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Kaydence Sports Medicine & Rehab, 12635 County Road 130, Carthage, MO (2026)

06/12/2026

Diagnosing Equine Hock Joint Problems

With multiple rows of uniquely shaped bones, several distinct joint spaces, and a plethora of soft-tissue attachments, the horse’s hock (tarsus) plays a crucial role in equine locomotion. However, its complex anatomy can prove a diagnostic challenge for veterinarians.

“Unlike the forelimbs, lameness related to the distal extremity is less common in hind limbs, yet the hocks are a common source of pain/discomfort causing lameness,” says Pablo Espinosa-Mur, DVM, DVCs, Dipl. ACVSMR, assistant professor of diagnostic imaging at Ontario Veterinary College, in Canada.

Horse Hock Anatomy
The hock joint is made up of three rows of bones and three distinct joints. The bulbous ends of the horse’s tibias, called the malleoli, come to rest on top of each talus, a uniquely shaped bone in the hock forming the tarsocrural joint. Each talus has two obliquely oriented (slanted or at an angle) ridges extending from the dorsal (towards the back) aspect of the bone that interlock with the malleoli and the distal (lower) intermediate ridge of the tibia.

The flat bottom of the talus articulates with the rectangular central tarsal bone, forming the talocalcaneal-centroquartal (or proximal intertarsal) joint. The bottom of the central tarsal bone overlies the small cuboidal bones, numbered one through four, forming the centrodistal joint. Finally, the small cuboidal bones articulate with the metatarsal bones (primarily the third metatarsal bone, which is the cannon bone) forming the tarsometatarsal joint.

Several soft-tissue structures such as muscles, ligaments, and tendons pass alongside the hock. This includes the digital flexor tendons coursing along the plantar aspect (toward the rear) of the joint, the extensor tendons running along the dorsal aspect, and the medial and lateral (located closer to and further away from the median plane of the horse, respectively) collateral ligaments extending from the lateral aspects of the tibia to the third metatarsal bones.

“However, there is sometimes communication between other joints as well, which means intra-articular (IA) anesthesia may not be specific,” adds Sue Dyson, MA, VetMB, PhD, an independent consultant based in the U.K. Joint communication refers to the interconnection between different joint compartments, which allows synovial fluid to flow between them.

“There are many attachments as well as deep and superficial parts both medially and laterally that have different orientations and attachments. These structures can get injured individually or together, complicating the workup,” Dyson explains.

Common Horse Hock Pathology
Dyson says common pathologies (disease or damage) causing lameness in the horse’s hock include:
1. Osteoarthritis (OA) in the distal hock joints, particularly the centrodistal (distal intertarsal) and/ or tarsometatarsal joints;
3. Osteochondrosis dissecans (loose cartilage or bone fragments in the joint) in the distal cranial (toward the horse’s head) aspect of the intermediate ridge of the tibia (DIRT lesions) or the trochleas of the talus, often combined with secondary osteoarthritis of the tarsocrural joint; and
4. Traumatic injury of the deep and superficial collateral ligaments.
“In some cases, osteoarthritis of the distal tarsal joints and desmitis (damage of a ligament and surrounding structures) of the proximal suspensory ligament (originates at the top of the cannon bone and supports the fetlock) can be seen in the same horse,” says Espinosa-Mur. “These conditions can be clinical while others can be subclinical (not visible to the eye) at the time of presentation.”

Diagnostic Analgesia in the Hock
Because the hock’s structures lie in such proximity to one another, performing nerve blocks to localize lameness to one location can be challenging for veterinarians, says Espinosa-Mur. Some of these structures share innervation or are close enough that diagnostic analgesic can diffuse and cause false results, he adds. For example, the anesthetic agent can diffuse from the tarsometatarsal joint into surrounding structures. This means the veterinarian unintentionally desensitizes the surrounding area, including the suspensory ligament.

“This is particularly true if too much local anesthetic solution is used as it will leak out from the tarsometatarsal joint and influence the suspensory ligament,” says Dyson. “Ideally, practitioners will cross-block, meaning they will block the suspensory ligament on one occasion and the tarsometatarsal joint on a separate visit.”

It is important for veterinarians to recognize that IA anesthesia will not remove bone pain, says Dyson. “So with OA that involves subchondral bone (beneath the cartilage) damage, an intra-articular block may be negative.”

