Talking with Dr. Heather Mack

Q: Several times a year my horse gets fairly swollen through his jowl area. This typically happens in the spring and fall. I had the vet out once to ensure it was not strangles, but he did not know what it could be. It never seems to be more than a bit uncomfortable for him, but it is definitely unsightly. Every time anyone at the barn sees it they cry “strangles” and won’t come near him. Any ideas?

A: The first two things I would consider are the possibility that a) this is your horse’s immune system reacting to spring and fall vaccinations, or b) this is a seasonal allergic reaction. Take a closer look at the timing of it. This is a difficult question for me to narrow down without a physical exam. Is it localized or general swelling? If localized, is it salivary glands or lymph nodes? Does the horse run a fever with the swelling? Is it related to a certain pasture or feed or cutting of hay, or seasonal weeds? True holistic care requires you to be aware of all these things, be proactive in your process of discovery, and see if you can figure it out. The goal is to find the root cause, eliminate it, and then move forward in perpetual good health — both mentally and physically. It cannot feel good to you or your horse when folks run away from him as if he has the “plague”. You can share your observations with your vet who will be able to help narrow down the possibilities. I think you need some blood work to help determine if it is an immune or allergic response. If you want an absolute diagnosis and the swelling is localized, your vet can do a fine needle aspirate. Swelling means inflammation, and this can create more free radicals and a slow drain on your horse’s vitality. So I suggest you gather your observations and look for a holistic minded veterinarian. In the meantime, why not put him on some immune stimulating herbs, and be sure his nutrition is solid. I would also have your vet or equine dentist look at his head/skull, and palpate the hyoid bones and TMJ (temporo-mandibular joint), as well as the distance between his atlas and the ramus of the mandible. I often see horses with limited space for all the soft tissues in this area, and they have a chronic hard unreactive swelling, usually in the salivary glands.

Q: My paint mare gets very bloated on a regular basis. She is a very easy keeper, so is kept in a dry paddock with rationed good quality hay and a vitamin/mineral supplement. The bloating does not seem to be in a pattern with her heat cycles. For the most part she will just appear to be quite fat, but some days she is visibly uncomfortable. Is there anything I can do to help keep her from bloating up?

A: Keep in mind that most of the protein and soluble carbohydrates in a horse’s feed is broken down in the stomach and small intestine. The remainder is broken down in the hindgut with liquids, leftover fats, cellulose and other fibrous feed bits. The cell walls of plants are composed primarily of cellulose, and horses (being grass eaters) rely on special microbes in the large intestine and cecum to digest cellulose through fermentation. True bloat is an accumulation of gas in the hindgut, and usually causes a great deal of pain and colic symptoms. If your mare is an easy keeper then she probably does not need any grains, but only hay and access to salt and minerals to stay healthy. Alfalfa is not recommended as it creates more fermentation and gas, and your mare is already sluggish in the hindgut. I suggest orchard grass or meadow grass hay only, three to four times daily instead of twice daily, as horses have a relatively small stomach and do better eating small amounts more frequently. Some horses also eat too fast and dividing up the feedings or using a device called a Grazer solves the whole problem. The Grazer is a spring-loaded cage that you put the hay in. The horse has to work at getting the hay out, and it slows him down significantly. Also, I would add probiotics to her nutritional program. I Like ABC’s (Advanced Biological Concepts) Pro-Bi — it is a highly palatable liquid that can easily be dosed orally, perhaps twice daily. I would also try giving her access to free choice salts and minerals, including Izmine from Dynamite. In addition, I would rule out parasites with a fecal exam. If this does not balance her I would suggest a thorough physical exam by your veterinarian, including a rectal exam and blood work. This mare could be pre-Cushing’s, on the verge of “metabolic syndrome”, or she may have a lipoma (a fatty tumor in the abdomen that intermittently constricts the large colon, and may cause the backup of gas). These are just a few of many differential diagnoses that come to mind, so I would rule them out first.

Q: My gelding had a fairly significant injury to his lower leg a few months ago, and now that it has healed up we are fighting proud flesh. What are some good ways to get rid of proud flesh?

A: If the proud flesh has proliferated above the skin line, have it surgically trimmed back flush with the skin by your veterinarian. Be sure the hair around it is trimmed also, because the hairs can hinder the skin’s repair mechanism. I have a ranch in Idaho where our horses can be out on hundreds of acres with stumps, trees, rocks, wire, cliffs, shale slides, etc. I am now an expert in lower leg wounds! I have saved, and still enjoy riding, a horse that my board certified colleague wanted to euthanize.

