Equine Dentistry - Should I Use A Lay Floater?

Spring is a common time for equine owners to have their horse’s teeth floated. In recent years, lay dentists have become increasingly popular. These are people who may or may not have some education in equine dentistry, and will perform floats on horses, commonly without sedation. Many horse owners choose to use lay dentists because of lower costs and the fact that they don’t want their horses sedated, among other reasons. Although it may seem self-serving, we recommend all horses receive dental care from a veterinarian.

“With education in anatomy, anesthesia, pain management, and other medical disciplines, a veterinarian is the best-equipped person to provide medical care to your horse.”

Lay dentists have variable education in equine dentistry. They do not have to be licensed, and therefore are not held to any consistent standards. By contrast, all veterinarians must be licensed and are held to state and national standards. All veterinarians have at least basic training in dentistry, with some (Dr. Kolar included) pursuing additional education in it. Combine this with a veterinarian’s education in anatomy, anesthesia, pain management, and other medical disciplines, and you can understand why a veterinarian is the best-equipped person to provide medical care to your horse.

Some lay dentists will use sedation for their floats. We must remind everyone that it is illegal for a lay person to sedate any horse but their own, especially if they are receiving compensation for doing so. This also presents a huge risk. If a horse has a reaction to sedation, the lay dentist is unequipped to help. If any adverse effects occur during the procedure due to error on the part of the lay dentist, the owner cannot hold them accountable since they are not governed by any licensing body.

We know there are many additional misconceptions about having your horse’s teeth floated by a veterinarian vs lay dentist. We’d like to address the ones we see and hear most commonly:

“Using a powerfloat causes damage to the teeth”

Yes, we use a powerfloat instead of hand tools, and yes it can cause damage to the teeth if used inappropriately. It is possible to take too much tooth off at one time with a powerfloat, and it is possible to overheat the tooth and injure the pulp cavity. Both of these can cause long-term damage to a tooth. We use a lot of water while floating to cool the powerfloat and teeth. We also never remove more than 3mm off a tooth in a single float, and only keep the float on a tooth for a few seconds at a time. These methods are recommended by board certified equine dentists, and we use them with great results.

“Veterinarians are more expensive and you get the same result”

In short, you are not getting equal value in services between a veterinarian and lay dentist. You are paying for your veterinarian’s extensive education and knowledge, their legal ability to sedate and provide multiple methods of pain management, and a more thorough exam (due to sedation and better equipment). Once again, no one is better equipped to provide medical care to your horse than your veterinarian. You can also create better value for a float appointment with your veterinarian by having them perform other routine care: vaccines, deworming, sheath cleaning, coggins, health certificates, and more can all be performed in the same appointment and save you gas mileage or outcall fees later on.

“Veterinarians over-float teeth”

We won’t speak for all veterinarians, but any veterinarian that has graduated within the last decade (and likely longer ago than that) has been taught to only take as needed. There was a time when some horse owners and veterinarians thought that a tooth had to be ground completely smooth on all sides in order for it to be floated well. We know now that this isn’t true. As stated above, we take multiple precautions to only float what’s needed and minimize any potential damage to the teeth.

At South Peak Veterinary Services, we pride ourselves on thorough, high-quality equine dental care. We are always happy to answer any questions you might have about dental care for your horse!

The article “Equine Dental Care - Should I Use a Lay Dentist?” first appeared in our Spring 2023 Newsletter.

Equine Lameness Series: All About Joint Injections

Intra-articular injections, more commonly referred to as joint injections, are one of the most commonly performed procedures on equine athletes. In years past, joint injections received a bad reputation. This was largely a result of misuse and using lower quality medications in the injections, which gave subpar results. Research has proven that joint injections, if done appropriately, are a benefit to the equine athlete and can actually help to heal the joint rather than tear down the cartilage.

Joints are most commonly injected with a combination of hyaluronic acid (HA), a corticosteroid, and a small amount of antibiotic. However, there are different levels of injections that are available to tailor to each horse’s discipline and each owner’s budget.

• Corticosteroid: Using steroid alone is the simplest level of joint injection offered. This helps to quiet down inflammation within the joint and increase comfort for the horse. Peak effect is typically achieved around 10 days post-injection.

• Hyaluronic acid: Adding HA to a steroid injection is the next step up. In healthy joints, HA acts as lubricating molecules that promote smooth, frictionless motion. It also helps mitigate the action of inflammatory mediators within the joint and protects joint cartilage from degeneration. There are also different classes of HA, and at SPVS we use the highest quality with the highest molecular weight. This is important as the higher molecular weight products don’t diffuse across the joint capsule as easily as lower molecular weight products. This means the HA molecules keep the steroid centralized within the joint longer, which in turn enhances the healing process.

• Antibiotic: All our joint injections include a small amount of an antibiotic to help minimize any joint infection.

