Ask The Vet: Reproduction & Dental Care - April 08

It could be red clover toxicity, which can cause excessive drooling. If not, has your veterinarian done a thorough oral exam? There may be a problem with a salivary gland or duct or some other irritating factor such as a chronic foreign body embedded in the tongue. Lynn Caldwell, DVM

You first need to diagnose whether she's pregnant or not. From your question, I gather no one has examined the mare.

In order to prepare for foaling, she needs to receive a herpesvirus (rhino) booster in the 5th, 7th and 9th month of gestation. BUT, since you bought her 9 months ago, you know she is at least 9 months gestation.

Here are some things you should do:

* Ensure she doesn't have a caslick's in her vulva;

* Vaccinate her with everything you want the foal vaccinated for and deworm her with an ivermectin product (with or without praziquantel);

* Have two fleet enemas on hand to give the foal after it is born;

* Have on hand some nolvasan/chlorhexadine to dip the foals navel during the first 36 hours of life.

If she foals in 3 to 6 weeks after you vaccinate/deworm the mare, the foal should be drinking extremely high-quality colostrum and would not need to be vaccinated until it's at least 4 months of age. Ben Espy, DVM, DACT

All products that have FDA licenses attached have been tested for safety and efficacy.

Read the label or call the 800 number that should appear for product information. No veterinarian will know about toxicity of these chemicals more than the manufacturer. Ben Espy, DVM, DACT

I would recommend you ask your veterinarian to contact me directly. Estrogen and testosterone are markers for some hormonally-based ovarian tumors, but inhibin MUST be submitted for an acurate diagnosis. The lab that is very trusted on a national scale with many referral hospitals is at Cornell University, which is who I recommend even though the last two places I have practiced are in Lexington and Texas.

I cannot make suggestions because you don't have an inhibin value and I don't know what your lab's normal values are for testosterone and estrogen. Ben Espy, DVM, DACT

Lutalyse is a synthetic prostaglandin. It is given intramuscularly to eliminate the structure on the ovary that makes progesterone and keeps the mare out of heat.

All animals, horses and humans included, secrete this same chemical to start their reproductive cycle over again.

You're just giving it artificially early to fit into your schedule or to do what we call "synchronize" a mare.

It is done daily all over the world. I, myself have given it to six mares this morning. It does cause excessive sweating and cramping for about 45 to 60 minutes. Most mares will be in heat 3 to 5 days after the shot and will ovulate 7 to 10 days after the shot. Ben Espy, DVM, DACT

Stallions all, regardless of age, have what we call a "rusty load" phenomenon. This means, if it has been a number of months since ejaculating, you need to ejaculate his seminal vesicles of all the dead sperm that have accumulated. This is typically done with 2 to 3 unuseable ejaculates over the course of 2 days. You can actually ejaculate him twice with 2 hours between with effectiveness.

I have bred many miniature stallions that are aged, but if he doesn't cause a mare to conceive, you can do a semen evaluation on him exactly like a full-size horse, but would simply use an artificial vagina for a bull (that has a much smaller penis than a full-size horse). Ben Espy, DVM, DACT

I wrote an article in the Q Journal (AQHA) last year about this called "Tales from the Crypt". This same article is located in the health articles section under the Behavior category. The direct link is included below:

http://www.aaep.org/health_articles_view.php?id=303

Colts don't tend to be painful from this condition, but it is hereditary.

I would wait until the foal is 18 months old to assess whether his absent testicle will drop. If it doesn't drop, removing it requires sterile technique, general anesthesia and going into the abdomen to find it. Ben Espy, DVM, DACT

You can find already chopped hay available in cubes or pellets or as "chop", which is mixed with molasses. I'm not a big molasses fan for horses, so I'm not a big fan of commercially prepared chopped hay/molasses feeds. You can probably save a lot of time and money by purchasing a chipper/shredder designed for homeowners and chop your own hay. The ideal length probably depends on the horse and the specific problem that you're chopping the hay for, but most likely, as long as you get the fiber length down to a couple of inches or less, you should be fine. If you're treating a chronic colitis horse, the shorter the fiber length the better, and I generally recommend beet pulp for those cases. Lynn Caldwell, DVM

There are some chopped hay products available, which you could check with your feed store. When my horse required chopped timothy hay after colic surgery, one of the guys at the hospital did it easily using a weed trimmer in a big (clean) garbage can.

