The Equine Clinic of Saratoga

08/29/2025

Electroacupuncture (EA) has been used successfully as a treatment for trigeminal nerve-mediated head-shaking (TMHS) in horses.

Head-shaking in horses can be a clinical sign of a wide variety of conditions from a poorly fitting bridle/bit to dental or sinus disease and a range of other issues. TMHS is the most common diagnosis, usually made by process of elimination for other possible issues.

TMHS is a painful and distressing condition where horses exhibit uncontrollable head shaking and flicking. This can make it dangerous for them to be ridden and, in the most severe cases, may lead to euthanasia. Although the exact cause remains unknown, the condition is believed to be triggered by excessive reactions in the trigeminal nerve to external stimuli.

No treatment has been identified that works universally and improvement with any given treatment is seen in 20-50% of affected horses.

The most recent progress in treatment of TMHS has been the use of neuromodulatory therapy, either by percutaneous electrical nerve stimulation (EquiPENSTM) or by electroacupuncture (EA). Both treatments apply electrical stimulation to the infraorbital nerve, which aims to adjust the perception of incoming painful stimuli by inhibiting afferant pain signals and activating descending inhibitory pathways.

A study, which looked at 42 horses treated between 2015 and 2024, revealed positive outcomes. Impressively, 64% of the horses demonstrated some improvement, and a third experienced a complete resolution of the symptoms. However, a small percentage –31% – did not see any improvement, and two horses (about 5%) had their symptoms worsen following treatment.

Electroacupuncture was well tolerated by all the horses, with minimal complications. Its success rate is comparable to similar treatments, like percutaneous electrical nerve stimulation (PENS), and it offers the advantage of being performed in a yard setting, without the need for a veterinary hospital visit.

While not a cure-all, electroacupuncture could provide much-needed relief for both horses and their owners, offering a non-invasive treatment option with fewer risks than many other interventions.

05/23/2025

🐎 Exciting developments in equine medicine! Recent research is exploring the potential role of SGLT2 inhibitors (sodium-glucose cotransporter-2 inhibitors) in managing Equine Metabolic Syndrome (EMS).

Equine metabolic syndrome (EMS) is a disorder associated with inappropriate blood insulin levels (insulin dysregulation) along with a combination of increased fat deposition and a reduced ability to lose weight. When affected horses consume meals high in specific carbohydrates, their bodies produce higher than normal levels of insulin and are slow to return to baseline values. These clinical signs were previously referred to as hypothyroidism, peripheral Cushing’s disease, prelaminitic syndrome, or Syndrome X.

Key symptoms to watch for: 🔹 Abnormal fat deposits (especially cresty neck, fat pads around the tailhead) 🔹 Insulin resistance 🔹 Increased susceptibility to laminitis 🔹 Difficulty losing weight despite dietary management 🔹 Regional adiposity (fat accumulation in specific areas)

SGLT2 inhibitors work by blocking glucose reabsorption in the kidneys, allowing excess glucose to be eliminated through urine. While primarily used in human diabetes management, early research suggests these medications might help improve insulin sensitivity and glucose metabolism in horses with EMS.

This is still emerging research, and any medication decisions should ALWAYS be made in consultation with your veterinarian. Proper diagnosis, dietary management, and exercise remain the cornerstones of EMS treatment.

04/04/2025

What is a dummy foal?
Neonatal maladjustment syndrome (NMS), often referred to as “dummy foal syndrome,” is a condition affecting newborn foals. These foals appear perfectly healthy at birth, but shortly after, they exhibit a range of neurological abnormalities. Instead of demonstrating the usual curiosity and alertness of a newborn, dummy foals become detached, disoriented, unresponsive, and confused. One of the most distressing signs is their difficulty or inability to nurse, which can rapidly lead to further complications. The condition is alarming for horse owners, but thankfully, with prompt diagnosis and appropriate intervention, many foals recover fully.