Imaging the Horse’s Hock
Veterinarians can use X rays as a first-line method to evaluate the structures in the hock. When they cannot reach a clear answer using this imaging modality, advanced imaging is the next step.

To help home in on the specific source of hock lameness, Espinosa-Mur and colleagues recently published a studyusing 18F-sodium fluoride (18F-NaF, a radioisotope) PET for imaging the tarsus and proximal metatarsus (the upper aspect of the cannon bone near the hock). They took 18F-NaF PET images of 25 horses with lameness localized to these regions and compared them to computed tomography (CT) scans of those same 25 horses.

Espinosa-Mur says he and colleagues believe imaging modalities capable of distinguishing active injuries from chronic or incidental (found unexpectedly, typically without clinical signs or need for treatment) lesions would benefit equine practitioners, especially when evaluating the hock. In this case 18F-NaF PET provides an image that helps veterinarians detect active lesions by highlighting areas where the bone takes up the radioisotope—similar to a bone scan but in 3D.

In some cases the PET scan results correlated with those from the subjective and objective lameness evaluations. “Advanced imaging with PET could definitively help determine the (lesions) that display higher osseous (bony) turnover, which in some cases can be the ones that are causing lameness,” says Dyson.

Take-Home Message
The equine hock is a complex collection of joints, which makes diagnosing hock pain challenging. “With a good clinical examination, systematic use of nerve blocks, and good radiography and ultrasonography, many diagnoses of hock-related injury can be achieved,” says Dyson. Since the advent and wider availability of advanced imaging, including CT and PET, veterinarians can more easily diagnose hock problems and determine their clinical relevance, allowing targeted treatment options.

The Horse

06/05/2026

Keeping the School Horse Sound and Healthy

How do you preserve your school horses’ health, soundness, and well-being long-term? This difficult question challenges every good horseman, says Jesslyn Bryk-Lucy, DVM, cAVCA, professor of equine studies and resident veterinarian at Centenary University, in Long Valley, New Jersey, where she manages the daily medical needs of the school’s approximately 85-horse herd.

Riding school owners like Nina Leeds, who runs Manor Hill Farm in Nicholson, Pennsylvania, constantly face the challenge of balancing their ponies’ and horses’ health and welfare with the financial pressures of their business. “You must do right by your equine employees,” she says.

Let’s take a closer look at the challenges and unique needs of riding school mounts.

School Horses’ Unique Challenges
Unlike a privately owned pleasure horse that’s not expected to pay for himself, school horses must earn their keep, generating enough income to cover their own care. But despite widespread stigma, a riding school job doesn’t necessarily equal subpar access to equine health care. In Bryk-Lucy’s collegiate program, where horses train and compete in the hunter/jumper and dressage disciplines, these equine professors have access to top-of-the-line care—a prime example being regular chiropractic and acupuncture treatments.

Nonetheless, these animals deal with stressors specific to their school horse status. “Inconsistency of riders is undoubtedly the biggest challenge,” Leeds admits. “These individuals must be forgiving and adaptable. Most of the time their student riders are still working on the basics and, as a result, may unintentionally sit crooked, add more pressure to one rein than another, etc.,” she says. “This can be habit-forming for the horses, causing them to travel incorrectly and creating compensatory pain over time.”

Adding to the challenge, she says, most ponies get ridden by children of varying skill levels because small, light, and experienced adult riders are hard to find.

Different Jobs, Similar Needs
Despite their occupational challenges, school horses have the same physiological needs as any other horse. “I manage the 85 school horses like any privately owned horse in my ambulatory practice,” says Bryk-Lucy, who also owns Leg Up Equine Veterinary Services in northern New Jersey. “The issues that I often have to manage—arthritis, sore backs, chronic soft tissue injuries, navicular syndrome, etc.—are the same pathologies (disease/damage) I see in private practice.”

Starting with the basics, school horses need suitable forage-based nutrition, sufficient turnout, proper grooming, regular dentistry and hoof care, and appropriate vaccination and deworming. In 2021 Bryk-Lucy’s then-student Abigail Reilly found that university horses turned out for at least 12 hours a day had a 25% lower incidence of soft tissue injuries than those turned out for less time1. Researchers on a French study looking at 184 school horses found housing had the biggest impact on the animals’ emotionality level, a factor affecting their suitability to teach riders of varying levels2. The data underscore the importance of species-appropriate care, including turnout and social contact for school horses.