Here is what I have learned:

1) Leg wounds need diligent attention, energy, and care. You can’t just put a bandage on for three or four days with a dressing and think it’s going to heal. Find out what modalities feel good in your hands and work on increasing both circulation and the body’s attention to the wound. The reason proud flesh occurs more on the lower leg is because there is no underlying muscle, and therefore less circulation to carry neutophils, macrophages, and other constituents that help heal and clean up waste. However, there is still circulation in the surrounding tissue of blood, lymph and nerves. Put your healing intention there first and foremost. When you look at the wound, don’t envision how bad it looks. Look with admiration on the body as a whole, and how well it is working on repairing itself. When you wash it, use intention and gentleness in your touch. Perhaps run a hose around it to do some hydrotherapy on the local tissues. I also use lasers, infrared, and micro current on leg wounds. Many of these machines can be leased or rented for a short term.

2) Horses have an innate healing mechanism. Chances are the wound is going to heal; the question is, how well. You want to decrease scar tissue and adhesions to allow optimum function of the leg. Make sure the horse has: –    Free choice salt and minerals. –    Enough nutrition to give him the energy to heal, but not so much to get him too high. –    Herbs to increase circulation to the lower extremities and bolster the immune system.

3) Healing occurs in stages. The proud flesh usually occurs at the end stage. You have obviously made it past the acute initial stage. If you used antibiotics, put him on some good probiotics to be sure his GI flora is balanced. In terms of oral supplementation, I like #12 (to increase circulation to the extremities) and #24 (to strengthen the immune system) from Silver Lining Herbs. I have also had luck with homoepathic Silcea and Traumeel. Topically, I have tried many different salves, mixtures, powders, washes, and dressings. If you get the proud flesh trimmed back, the epithelial cells will start to grow toward the center. There will be a lot of blood but that brings new energy and nutrients to the epithelial margin. Wash it with a mixture of calendula mother tincture, tea tree oil and aloe vera gel in warm water. The wound then needs a good pressure bandage. I alternate my dressings from various herbal ointments and Traumeel cream with colloidal silver concoctions, to a mixture of cortisone ointment and Novalsan antibacterial cream. I find using the topical steroids after the trimming helps prevent re-growth of proud flesh. I put a no-stick pad up against the wound with ample dressing on it — you want to keep the wound moist to encourage the cells to grow. Fresh air and sunlight also help, so when I change the bandage, at least every other day, I allow for some breathing time. After awhile, the wound will stop swelling and you’ll see healthy skin – you can stop bandaging at this point. Continue with topical salves, such as Dynamite’s Wound Balm. I love to alternate the salves with essential oil mixtures like cypress, lavender, tsuga, and tea tree in carrier oil. I massage it into the surrounding tissues, with a mind to break down any fascial adhesions that may have occurred when the body was laying down scar tissue. All of this requires diligence and timing. It is a bit of a dance – you will be surprised how quickly you learn the steps the more you trust your intuition. Remember, we all have a lot of medicine in our hands and thoughts. Put your good intentions and healing, loving hands on him!

Q: At the barn I am boarding at, the horses do not have access to water during turnout. They are out for around eight hours each day. Is this a problem in the summer? Also, in the winter, the barn owner told me the horses could just eat snow to stay hydrated – is this true?

A: Horses should have fresh water available at all times. The average horse’s body is comprised of about 85 gallons of water or fluids, including intra- and extra-cellular fluid, blood, lymph, urine, even saliva. A horse produces six to ten gallons of saliva a day. Much of the water a horse drinks is used to create saliva, which helps in mastication and digestion. Water maintains the delicate balances within a horse’s body and keeps digestive tract mobility regular. While it is true that horses can go for extended periods without water, it is not recommended, and greatly increases the risk of impaction colic. In the summer, they may get hot and dehydrated, especially if they are active during turnout. In the winter, when it is cold, horses tend to drink less at each opportunity, so they may still be at risk for impaction and dehydration. The signs of dehydration are a bit harder to read in the winter. Some horses will eat snow, and some won’t. I have a ranch in the wilderness where the horses drink the clear, cold water that runs through the East Fork of the Salmon River. I have observed them drinking slowly, almost dreamily, especially on hot summer afternoons. The entire herd will find a comfortable spot and stand right in the water, or on the river’s edge. The whole process of getting a drink can take over an hour. It is as if they are dining on the freshness and ionization of this water. One of my big warmbloods rolls his tongue and sips the river as if through a straw — then he picks his huge head up and rolls his eyes back as he is swallowing. Having watched this beautiful intimate relationship they have with the water, I could never recommend horses intentionally being deprived of it.

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Dr. Heather Mack has been practicing Holistic Veterinary medicine for 15 years. She was one of the first women admitted to Columbia University where she finished her undergraduate degree. She received her VMD at the University of Pennsylvania in 1991. She was certified by IVA S (International Veterinary Acupuncture Society) and AV CA (American Veterinary Chiropractic Association) in the early ‘90s. She maintains a very busy practice with sport horses on the west coast. When she’s not practicing, you can find her refining her riding and horsemanship skills with her horses in Idaho, or exploring the wilderness on horseback. She has devoted her life to the conscious practice of holistic horse care and medicine with animals. She is also a co-instructor of Balanced Equine Wellness.