What are the causes of dummy foal syndrome?
The primary cause of dummy foal syndrome is believed to be decreased oxygen reaching the foal’s tissues during birth, a condition known as hypoxia. This oxygen deprivation can lead to varying degrees of damage to the central nervous system. The severity of the damage depends on several factors:

• Age of the fetus: A fetus closer to term may be more vulnerable to oxygen deprivation.
• Length of oxygen deprivation: The longer the foal is deprived of oxygen, the more severe the neurological damage is likely to be.
• Severity of oxygen deprivation: A complete lack of oxygen will cause greater damage than a partial reduction.

During a normal birth, the foal experiences a physiological “squeeze” as it passes through the birth canal. This squeeze, researchers now know, triggers a crucial biochemical shift in the foal’s brain, essentially flipping a switch that prepares it for life outside the womb. In cases of NMS, this transition may not happen properly, often due to birthing complications such as a prolonged or difficult labor, which can lead to reduced oxygen delivery.

The success rate for treating dummy foals to greater than 80% over the past decades in hospital treatment settings. We have also been able to translate many treatments to the field with good success.

Treatments
Traditionally, treatments for dummy foal syndrome have focused on supportive care like intravenous fluids, nutritional support, and in some cases, anti-seizure medication. However, recent breakthroughs, particularly the work of researchers like Dr. John Madigan, have introduced a revolutionary approach called the “Madigan Squeeze.”

This method mimics the pressure experienced during normal birth using a simple rope harness. When gentle pressure is applied with the rope around the foal’s chest, it appears to fall asleep. This seemingly paradoxical action re-activates the biochemical switch that was missed during the birthing process. The foal is often placed laying down, which appears to allow the necessary physiological changes to take place.

The Madigan squeeze is relatively easy to administer and doesn’t require complex or expensive equipment. Once the procedure is complete, many foals begin to show rapid improvement in their neurological status, often within hours. The technique is simple:

• An assistant holds the foal securely.
• The handler stands behind the foal.
• A rope is positioned around the foal’s chest.
• Gentle, steady pressure is applied using the rope until the foal lays down.
• If the foal doesn’t lie down, pressure should be increased gradually.

This method has demonstrated remarkable success, and the vast majority of foals treated in this way show improvement.

To achieve the best results the foal must be younger than 3 days old, and even better if the foal is younger than 24 hours old.

This is only used on foals that have stood up prior to showing signs of NMS. It is not to be used on a foal with respiratory distress, shock, sepsis, rib fracture, prematurity or congenital anomalies.

A practitioner should be skilled in the procedure, and it should be performed only after a thorough physical exam. Monitoring the foal after the procedure is important. The foal squeeze is performed in a softly bedded area.

Once the rope pressure is released, the dummy foal immediately converts into an aroused, nursing foal engaged with its surroundings. If done properly, the foal experiences no adverse effects from the procedure.

01/23/2025

Just a reminder that Friday, January 24th is the last day to sign up for our 2025 Wellness Plan!

This plan combines routine health care with an individual approach to performance and longevity. Comprehensive care while saving 30% for your horse’s routine annual care. Worry-free: We schedule your wellness appointments.

What is included in the plan?

Spring (split into two visits)
Full Physical exam
CBC/Lyme Multiplex
Coggins (My VetLink)
Rabies Vaccine
EWT/WNV Vaccine
Flu/Rhino Vaccine
Potomac Horse Fever Vaccine
F***l Egg Count with Dewormer
Strangles Vaccine (as deemed necessary)

Fall
Oral Exam including Dentistry
F***l Egg Count with Dewormer
Flu/Rhino Vaccine
Sheath Cleaning
Potomac Horse Fever Vaccine

The cost of the Equine Wellness Plan is $838. Add an endocrine panel (ACTH, insulin, adiponectin, glucose) for $185 (normally $245).

Payment must be received by January 24th. Email: [email protected] or call today at 518-584-1633

01/12/2025

We like to take this opportunity to wish you a great and happy New Year 2025.

We are thrilled to have you and your horse(s) as part of our practice and proud to provide your horse(s) with health care in the new year. We also strive to keep you updated on the latest health news and developments as well as alerts and recommendations pertaining directly to your horse's health and performance.