Recognizing Signs of Pain in School Horses
Many school horses are hardy and stoic, making it easy to overlook signs of distress and discomfort. Pain can also manifest in subtle ways, which is why Bryk-Lucy relies on the staff and students to alert her to any potential issue with a university-owned horse. In her experience, early detection can have a significant positive effect on the horse’s recovery.

“Some common complaints that prompt an exam are an evasive response suggesting back soreness when being brushed, crabbiness when grooming and tacking, mounting block issues, reluctance to move forward, refusing jumps, favoring a lead, swapping (leads) before a jump, missing a lead change, running on the landing of a jump, tripping, etc.,” she says.

“In our lesson program we try to rule out pain as a cause of the behavior before classifying that behavior as a training issue,” she adds. In another study, the same French authors mentioned earlier found school horses were less likely to exhibit back disorders if managed by attentive caretakers who tend to overevaluate potential back pain

Essentially, scientists have shown attention to subtle changes in horses’ demeanors and getting the vet involved early pays off.

Limitations And Expectations
“Like most riding school programs, we have quite a few ponies that come to us as a step-down job from their competition careers with preexisting limitations,” Leeds says. She credits their long-term success to resisting the urge to push these schoolmasters when they are seemingly going so well.

“If our veterinarian has advised us that a pony should be used for flatwork only, not be longed, etc., there are no exceptions for us,” she adds. “It’s tempting when you are in a pinch, but ultimately pushing them past what is advisable, even as a once-in-a-while exception to the rule, can be detrimental to the goal of a long, productive career.”

Leeds says she’s found that teaching true horsemanship helps minimize wear on her ponies while still allowing her to run a large, successful program. Here again, setting expectations and prioritizing horse welfare remain key. “My students do not expect to jump every day, jump huge fences, or ride in extreme temperatures,” she says. “Our goal is to teach them that the animal must always come first. In turn, we can provide a more realistic workload for the lesson ponies.”

Further, Leeds emphasizes correct flatwork and small jumps with more technical exercises, and she turns to activities such as groundwork sessions and trail rides on extremely hot or cold days. For both their physical and mental well-being, she’s found it helpful to introduce variety in school horses’ work while limiting longe-line lessons because repeatedly traveling in circles adds strain to the musculoskeletal system.

Money Matters
The stakes are high for the barn owner who depends on lesson income to feed and care for all her in-work, laid-up, and retired school horses and pay for and maintain the property. In France students often purchase an annual riding school pass with a fee to fund the school horses’ retirements. In the U.S. some establishments are switching from a no-commitment pay-per-lesson billing method to a semester-long subscription system, eliminating the sometimes devastating unpredictability of fluctuating monthly income. Some early adopters of the practice point out that school horses need to eat regardless of whether students attend their scheduled sessions.

We turned to Bryk-Lucy to describe the common physical limitations of school horses. “Beyond soft tissue and joint injuries, I see a lot of back soreness,” she says, pointing out that these animals typically carry different saddles and riders daily. Under her care university horses with chronic back pain get their own saddles. The rest get time off, non-steroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone (Bute) or firocoxib, methocarbamol (a muscle relaxer), acupuncture, and chiropractic care. “These individuals usually return to work and are monitored and managed closely,” she says. However, if one needs shock wave therapy or regenerative therapies, she must refer to an outside practice, which she says isn’t always cost-effective for such a large herd.

Beyond her own expectations, Bryk-Lucy must also manage those of the faculty, staff, and students. “The reality is these donated horses are on their second or third career; they may come to us with a stiff hind end, good and bad days, etc.,” she says. As long as horses are comfortable and willing to work,and the slight gait abnormality (also called a mechanical lameness) does not worsen, she allows them to keep doing their job.

“I prepare the faculty, staff, and students to expect these individual variations in certain horses and educate them on what to look for to identify a new or worsening condition,” she says. There’s an upside, though. “Sometimes soundness issues in a low-level riding program are not as limiting as they once were on the show circuit because the horses are doing an easier job, and then I don’t have to manage anything!”

