to older Stabled, seasonal Exposure to dust and molds Previous viral respiratory disease Intermittent, progressing to continuous CLINICAL SIGNS OF RAO Exercise intolerance Increased expiratory effort Biphasic respiratory effort Dyspnea Coughing associated with feeding and exercise Heave line Heave Line 21

22 CLINICAL SIGNS Wheezes and crackles +/- mucoid nasal discharge No fever DIAGNOSIS OF RAO ENDOSCOPY DIAGNOSIS OF RAO ENDOSCOPY COPD Normal 22

23 RAO THERAPY THREE GOALS Optimize environment Clear airways (mucus and debris) Decrease inflammatory response Therapeutic efforts are nearly always unsuccessful unless to horse s environment is altered and exposure to offending allergens is eliminated. MANAGEMENT Turn horse out to pasture Improve stable ventilation Change bedding Adjust diet 23

24 Medical Treatment Broncodilators Oral corticosteroids Expectorants Antihistamines Inhalation therapy Drug Therapy INHALATION THERAPY Direct delivery to site of problem Minimizes side-effects Aero Mask or metered-dose inhalers Anticholinergic Agents ß 2 Adrenergic Agonists Mast Cell Stabilizers Corticosteroids 24

25 Flexineb Heart murmurs Aortic Mitral Cardiovascular 25

26 Management of the Geriatric Horse Diet Pain management Preventative care Teeth Farrier Vaccination Deworming Quality of life Pierre, age 33 Physical activity & exercise Environmental and medical management Seasonal changes in management Questions????? 26