This past year our practice has seen significant growth in our medical and surgical services from laparoscopic procedures to advanced life-saving gastro-intestinal diagnostics to orthopedic repairs and complex infectious joint management. We want you to know that Dr. Sondhof and Dr. Nutt are happy to answer any questions regarding procedures, costs, prognosis, outcomes, and options for any conditions. Just call or visit us!

LOOK BACK
The past year deserves a look back as we can always learn from it moving forward. An important reminder of the value of vaccines was the occurrence of Eastern Equine Encephalitis in 2024. As we had not seen any of the three strains of the Equine Encephalitis family (EEE, WEE, VEE) in the past years in horses (and the first human case in NYS since 2015) we are fortunate to have a vaccine available for horses (but not for humans). It realistically made the difference to have had our horses current and vaccinated for EEE as far as mortality is concerned, as only unvaccinated horses succumbed to the infection (see the case of an unvaccinated horse in Ballston Spa, NY). Take advantage of our Health Care Program, sign up to get covered, and receive a significant discount.

FIRE SAFETY
Another reminder of just how important fire safety remains was the barn/fair fire in Springfield, MA, this past September with over 160 horses walking away from it without any injuries. Because of diligent fire regulations and safety measures, no horse was harmed. We have since consulted (we offer this service at no cost to our clients) with several barns and horse owners evaluating fire safety for their horses in their barns to ensure in the worst-case scenario a fire escape plan is in place and the horses have an escape route. Please feel free to inquire more about how you can make sure your horse is safe in case of a barn fire.

PODIATRY SERVICE UPDATES
Exciting developments are happening in our Podiatry department. Many lameness issues originate from feet issues and as our horse population is aging (gracefully) assuring healthy hoof quality and good shoeing remains a crucial aspect of well-being and performance. We have invested in a modern farrier shop with the latest specialty options for horses with minor issues requiring more support or need to be re-balanced; and for horses with more serious issues, including mild or severe laminitis (glue-ons, Sigafoos, Nanrics, Clogs, Ultimates to name a few options) as well as advanced diagnostic options such as venograms to evaluate the vascular health of the horse's foot. We are currently exploring the addition of a CT Scanner to our diagnostic repertoire which will advance our understanding of a horse's foot problem, as well as head and neck conditions.

Lameness and Performance problems have always been our focus, particularly regarding joint and tendon health, and remain an integral part of looking at your horse's well-being. Advances in regenerative medicine, (orthobiologics), have allowed us to treat and manage joint and tendon injuries and address maintenance needs with more than just corticosteroids. The power of autologous (from the horse's blood-derived) enzymes and proteins (PRP, IRAP, proStride, Alpha2M, BMACs, etc.) is an expanding area of research from which we learn every day. The clinical challenge is which of these “products” may work best for YOUR horse. Interestingly, to this date, the only research consent we can soundly build our treatment approach on is promising evidence supporting the use of a Platelet Rich Plasma derived, and/or a Stem Cell-derived treatment plan (Nedergaad, Carlsson, et al., Equine Vet Educ., 2024). Stay tuned, there is plenty more to come.

As always, you are welcome to “pop in” and quiz us with any horse questions or problems. We are here for you!

Happy New Year,

Your Team at the
The Equine Clinic of Saratoga

09/24/2024

To our clients and followers,

We want to keep you updated on the current Eastern Equine Encephalitis (EEE) situation.

A positive case (middle-aged Belgian female with no known history of vaccinations and previously acquired from the Amish) of EEE has just been confirmed in the Ballston Spa area.

The mare had rapidly deteriorated with acute recumbency and being unresponsive to stimuli. The mare was humanly euthanatized, and blood samples were submitted to Cornell University confirming the suspect.

Here are some aspects of the disease to consider (Source: UC Davis):
Eastern equine encephalitis (EEE) is an extremely rare but serious and often fatal infection that causes encephalitis or inflammation of the brain. It is spread by the bite of a mosquito infected with EEE virus (EEEV). EEEV can also infect a wide range of animals including mammals, birds, reptiles, and amphibians.

Cases are most commonly seen in the southeastern United States, with the mosquito Culiseta melanura as the primary vector (although other species of mosquito can also transmit the virus). Infected horses and humans do not have enough virus in their blood to be contagious to other animals or people. As such, infected individuals do not need to be quarantined.