The fiber length required will depend a bit on just what your horse's teeth look like, and also on the hay itself. You may want to aim for particles 1" or less. There are regional differences in hay availability and quality, so you might want to check with your veterinarian.

You could also soak hay cubes since once rehydrated and soft, they can be easier to chew. I often add WELL SOAKED beet pulp for these guys too. Be sure to check with your veterinarian. If your horse has metabolic issues, you may need to manage the NSC (non-soluble carbohydrate) levels in the feed. I would imagine your horse is already on a senior ration as well.

In many areas, some types of hay (bermuda) may already pre-dispose the horse to a serious problem (such as small intestine impactions) and so you might chop it even smaller or avoid it entirely. Some alfalfa hays have much coarser stems than others, and might be better soaked, chopped more finely or avoided. Elizabeth Schilling, DVM

The tooth needs to be extracted in its entirety. This will require pre and post operative radiographs (x-rays) to be sure that the tooth and its roots are completely removed. The other side of his mouth should be radiographed as well since many times, the problem is bilateral. I recommend intra oral extraction be attempted first, as surgical repulsion can leave a bony defect between the sinus and the oral cavity. This is known as an "oro-sinus fistula" and can be very difficult to repair. However, I generally find that teeth fractured, as you describe, are not too difficult to remove. After this extraction, your gelding will need to be seen by a veterinarian who has a special interest in dentistry on a yearly basis, as the unopposed 309 will supererupt and cause another malocclusion. Additionally, the 311 will form a hook as the 210 and 211 drift towards the front of the mouth over time. Lynn Caldwell, DVM

Although you are past the time frame of mid to late gestation where influenza and herpesvirus cause abortion (five to 10 months of gestation). I would be concerned about the foals after birth.

You should have vaccinated the mares 30 to 45 days before their due date. If you did, then great, the foals should be exposed to high quality colostrum and should be adequately protected. If you did not, then you need to avoid comingling newborns with show horses since influenza ("flu") and herpesvirus ("rhino") are prevalent in show horses.

You need to ensure the show horses are vaccinated every 3 to 4 months for flu-rhino and that the pregnant mares were vaccinated 30 to 45 days before their due date. This should protect everybody for comingling, but to err on the side of caution, they should be entirely separated while you have neonates on the ground. Ben Espy, DVM, DACT

All hernias, scrotal or umbilical, are congenital. I would not recommend using this match again.

Scrotal hernias are easily fixed, often times on the farm. Scrotal hernias are extremely dangerous, often have entrapped bowel in them, which can cause colic with the bowel having to be removed and castrated.

I would get a second opinion by someone who is a reproductive specialist (theriogenologist) or an experienced abdominal surgeon. Most experts will recommend this horse be castrated on the side that is herniated and many will recommend the horse be castrated on both sides because of the seriousness of this condition.

If it is truly a hernia, it will not resolve in this location. Ben Espy, DVM, DACT

Horses that are in estrus ("heat"), repetitively discharge small amounts of urine. Some are more "expressive" than others, but it may be as little as 30-60cc of urine. Normal horse urine is very milky and in such small amounts can even appear pus-like.

Horses that have uterine infections rarely discharge fluid. Horses don't get vaginal infections with the exception of yearlings and young horses going through their heat cycle for the first time.

As with any health concern, you need to establish a relationship with an equine veterinarian, preferably one who can ultrasound this mare's uterus. That should eliminate your concern as to the origin of the fluid. It has to be coming from the bladder or the uterus and the uterus is unlikely. Ben Espy, DVM, DACT

Late term abortions, until proven otherwise, are caused by Herpesvirus (rhinopneumonitis).

All horses should receive rhino vaccinations 3 to 4 times per year, though most owners only give two. ALSO, pregnant mares should get an additional rhino booster in the 5th, 7th and 9th month of gestation.