What Makes or Breaks School Horse Soundness
Bryk-Lucy says some of the big considerations that affect school horses’ ability to stay sound for the long haul include:
* Limiting rider weight to no more than 20% of the school horse’s body weight, because researchers have found exceeding this can temporarily cause lameness5.
* Maintaining fitness. Researchers have shown hippotherapy horses better tolerate heavier riders when fi tter6. “Fit horses are better able to handle their workload and less likely to sustain a soft tissue injury,” Bryk-Lucy says. “Some of our university horses are off for the summer and winter breaks. We are very careful and strategic with their return to work to ensure they are fi t enough for the first intercollegiate horse show, generally four to six weeks after the start of the semester.”
* Imposing limits on how often and how high horses jump. In a 2010 study of eight school horses, researchers in the Netherlands confirmed via blood tests what professionals already knew—jumping, even at a low level, significantly increases workload compared to cantering the same distance and speed without jumps7.
* Scheduling lessons so school horses have rest days and time off to recover. In 2023 researchers published data suggesting that following an increase in work hours, school horses show a greater degree of behaviors that can be interpreted as either fatigue or discomfort using the Horse Grimace Scale (HGS)8. Trainers must provide proper recuperation time to support career longevity.
* Choosing the appropriate level for use in a riding program, considering previous injuries, age, soundness, and suitability. “The horses that successfully work for a long time start at upper levels and slowly teach less experienced riders as they age (and need to step down),” Bryk-Lucy says. “These horses can continue to earn their keep as they age gracefully, fulfilling multiple roles as their career progresses.”
* Keeping up with maintenance as needed and addressing health and soundness issues early. At Manor Hill Leeds’ vet evaluates her ponies at least twice a year when it’s spring and fall vaccination time.

Leeds has found workload to be the most significant factor affecting a school horse’s career longevity. “Overloading an individual with a jampacked schedule risks leaving them physically sore and mentally burnt out,” she says. “Being realistic about how many students you can take with your current lesson stock is important,” she adds, tying back to the importance of keeping expectations in check.

“Pushing your lesson horses beyond reasonable risks harms both your animals and your means of making an income, potentially resulting in horses needing significant downtime and incurring vet bills,” she adds. To find the right balance, she grew her program gradually, accepting more students only as she could find more ponies to join her team.

Final Thoughts on School Horse Soundness
People say good school horses—reliable, adaptable, forgiving, and sure-footed—are worth their weight in gold. Our sources establish a few truths about the noble fourlegged teachers in riding schools: They need to earn their keep. They are athletes and should be treated accordingly, and they face unique challenges tied to their occupation. Ultimately, school horses form the foundation of our equestrian sport and deserve our commitment to a lifetime of care.

The Horse

06/01/2026

Strategic Deworming Schedules for Horses

The American Association of Equine Practitioners (AAEP) recommendations for deworming horses have changed substantially over the years, with the current emphasis on strategic targeting (treating certain horses) rather than the outdated rotation-based treatment of all horses at a facility.

“The primary objective of managing parasites in horses (as well as other equids) is to minimize parasite infections, ensuring the well-being of the animals and preventing the onset of clinical illness,” says Jonathan Yardley, DVM, associate professor of clinical equine field services at The Ohio State University’s College of Veterinary Medicine, in Columbus. Of the internal parasites found in adult (over 18 months of age) horses, the most damaging and potentially fatal for the horse are large strongyles (bloodworms), small strongyles (cyathostomes) and tapeworms. Other intestinal parasites include pinworms, threadworms, stomach worms and lung worms. In foals less than 1 year old, ascarids (roundworms) are the most problematic. “It’s worth noting that adult horses develop immunity to ascarids, making this less of a concern in older horses,” says Yardley.

The Life Cycle of Internal Parasites in Horses
The life cycle of most equine internal parasites includes egg, larval, and adult stages. In general, the horse eliminates parasite eggs in the manure, depositing them onto the ground. The larvae develop in eggs and might hatch out, depending on the species, which allows the horse to ingest the parasite’s infective stage. The larvae then develop into adults within the gastrointestinal tract of the horse, with some parasite species migrating throughout the horse’s various organ systems as developing larvae before completing their life cycles.

Previous Equine Deworming Practices
In the past, owners dewormed their horses every four to eight weeks to treat them for any possible intestinal parasites, but more recent research shows this practice leads to parasite resistance. Scientists predicted resistance to horse dewormers (anthelmintics) a long time ago, says Antoinette Marsh, PhD, associate professor and service head at Ohio State’s Veterinary Medical Center Diagnostic Parasitology Lab. “(Because) roundworms, small strongyles, and tapeworms reproduce quite rapidly and display high fecundity (the ability to produce a large number of offspring), the opportunity for genetic change significantly increases,” she says. “The presence of viable, reproducing worms remaining after any deworming gives surviving worms an advantage to reproduce as compared to nonresistant worms no longer around.”