The disease has a high mortality rate in horses and humans, and, as such, is considered one of the most serious mosquito-borne diseases in the United States.

What are the clinical signs of Eastern equine encephalitis?
The clinical signs of EEE often come on abruptly. These can include depression, anorexia, fever, and lethargy. Neurological signs may include tremors, weakness, ataxia, paralysis, seizures, decreased awareness of surroundings, and recumbency.

How is Eastern equine encephalitis diagnosed?
Eastern equine encephalitis is diagnosed through bloodwork. Testing can include enzyme-linked immunosorbent assay (ELISA) or polymerase chain reaction (PCR) on cerebrospinal fluid (CSF) samples to identify the EEE virus.

How is Eastern equine encephalitis treated?
There is no cure for EEE. Treatment largely consists of supportive care for horses with clinical signs, including intravenous (IV) fluids and anti-inflammatory medications.

What is the prognosis for Eastern equine encephalitis?
The prognosis for horses diagnosed with EEE is poor. The disease has a high mortality rate, with up to 90% of infected horses dying from the disease. Horses with neurologic signs that become unable to stand on their own have the poorest prognosis for survival. Horses that do survive can have permanent brain damage.

How can Eastern equine encephalitis be prevented?
The American Association of Equine Practitioners (AAEP) recommends the EEE vaccine as a core vaccine. Horses should be kept up to date on vaccinations, which are usually administered yearly (boosters may be recommended more frequently in warm climates with year-round mosquito activity). Boosters may be advised when outbreaks occur.

In addition to vaccination, it is important to practice good vector control to protect your horse from EEE. Use insect repellents and keep horses in at night when mosquitoes are most active and shut off barn lights attracting insects. Eliminate mosquito breeding grounds such as standing water, brush piles, and old tires. Stock tanks and water troughs with mosquito-feeding fish.

At this time, we are recommending the following fall vaccine protocol:
1. For horses who have not received the core vaccines incl. the EEE this year to vaccinate them ASAP.
2. For horses who DO NOT travel to booster them with the EEE/WEE, and WNV vaccine (and PHF as needed).
3. For horses who DO travel to booster them with the EEE/WEE, and WNV vaccine as well as Influenza and Rhino (EHV-1+4). The PHF vaccine may be given as needed.

Please call the office with any questions you may have. We are here for you to help keep your horses healthy!

Sincerely,
The Team at the Equine Clinic of Saratoga

09/23/2024

A fire broke out in barn C at The Big E on Friday night. Fortunately, all horses were evacuated quickly, and all horses and humans survived. Some horses were loose for a time but all have been found. Horses and people have been treated for non-life-threatening injuries.

We are so thankful that everyone is okay.

A fire was put out on The Big E Fairgrounds Friday night.

09/17/2024

The NYS Department of Agriculture and Markets, Division of Animal Industry is confirming new cases of EEEV in horses around the state recently.

EEE Case 7 – Vernon, NY (Oneida Co) 1y QH c**t
• According to owner, vaccinated by owner with a 5 way in August 2023. Has not been vaccinated by veterinarian. No travel history.
• 8/7 – owner noticed c**t was lethargic and stiff
• 8/8AM – c**t was found seizing in pasture, quivering, going laterally recumbent and making galloping like motions
• 8/8 vet exam: T= 101.7 , normal menace, normal CN exam, no evidence of trauma. Vet took samples for arboviruses and started treatment. Seizures seemed to stop. C**t stayed down and seemed obtunded for a while but was eventually able to return to barn.
• 8/8 later on: seizures resume, circling rapidly in stall, seemingly blind as c**ts bumped into walls and was creating trauma from this. Owner elected euthanasia.
• Blood samples were sent to Cornell. The PCR for EEEV was positive and negative for WNV.

Please take this seriously. If your horse hasn't been vaccinated for EEE within the last 6 months - give us a call.

09/12/2024

The NYS Department of Agriculture and Markets, Division of Animal Industry is confirming new cases of EEEV in horses around the state recently.