• Biologics: These are the current “gold standard” of joint injections. For biologics, we extract living organisms from the horse’s own blood and inject them directly back into the joint. By putting the horse’s own healing factors back into the joint, we are achieving an amplified healing effect. There are many biologic products on the market, including Prostride, IRAP, PRP, RenoVo, and more. At SPVS we are now offering Prostride!

Before we are able to inject joints, we need to determine which joints require treatment. This starts with our comprehensive lameness exam, as we discussed in our previous blog post. If more localization of the lameness is needed after the exam, we can narrow it down further with nerve blocks. With nerve blocks we can numb areas of the limb in a stepwise fashion to see if the horse becomes sound again. We can also try to localize the source of the lameness with diagnostics such as radiographs or ultrasound. Once we have identified the source and determined whether the issue would benefit from injections we can proceed with treatment.

Because we are entering into a joint when performing injections, a sterile prep of the site is absolutely necessary to minimize risk of infection. We also use a small amount of antibiotic in our joint injections to help minimize infection. Using antibiotic in joint injections has been a debated topic among equine veterinarians in the past, as it has been shown to have some negative effect on cartilage. However, many veterinarians believe that the benefit of protecting against joint infection outweighs the risk, especially if using very small amounts like we do.

After joint injections, we prefer the patient to rest for at least 3 days, but 5-7 days is most ideal. Then they may return to work. We recommend doing a follow-up lameness exam 4-6 weeks after injections to monitor response to treatment and make sure the patient is 100% sound. Occasionally we find that the injections treated a large source of discomfort and once that is treated there is another issue that was being masked by the joint pain. At SPVS, we offer our follow-up lameness exams for free after performing joint injections.

Interested in learning more? Follow along in future newsletters for our continuing series on equine lameness!

The article “Equine Lameness Series: All About Joint Injections” first appeared in our Summer 2023 Newsletter.

The Importance of Equine Lameness Exams

If you follow any equine-related accounts or groups on social media, you likely have seen the post about how flexions during lameness exams are causing pain and injury to your horse. The typical accompanying image on that post compares flexing a horse’s front limb to a person’s arm being twisted behind their back. This is an inaccurate comparison because during a flexion test you are flexing the horse’s limb in its normal alignment, while twisting someone’s arm behind their back is bending it in an abnormal alignment. Posts like this make us realize how little some people understand the “why” behind comprehensive lameness exams. Since we are passionate about equine sports medicine and are committed to performing high quality lameness exams and therapies, it’s important to us that equine owners understand what we are doing.

Janelle spent a large part of her vet tech career working on the top performance horses in Colorado and beyond during her time at Countryside Veterinary Hospital in Colorado. Thanks to Janelle’s connections, Dr. Kolar was able to do lameness training with Dr. Shoemaker at Countryside as well and hone her skills. At South Peak Veterinary Services, we perform a full lameness exam every time we are seeing a new patient for lameness or a new issue.

A thorough lameness exam consists of the following:

• Gathering a thorough medical history on the horse

• Evaluation of the horse at rest and in motion. We evaluate the horse at a walk, trot, and lunging in a circle in both directions. If conditions allow, we also prefer to evaluate the horse moving on firm and soft ground for comparison. This gives us a baseline to compare our flexions to.

• Thorough hands-on exam. We palpate along the entire spine, each limb, and major muscle groups to identify areas of sensitivity and any abnormalities

• Hoof testers. Hoof testers are applied to every foot to look for sensitivity

• Flexions. We generally flex the carpus and fetlock on both front limbs, and the stifle, hock, and fetlock on both hind limbs. There are additional flexions we can perform if we feel they are necessary, but they aren’t part of our routine flexions. The purpose of flexions is to place mild strain on specific areas of the limb to try to identify the source of the horse’s pain. The limb is held in a flexed position for a recommended length of time, then the horse is jogged off in a straight line. If the horse appears lame in the first few steps but then is sound, we would not call that a positive response. We expect the horse to take a couple bad steps as they readjust, just as if a person held their leg flexed at the knee for a period of time and then tried to jog. However, if the horse appears lame the entire length of the trot then we would call that a positive response. During flexions, we are not bending the horse’s leg in a way that is abnormal to them, so it is not comparable to twisting someone’s arm behind their back. We are placing mild strain on a specific area of the limb, but not enough to cause injury.

After a thorough lameness exam, depending on results, a patient can either receive treatment or may require additional diagnostics to isolate the cause of the lameness.

Lameness exams are a vital component of any performance horse’s care. Providing a thorough exam every time is critical to ensure that horse is receiving the best care and can return to work. Since equine lameness is a favorite topic of ours, we plan to put out more educational content! Keep an eye out for more information on our social media and in our future newsletters!

The article “The Importance of Equine Lameness Exams” first appeared in our Spring 2023 Newsletter.