The greater the deworming frequency, the faster resistance develops and, once this resistance occurs, it is not reversable, Marsh says. One parasite generation can pass drug resistance or susceptibility to the next, creating more resistant parasites over time if all the anthelmintic-susceptible parasites are killed off.

Updated Equine Deworming Practices
Current deworming practices involve only treating the horses that need it the most (young horses and those with a heavy parasite burden) to slow the rate of parasite resistance development by maintaining a population of nonresistant parasites in the horses that are not receiving any deworming treatment.

“By leaving some drug-susceptible worms behind to mate or reproduce with drug-resistant worms, the drug-resistant genes in the worms can be diluted out when examining the parasite population as a whole,” says Marsh. This nonresistant, untreated population is called refugia and is key to the success of current strategic deworming practices. The refugia will shed eggs containing the nonresistant genetic code into the environment and, over time, this will help dilute the drug-resistant parasite population.

Because tapeworms are difficult to identify in f***l examinations, horses should be dewormed for tapeworms biannually or annually with a product containing praziquantel, says Marsh.

Safe Deworming Practices for Adult Horses
“It’s important to note that the aim is not the complete elimination of all parasites within a specific individual,” says Yardley. “Pursuing total eradication is not only unattainable but also leads to the accelerated emergence of drug-resistant parasites.”

Because a heavy burden of internal parasites can cause weight loss, rough hair coats, poor performance, diarrhea, and colic in horses, the deworming plan should target maintaining the health of the horse and prevention of drug-resistant parasites. “F***l egg counts (FECs) are useful to determine the magnitude of egg shedding of an individual horse and the level of pasture contamination,” says Marsh.

After a FEC veterinarians categorize horses as nonshedders (no eggs seen), low shedders (usually less than 150 eggs per gram (EPG), moderate shedders (usually 150-500 EPG), or high shedders (usually more than 500 EPG). The FEC allows veterinarians to more clearly identify horses with consistently higher parasite egg counts. These horses are most likely to show signs of parasitism, such as weight loss, dull coat, or pot belly, and pass large numbers of infective eggs into the environment.

Veterinarians select dewormers based on the FEC results, the horse’s age, and the type of parasite identified or suspected. Repeating the FEC 12-14 days after deworming provides information on the effectiveness of the dewormer used, says Marsh. “The (repeat) test is referred to as a f***l egg count reduction test (FECRT). Essentially, do an FEC, deworm, repeat the FEC, and then use a formula to determine the treatment efficacy. When there is a 95% or greater reduction in parasite egg number in the f***s, then that dewormer is still quite effective.”

Deworming Foals
While strategic targeting works well in adult horses, owners should take a different deworming approach for foals (under 1 year of age), says Yardley. “Younger horses, due to their developing immune systems, should be treated as high shedders from birth to 2 years of age,” he explains. “Typically, high shedders require deworming every four months with a crucial assessment of their status through a f***l egg count.” Foals aged zero through 6 months are especially vulnerable, having a higher population of roundworms in their intestines, he adds. “It’s noteworthy that these roundworms can migrate from the small intestine to the liver and then to the lungs of the foal, potentially leading to clinical signs resembling pneumonia. First deworming should be carried out at about 2-3 months of age, and a benzimidazole drug is recommended to ensure efficacy against ascarids. Second deworming is recommended just before weaning (approximately 4-6 months of age).” Using ivermectin in young foals can be fatal if they have a heavy burden of adult roundworms in their small intestine, says Yardley, so it is important to have an FEC in a young foal before using ivermectin.

Take-Home Message
Most horses do not need to be dewormed as frequently as researchers previously thought. The new equine deworming protocol allows veterinarians and horse owners to tailor the deworming program to each horse. Individualizing deworming strategies can minimize parasite contamination of the environment, improve the horse’s overall health, and limit parasite resistance.

05/30/2026

Running Loose: Tackling Chronic Diarrhea in Horses

Chronic diarrhea in horses can be a frustrating, elusive challenge for owners and veterinarians alike. Typically characterized by the continuous or intermittent passage of soft, watery f***s, diarrhea can be linked to underlying colonic abnormalities that lead to intermittent colic (abdominal pain) and an overall decline in body condition, health, and welfare.