EEE Case 6 – Newburgh, NY (Orange Co) 18m TB c**t
• Not vaccinated, no recent travel history
• 8/7 – owner noticed c**t was acting off – eating sluggishly, T = 103, called for vet to examine
• 8/8 – vet exam: standing despite displaying neuro signs (head pressing, preferring to lean against walls, exaggerated pawing at walls). Vet thought c**t may have vision issues beginning due to behavior in stall. Vet took samples for arboviruses and commenced treatment, discussed ddx with owner.
• 8/9 – 8/10 – continued decline with c**t buckling and going recumbent, having paddling activity (a slow gallop like motion), stupor like mentation.
• 8/11 – owner called to say c**t died.
• Blood samples were sent to Cornell. The PCR for EEEV were positive and negative for WNV.

It is extremely critical for you to take the necessary precautions for you, your patients and your own animals at this time. Arboviruses are no joke! We have a long way to go before we have killing frosts, freezes to end the arboviral season here in New York.

09/09/2024

The NYS Department of Agriculture and Markets, Division of Animal Industry is confirming new cases of EEEV in horses around the state recently.

EEE Case 5 – Heuvelton, NY (St. Lawrence Co) 2y Belgian filly
• Not vaccinated, no recent travel history
• 8/7 – normal per owner
• 8/8 – owner found horse dog-sitting out on pasture, called for vet to examine
• 8/8 – vet came to examine few hours later and noted: horse could not try to get up, would just fall back over. Vet discussed poor prognosis and ddx with owner. Vet took samples for arboviruses and gave supportive tx.
• 8/8 later – owner called to say that horse was declining and horse was euthanized.
• Blood samples were sent to Cornell. The PCR for EEEV was positive and negative for WNV.

If your horse has not been vaccinated for EEE within the past 6 months - please give us a call to schedule an appointment.

09/04/2024

The NYS Department of Agriculture and Markets, Division of Animal Industry is confirming new cases of EEEV in horses around the state recently.

EEEV Case 4 - Kirkville, NY (Madison County) - Aged Standardbred

Unknown vaccination history (rescue horse within the last 6-9 months), none administered by veterinarian, no travel since acquiring

8/5 – normal per owner

8/6 – owner noted horse with base wide stance and then eventually went down, T = 102s, shallow breathing, owner started some treatments, called vet

8/6 – vet exam few hours later: concern for rabies due to lack of vaccine history and symptoms. Horse was unresponsive to pain in rear limbs, was in lateral recumbency at that point. Vet discussed prognosis and ddx. Rec removal from other horses, euthanasia and test for rabies, arboviruses. Owner consented.

Brain was submitted to the Wadsworth Center and Griffin Laboratory. Rabies Virus testing was negative. The brain PCR for EEEV was positive and negative for WNV.

Please make sure your horse is up to date on this vaccine, and if it's been more than 6 months - get vaccine or booster immediately.

09/03/2024

As cases of Eastern Equine Encephalitis (EEE) are on the rise, it remains critically important that horse owners take steps to protect their equine friends (and their families) from mosquito bites. If you live in a region where mosquito populations persist well into the fall months, your veterinarian may recommend additional fall booster vaccinations against EEE/WEE and WNV (West Nile Virus).

If you don't know your horse's vaccination history or you are unsure whether they have received a certain vaccine, it's not too late to start from scratch with an initial series of inoculations followed by the appropriate boosters, as recommended by your horse doctor.

So, what is Eastern Equine Encephalitis?

EEE is a severe, viral disease affecting the central nervous system, and is transmitted to equids (and humans) by infected mosquitoes. There is no cure for EEE, and the mortality rate is 75-95% (in horses). Prevention through vaccination is key.

Contact your veterinarian for more information, or learn more about EEE with the following resources:

USDA Equine Arbovirus Dashboard: https://www.aphis.usda.gov/livestock-poultry-disease/equine/arbovirus-dashboard

Equine Disease Communication Center (EDCC): https://www.equinediseasecc.org/eastern-equine-encephalitis

AAEP EEE Guidelines: https://aaep.org/resource/eastern-equine-encephalitis-eee/