Jennifer Miller, DVM, CVSMT, CVA owns Prairie Rivers Holistic Veterinary Service in Byron, Georgia. After practicing conventional equine veterinary medicine for a number of years, she came to realize it did not offer all the answers to her patients’ needs. In an effort to provide well-rounded, excellent care she chose to expand her education. She obtained certification in Veterinary Spinal Manipulation Therapy from the Healing Oasis Wellness Center, and in Veterinary Acupuncture from the Chi Institute. She has also studied Applied Kinesiology and Craniosacral Therapy.

Dr. Jennifer Miller is herself a student of the horse and studies classical dressage, lessoning as often as she can. She has a passion for functional neurology and loves being able to integrate functional neurology concepts with classical dressage. She lectures to groups on how understanding the neurology of the horse can make all of us more empathetic riders.

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Holistic veterinary advice. email: info@equinewellnessmagazine.com. Our veterinary columnists respond to questions in this column only. We regret we cannot respond to every question. This column is for information purposes only. It is not meant to replace veterinary care. Please consult your veterinarian before giving your horse any remedies.

Q: My mare is good about most things, but really struggles with getting needles. Is there anything I can give her before the vet comes, to help her remain calmer?

As veterinarians, we often only see our patients once or twice a year. We are usually administering vaccines, drawing blood, or performing some other not-so-comfortable procedure. So it is not unusual for horses to develop a dislike of the veterinarian and veterinary procedures, and a fear of needles.

When a client’s horse is fearful of procedures or needles, I recommend a combination of trust-building groundwork and a desensitization program. If possible, I try to schedule visits to the farm for other patients. I then take the time to visit and feed treats to the fearful horse, but do not perform any procedures. This can go a long way towards gaining the horse’s trust.

Interestingly, many horses that struggle with needles will be more tolerant if the owner is not the one holding them. Sometimes the owner’s worry further upsets the horse. When we take the owner out of the equation, the horse will often be more comfortable. It can also be safer to allow the veterinarian to hold the horse and perform the injection at the same time.

From a TCVM perspective, behavioral issues are called Shen disturbances and can be treated with different herbal formulas. However, these are not one-size-fits-all and must be tailored to each individual. A TCVM workup, including a physical exam and history, is needed before the proper herbal formula can be selected. As a last resort, there are sedatives (available by prescription only) that can be given orally before the veterinarian comes. I like to exhaust all the other options first, trying to teach the horse how to control his emotional response to the veterinarian and to needles, before choosing to use sedatives.

Q: I have a gelding that had a scrape on his hind leg, just above the fetlock. It was fairly large (4” to 5”), but not deep, and couldn’t be stitched. We treated it daily and it has closed over just fine, but no hair will grow back over the area. It doesn’t appear to have proud flesh, but is this a possibility? Or do some wounds just never grow back hair?

Wounds that occur over the front of the cannon bone can be so difficult to manage. But you already know that! There is really no muscle covering the cannon bone – there is only bone, tendon and skin. Because of this special anatomy, the blood flow to the cannon bone area is limited. Limited blood flow may cause delayed healing, possibly resulting in proud flesh or fibrotic scarring.

Proud flesh has a very distinct appearance. I describe it as a glistening cobblestone path. Proud flesh bleeds very easily. If left unbandaged, it will become swollen, with the wound edges above the level of the surrounding skin. Fortunately, this does not sound like what you are describing.

Your description sounds more like a fibrotic scar. These are areas in which the skin that fills in a wound bed is not composed of normal epithelial (skin) cells – instead the new tissue is less elastic and “rougher” looking. These areas often do not have hair follicles and therefore, no hair grows back! These scars are usually dry and may look scaly. One of the biggest problems is they lack the elasticity of normal skin and are not as resilient, making them more prone to re-injury.

Unfortunately, the only way to repair these areas is to surgically remove the scar and start over. This works in places on the body where there is enough skin to close the surgical wound, but not on lower limbs. Skin grafts are possible; talk to your veterinarian about this if you are interested.

I advise my clients to keep an organic wound salve on hand and apply it to these scars two to three times a week to keep them soft. If the area becomes injured again, vet care and bandaging are needed to aid proper healing.

On very rare occasions, these scars will begin to change in appearance and look like they are growing warts. If this occurs, a skin biopsy is needed. For some unknown reason, lower limb scars may transform into sarcoids and an early diagnosis is needed for treatment to be successful. I recommend taking a picture of the scar every two to three months so you have a photographic record of what it looks like should it start to change. This is usually not a problem, though, and horses do well after the wound is healed.

Q: I have a three-year-old mare that I am just starting under saddle. I have noticed that her right hind stifle “clicks”, and her hind end seems weaker on that side. Should I be concerned, or just focus on strengthening her more?

The answer is both! Any time I hear a joint making noise I want to investigate it thoroughly. Joint “clicking” can be innocuous or a sign of degenerative joint disease (DJD). It is best to start with a thorough lameness workup, to make sure there are no signs of DJD in the clicking stifle. This may include flexion of the limb to look for lameness, lunging to watch the horse move, and radiographs to look at the integrity of the joint itself. Once DJD is ruled out, the fun can begin.

Horses, in general, have a sidedness or crookedness. Just like people who can be right or left-handed, horses are often stronger on one side than the other. This inherent crookedness is what balanced training strives to address. Balanced training focuses on strengthening and straightening the horse and its goal is to make a horse symmetrical. For training to be effective, all the joints in the spine, head and limbs must function optimally. This is where Veterinary Spinal Manipulation Therapy (VSMT – animal chiropractic) and acupuncture come in.

As a veterinarian who practices both acupuncture and VSMT, I love working on horses who have a weakness, but no DJD. VSMT is not about “popping bones back into place”, but instead restores correct and healthy motion to the joints of the spine, head, and limbs. Once the proper motion is restored to the joints, the nerve impulses that control the muscles are more likely to be transmitted appropriately. This allows the rider/trainer to help the horse strengthen the muscles on the weaker side, resulting in a straighter horse.

Joints that are not moving properly can cause pain. Pain can, of course, make a horse resistant to accepting aids or cues and can make her appear weak. So it is very important to have VSMT treatments to restore joint motion. In my practice, I almost always use acupuncture with VSMT. Acupuncture is wonderful to help resolve pain and restore good energy flow through the whole body. Young horses are especially responsive to VSMT and acupuncture. So, as long as your mare does not have any DJD, then balanced training along with VSMT and acupuncture should help her to become a strong, sound horse.