Amy Stewart, DVM, PhD, Dipl. ACVIM-LA, assistant teaching professor at the North Carolina State University College of Veterinary Medicine, in Raleigh, reviewed the most up-to-date guidelines for investigating equine diarrhea cases at the 2026 Veterinary Meeting and Expo, held Jan. 17-21, in Orlando, Florida.

Chronic Diarrhea in Horses: What It Is, and What It Isn’t
Stewart established that clinical signs of diarrhea in horses vary widely, from a f***s-stained, dirty tail to intermittent colic, sudden weight loss, or periods of reduced appetite. “Evaluating severity can be difficult, as the equine colon’s efficient water resorption can mask ongoing disease,” she said. “I recommend investigating all possible causes rather than assuming a benign ‘f***l water syndrome’ (FWS), particularly if there are additional signs of ill health.”

F***l Water Syndrome and The Role of the Microbiome
“F***l water syndrome affects apparently healthy horses that exhibit intermittent leakage of water before, sometimes during, and/or after passing otherwise normal f***s,” Stewart explained.

Researchers have highlighted the complexity of the equine gut microbiome; both disease and medication can disrupt microbial populations therein, potentially leading to persistent FWS. However, they do not yet know a definitive cause. Additional factors associated with FWS might include stress, dietary imbalance, or types of fiber in the diet. To diagnose f***l water syndrome, Stewart said veterinarians must first exclude underlying causes of true diarrhea.

Causes of Diarrhea in Horses
Diarrhea in horses can be infectious or noninfectious. Common infectious causes include internal parasites—most commonly cyathostomes (small strongyles)—and bacteria such as Salmonella and Clostridium difficile.

“Diagnosing parasitism can be especially challenging when parasites encyst within the colon wall; f***l egg counts (FEC) may not reflect true parasite load,” Stewart said. “And while advanced tests, including serum ELISA for strongyles, show promise, they are not yet standard in the U.S.”

She added that bacterial causes, particularly in chronic Salmonella carriers, can also be difficult to pinpoint due to intermittent and low-level shedding. “Diagnosis often requires repeated or pooled f***l samples and, occasionally, culture of a re**al biopsy,” she said. “Treatment is complicated as antibiotics can prolong shedding. Clostridium-associated diarrhea is most often recognized after antibiotics disrupt normal flora, and diagnosis requires toxin identification.”

Noninfectious causes of diarrhea include sand ingestion and various inflammatory or infiltrative bowel diseases, including lymphocytic plasmacytic enteritis/colitis (a rare infiltrative intestinal disease) or neoplasia (abnormal tissue growth) such as lymphoma.

Veterinarians and researchers recognize long-term non-steroidal anti-inflammatory (NSAID) administration as a cause of right dorsal colitis, commonly manifesting as low blood protein with few external signs. Stewart noted that while foals might experience diarrhea caused by issues in the small intestine, chronic disease of the large intestine is the most common culprit in adults.

Current Diagnostic Options and Limitations
With idiopathic diarrhea cases Stewart follows a progressive diagnostic strategy. She starts with taking a comprehensive history, conducting a thorough physical examination, and running laboratory tests that include blood panels, FEC, and Salmonella testing.

If initial assessments are inconclusive, her next steps include an abdominal ultrasound, radiographs, abdominocentesis (collection of peritoneal fluid), and re**al mucosal biopsies. “The latter is valuable for differentiating inflammatory from neoplastic conditions, while imaging assesses for conditions such as sand accumulation via radiographs or colonic wall thickening via ultrasound,” she said.

Managing Horses with Chronic Diarrhea
Successfully managing chronic diarrhea in horses depends on identifying and addressing the underlying cause. Stewart emphasized the importance of dietary management and carefully reviewing all feed and supplements for potential allergens that could irritate the gut.

For confirmed moderate-to-severe infiltrative bowel diseases, whether inflammatory or neoplastic, veterinarians might recommend immunosuppressive therapies such as steroids. Cases linked to sand ingestion require effective psyllium regimens, while infectious cases call for strict biosecurity and, occasionally, antimicrobial therapy.

Take-Home Message
In all cases of diarrhea in horses, Stewart stressed the importance of ruling out treatable infectious or noninfectious causes of diarrhea before diagnosing a particular patient with the less serious condition f***l water syndrome.

The Horse

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