Placentitis and leptospira are also possible causes for late-term pregnancy loss, but the history you give leads me to believe it's Herpesvirus. Ben Espy, DVM, DACT

The most important thing is to scan the placenta and assess whether the thickness of the placenta and uterus combined (CTUP) is less than 1.2cm. This will allow you to assess the environment for the baby.

Secondly, mares don't have the effects of fescue if you remove them 45-60 days prior to foaling, so the 70 days you have listed is more than enough. Fescue toxicity causes prolonged gestation but also AGALACTIA (lack of milk production).

I STRONGLY recommend against induction of labor as most boarded reproduction people will also advise you not to follow that route. I have had mares carry normal pregnancies up to 13 months, year after year.

Everything sounds normal and I would advise not stimulating the udder or cervix since that alone will cause premature oxytocin release. Ben Espy, DVM, DACT

There are many plants that have varying amount of estrogens in them. These chemicals are called "phytoestrogens".

What you are seeing is a classic syndrome that appears in the springtime. "False pregnancy" is usually caused by a mare ovulating and then the corpus luteum continuing to secrete progesterone inappropriately even after she is not pregnant.

Inappropriate lactation can occur in all ages of horses and I have even seen foals that have udder enlargement and lactating yearlings that are in heavy concentrations of phytoestrogens.

These are not dangerous and the symptoms go away as the plants are replaced by hardy, summer varieties. Ben Espy, DVM, DACT

I would scan her uterus to make sure she doesn't have a hematoma in her broad ligament that suspends the uterus. That can be painful and can, in subsequent pregnancies, be fatal.

I agree with your vet, it was probably entirely positional and would not influence my decision to rebreed. Ben Espy, DVM, DACT

Twinning has not been shown to be genetic. Also, remember that twins in horses are fraternal NOT ever identical.

In other words, twins in horses come from two follicles ovulating, not the division of DNA, which would happen in identical twins.

So the "act" of double ovulating to produce twins is NOT genetic. It is reported that horses that are known to twin will typically do it year after year, regardless of how old they get.

Read last month's AQHA's America's Horse (April 2008 issue) where I was asked to help collaborate on an article about twinning. Ben Espy, DVM, DACT

The sideways head chewing may have become a stereotypical behavior, but I would not want to write it off to that for my own convenience. It is very likely that your mare may need more frequent visits by the veterinarian who is experienced in advanced equine dentistry. Some severe malocclusions need to be addressed slowly and frequently for a while in order to achieve the balance that we are looking for when restoring the mouth's function. Also, malocclusions and points do recur and the problem will just come back if it is not adequately addressed to it's ultimate resolution, if possible. Finally, some horses amaze me when I discover their severe dental issues that they apparently have not told anyone about, whereas other horses can't tolerate the first sharp spot on a tooth. Lynn Caldwell, DVM

It is entirely possible that your horse has residual dental issues, or that this could be adaptive behaviour. If it has been more than a few months since the hooks were addressed, I would recommend a follow-up visit with your veterinarian as well as a veterinarian who practices advanced dentistry. It is possible that further equilibration is warranted, and additional diagnostics (i.e. radiographs of the tempromandibular (TM) joints, hyoid apparatus, skull and teeth) depending on what an examination might reveal. Your veterinarian may recommend a short course of pain or anti-inflammatory medication to see whether that changes the behavior.

I would put this mare on a 4-month recheck schedule to ensure that all of her abnormalities are kept in check. Elizabeth Schilling, DVM

A horse at the age of 21 months is just beginning the start of a three year "teething adventure". The first permanent tooth (first molar) erupts at 1 year of age, but the process of shedding deciduous or "baby" teeth begins at approximately 30 months of age (2 1/2 years). During this time, it is best to have him checked by an equine veterinarian with a special interest in equine dentistry every six months or so. Making sure that the new teeth's very sharp points are smoothed is just the beginning of young horse's dentistry. It is also important that all the baby teeth are shed at the right times and that the permanent teeth are erupting without problems. A complete exam is very important to the future dental health and overall well-being of a young horse. Lynn Caldwell, DVM

