Special Considerations for the Senior Horse · PPID horses. 36% are IR. •Equine Metabolic Syndrome (EMS) = regional adiposity (fat), IR and laminitis •EMS affects all ages. •IR

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