It could indeed be a possible problem with the teeth. If this colt is 21 months and had dental work done at 16 months, then he is due for a recheck (I recommend dental checkups and usually touch-ups every 6 months from birth to about 7 years of age). This problem may be as simple as irritation to the cheeks and tongue from sharp points, or may indicate a problem with a developing tooth. A full dental exam and possibly radiographs, would be in order. Elizabeth Schilling, DVM

I think that the costs associated with routine dental care, on a yearly basis, are actually less than the average annual farriery bill. It just comes all at once rather than broken up every six or eight weeks! Budgeting for this important aspect of equine health care should alleviate the stress that it seems to cause you. Of course, each individual horse owner has a different financial situation, so the question can only be addressed in a general fashion. The benefits to your horse's overall health and performance achieved by addressing his dental needs should be considered when one assesses the "cost effectiveness" of any health care program. Lynn Caldwell, DVM

This would depend on the particular veterinary practice. Many practices have begun to offer wellness programs, some of which include routine dental work. At this point, most insurance companies, of which I am aware, do not cover routine dental care, but would likely cover advanced dental care (the definition is usually “injury or illness”). Unfortunately, I suspect that costs associated with the care and upkeep of horses (not just dental care) preclude many horses from receiving correct appropriate care. For example, most of the horses that I saw contracted West Nile Virus Encephalitis, were not vaccinated because the owner had elected not to spend the money on vaccination. Unfortunately, for these horses, these owners also elected not to treat the horses. This segues into another topic – that of the issue of responsible horse ownership/custodianship. Many of my clients maintain a separate bank account for their horses, which allows them to budget for horse health and dental costs separately from the household budget. Elizabeth Schilling, DVM

A picture would be helpful. I am assuming that you are looking at the incisors. If there is an enamel defect in one of the incisors, it could be caused by an insult to the developing tooth or a habitual behavior such as rubbing her teeth against something. If this is the case, a veterinarian with a special interest in dentistry should be consulted. The tooth should be radiographed to assess its health, as some cavities can invade the live dentin and pulp (blood supply), which may necessitate endodontic treatment, such as root canal therapy. If the defect is past the enamel and into the dentin only, and the pulp has not been infected, a restoration of tooth colored material can be placed after thorough debridement and preparation of the infected and decayed tissue. Additionally, your equine veterinarian may choose to treat her with antibiotics, if she appears to have any question of endodontic infection. Follow-up radiographs should be done six months later to confirm that the treatment has resulted in a disease free tooth. Lynn Caldwell, DVM

It is difficult to answer this question specifically without an image of the tooth in question. If I assume that you are talking about an incisor, there is a possibility that this could be either decay or wear - in either case the tooth should be evaluated by your veterinarian (or a veterinarian with an advanced dental practice). Evaluation would include examination, exploration/probing of the area and radiographs. Depending on the size of the defect/erosion/lesion, either restorative ("filling") or endodontic (root canal therapy) may be indicated. Elizabeth Schilling, DVM

All mares are individuals so the way I would answer that question is that you may be fine with everybody living peacefully if you put them back together. HOWEVER, I also have seen mares that resent their "older" baby attempting to nurse and will attempt to hurt them after weaning.

You might sedate the mare, reintroduce them, and then see how they act together as she wakes up from her sedation. Ben Espy, DVM, DACT

Whether you know it or not, you're asking a complex question. Such questions can't be answered simply.

For example, if you asked a simple question to your spouse, such as, "Did you enjoy spoiling the dinner for everyone else?" you probably would be surprised if your spouse gave you a "Yes" or "No" for an answer. That's not the sort of answer you're going to get here, either.

First, let's ask, "What's an equine dentist?" In human medicine, the term "dentist" means that a person has a post-graduate degree of either a Doctor of Dental Surgery (DDS) or a Doctor of Medical Dentistry (DMA), and is also licensed to practice prevention, diagnosis and treatment of diseases, accidental injuries and malformation of the teeth, mouth and jaws. When it comes to the treatment of humans, you can't go about calling yourself a dentist without such training or you'll be in violation of the law.

When in comes to care of horses, the only people who have post-graduate degrees to treat animals, as well as licenses attesting to their expertise are veterinarians. So, if you phrased your question differently, say, "Why are many veterinarians concerned about the fact that people who claim expertise, but without an approved educational program and no licensing, are wanting to do invasive procedures to horses?" the answer might be more apparent. It's because veterinarians care about horses, and they don't like to see people working on them who may not have the requisite expertise, or the consumer protection afforded by a professional license.

Veterinarians ARE trained to work in horses mouths, and, in fact, they're the ones with the experience. It's not only experience related to routine dental interventions, but also to recognize pathology in the mouth that can lead to other problems, or can result from other problems. Further, veterinarians can also do many other things for horses, so there's really not any reason for them to tell you that interventions are needed when they may not be. So really, it's a matter of both protection for the consumer, who deserves to be served by someone who is licensed and insured, as well as the horse, that deserves to be worked on by someone with true expertise. Lynn Caldwell, DVM

DENTAL CARE:
It is entirely possible that your horse has residual dental issues, or that this could be adaptive behavior. If it has been more than a few months since the hooks were addressed, I would recommend a follow-up visit with your veterinarian as well as a veterinarian who practices advanced dentistry. It is possible that further equilibration is warranted, and additional diagnostics (i.e. radiographs of the tempromandibular (TM) joints, hyoid apparatus, skull & teeth) depending on what an examination might reveal. Your veterinarian may recommend a short course of pain or anti-inflammatory medication to see whether that changes the behavior.

I do not practice chiropractic, so cannot specifically address adjustment questions, but the jaw and head carrriage can certainly be just one aspect of an entire issue. The "fix" for your horse may invlove further dentistry, possible orthopedic problems, physical therapy and other modalities, and also evaluation on the tack.

These are just ideas and possibilities, but nothing can replace a thorough examination by your veterinarian to begin to pinpoint and address the issue. Elizabeth Schilling, DVM

Amount, quality and frequency of feeding are not questions that any vet can answer without looking at a horse. You can also avail yourself of your county ag extension agent to analyze your feed if you need.

Floating teeth on this mare is a good idea and will cause no untoward effects on her new baby. I was asked to be an expert in an article in April's AQHA America's Horse regarding twins, if you're interested in reading it. Ben Espy, DVM, DACT

Now is not the time to perform major medical work on her nor vaccinate her. You can deworm her, however, with a gentle dewormer such as ivermectin, so that you reduce her internal parasite burden. She doesn't need more stress at this time. What she needs is a good quality, commercially produced "complete" feed that is made for horses who are geriatric with dental problems. "Complete" feed means that the foods are formulated to provide all the protein, fat, vitamins and minerals that a horse needs. These "senior" feeds are designed to melt in their mouth's so that they don't have to chew their food to get the nutrition they need. Also, at this time, the mare should be getting about 30 percent more calories to account for lactation. If she is having extreme difficulty chewing hay, you can replace the fiber intake that she would normally be getting from grazing and hay consumption by soaking beet pulp for her two or three times per day and adding that to her senior ration. Additionally, you might consider soaking hay pellets or cubes so that she doesn't have to chew them at all. Just be sure to adequately soak all types of pellets or cubes to prevent her from choking on her feed. Lynn Caldwell, DVM

In my opinion, I would let the mare adjust to motherhood and settle down a bit before adding an further stressors. This may be only a few weeks, but this filly is still high-risk, so I would want to let her develop a little before stressing out the mare. The mare will obviously need to learn that people working around her and/or her baby are a fact of life, not a threat, but she may realize this on her own without the situation becoming more stressful or dangerous.

In the meantime, I like to ensure that the mare has hay in front of her at all times, usually at least half alfalfa (this of course depends on the region in which you live). To give her extra calories that are easy to chew, you could add well-soaked beet pulp, with a complete pelleted or extruded feed added in. Your veterinarian should be able to help you with this, as s/he will have knowledge of any nutritional or feed quality issues specific to your area. Elizabeth Schilling, DVM

There is still debate on this one. The reason I don't subscribe to this theory is because there are millions of factors more than sperm swimming ability to determine pregnancy.

You have all of the mare factors to deal with such as condition, length and diameter of the vagina, uterus, ovarian (fallopian) tube? You have considerations with how much of a straight line the sperm are swimming in, how efficient they are and whether they can even correctly deposit their genetic material AFTER miraculously, they penetrate the shell of the egg.

Interesting theory, but it oversimplifies the complicated miracle of conception. Ben Espy, DVM, DACT

Veterinary medical school is not too different from human medical school. It's where we learn to be doctors. Specialization comes afterwards. However, I don't know who told you that equine dentistry is not addressed, as it most certainly is, but that is a myth that I hear perpetuated by some lay people rather frequently. There are even equine dentistry "clubs" at some schools of veterinary medicine.

But, regarding your horses and the possibility of fluorosis, fortunately, it's a very rare condition. Veterinarians do also have some training in pathology, and severe pathology is something that should be noticed. In some cases, veterinarians will commonly work with board certified veterinary pathologists in order to get the answers to difficult questions, and to help prevent other horses from becoming diseased. Thank you for providing me with your published reports. I will look at them for general interest.

If you need further information, you might contact someone from the American Board of Veterinary Toxicology. Their website is www.abvt.org. Lynn Caldwell, DVM

The first thing you need to do is establish a relationship with a veterinarian.

Mares can have bloody discharge for seven to nine days after foaling in normal cases.

Most mares with metritis (uterine infections) will have fevers over 101.5 and foul smelling discharge. Discharge without odor and mares with temperatures less than 101.5 are normal for what you describe. Ben Espy, DVM, DACT

Stallions will have favorite mares. I have also seen stallions personally that will only achieve erections with certain colors of mares. You have to be an amateur horse psychologist sometimes, but to collect some stallions you have to find a "girlfriend" of the correct color/body-style to stand next to the appropriate horse he is not attracted to so he will get an erection and breed the appropriate/customer horse. Ben Espy, DVM, DACT

Mares that are older tend to have more problems with bleeding as they advance with age. Ligaments stretching and vessel walls becoming more thin are two suggestions on why this occurs.

Bleeding can be asymptomatic and on the other end of the spectrum can kill a horse. It is unlikely you would know if the mares have bled before because the hematomas are usually found in the ligament that suspends the uterus inside the abdominal cavity. It is NOT blood loss that you would see coming from the vagina/uterus. Ben Espy, DVM, DACT

These teeth (and the horse's incisors as well) should be radiographed to evaluate for periodontal or endodontic disease. You may be seeing the beginning stages of some destructive incisor disease, or the inflammation may simply be due to calculus (tartar) accumulation. In either case, early radiographs, allow us to identify and address these issues, and then follow-up radiographs taken in successive years will help us to determine the progress of disease, or success in treatment.

I would also add chlorhexidine to your rinse, but be sure to check with your veterinarian. Elizabeth Schilling, DVM

This may be the first indication of a disease that is peculiar to older horses that involves the canines and incisors. The disease process starts at the canines and corner incisors and moves toward the central incisors. We are seeing more and more of these cases all over the country, and I for one, see it on a weekly and sometimes daily basis. Several veterinarians who are heavily involved in equine dentistry, including Dr. Schilling and myself, are presently trying to define this condition and find it's cause so that we may learn how to treat it, other than extracting the teeth.

This disease, which as of yet has no name or known cause, is characterized by an intense inflammation of these teeth and the surrounding bone and gums, that eventually leads to their loss. The teeth seem to be resorbed both internally and externally, and the bone tends to be infected with various types of bacteria. Some veterinarians have tried treating this condition with antibiotics to no avail, and it is my personal opinion that the infected bone is secondary to the breakdown of the crowns of the teeth after endodontic death and infection. Additionally, some horses respond by producing massive amounts of cementum, which is part of the periodontium, with obvious hard swelling around the roots of the teeth. The condition, in my experience, is very painful to the horse in it's end stages. Extraction of the most severely affected teeth tends to alleviate the pain.

Intraoral radiographs are necessary to adequately stage the disease process and help to decide when to extract these teeth. Since we have no definitive name or understanding of the disease process, we would really appreciate clinical and radiographic input from veterinarians who observe this condition so that we might gather more data in our quest to find a solution to this horrible condition. I can supply photos and radiographs of this condition if you like. Lynn Caldwell, DVM

That depends to some extent on the numbers, location and distribution (all in one part of the mouth or different areas?) of the teeth involved as well as the condition of the remaining teeth. Some horses do well (provided that the remaining teeth get regular care so that the resulting overgrowths are taken care of), and others need to go to a diet consisting of soaked, chopped or sifted hay, or senior-type feeds and soaked beet pulp. Elizabeth Schilling, DVM

Yes, it would be best to do this, being sure that large twigs and stems are not in the feed. Senior feeds are complete feeds and are designed for situations like this. I have had many patients in my practice that have lived for many years on just senior feed and beet pulp and all the pasture they can get. Lynn Caldwell, DVM

This is an excellent question!

When I perform any dental exam or procedures, I always try to show the client exactly what we are looking at, explain what we are doing and why. Just as importantly, I will explain what we are NOT doing and why.

To do a good exam, the horse should be well sedated (because these are not comfortable procedures) both to enable a thorough exam as well as for safety - the horse's, the vet's, and yours. There should be a full-mouth speculum in place, to allow access to the entire mouth, and the vet should use a bright light. A complete dental exam includes both a visual (with light and eyes) as well as digital (using the fingers) exam. Areas examined include the surfaces of the teeth, the gums, cheeks and palate. Elizabeth Schilling, DVM

The only thing I have to add is that a veterinarian familiar with the function of the stomatognathic system will also evaluate the overall biomechanical efficiency of the horse's mouth. Lynn Caldwell, DVM

It would help if you could give more detail about what is going on - does she drop feed? chew open-mouthed? yawn or stretch her head and neck while chewing? excessively push food around with her tongue? can she pick up the food well with her lips? once it's chewed does she swallow normally or spit food out?

I would suggest a follow-up dental exam, preferably with a veterinarian that has advanced training in dentistry. Depending on what exactly she is doing, we might find problems in the temporo-madibular joints (TMJs), muscles of mastication, nerves supplying the lips, tongue, muscles and jaws or a dental problem that has not yet been diagnosed. Elizabeth Schilling, DVM

Generally, when we talk about an impacted tooth, we are talking about one which is prevented from erupting into the mouth by crowding from nearby teeth, not usually the case with wolf teeth. This situation may refer to a blind wolf tooth, which has not erupted into the mouth but is lying under the gingiva (gums). These blind wolf teeth often cause discomfort to the horse, and as such are better extracted, but I see many older horses with blind wolf teeth present that do not seem to have any problem (no discomfort with the bit, no sweling or inflammation). Depending on the age of the horse at castration, wolf teeth may not yet be present.

I'm glad that you mentioned radiographs, as we feel that radiographs are very important in diagnosing oral problems. Due to the irregular location and positioning of blind wolf teeth, radiographs give us information about the direction and shape of the root, and whether the root may be fractured (not common, but important to know). Elizabeth Schilling, DVM

Technically speaking, a blind wolf tooth or blind canine is just an unerupted tooth because they do not (generally) have a deciduous precursor. The need for extraction may be indicated if the horse is experiencing discomfort. The extraction of unerupted teeth is best performed under sedation and local anesthesia by your veterinarian. Lynn Caldwell, DVM

To answer the question simply, the answer is no. The more complete answer is this:

A specialist is a doctor or veterinarian who has pursued advanced training in a particular area and who is certified (a "diplomate") by a specialty board. (i.e. a general surgeon, orthopedist, dermatologist, gynecologist). There is an American Veterinary Dental College AVDC), which board certifies veterinary dentists, and whose scope is currently limited to small animal dentistry. That is going to change, but it will be a few years before there are equine dental specialists. There is also the Academy of Veterinary Dentistry (AVD), whose members are "fellows" rather than "diplomates". There is currently one equine fellow of the AVD, and two or three more who should pass the test this year. There are now two Equine Fellows that passed the test in February.

In most states, "equine dentist" does not exist by definition, because dentistry is considered to be part of the practice of veterinary medicine. When someone is "certified", this is not the same thing as board certification since these certifications are given by organizations of lay people.

IAED "certification" is in occlusal equilibration only and this organization does include some veterinarians.

Comparing veterinarians to lay tooth floaters is not a valid comparison. There are good and bad individuals in any group, and there are some veterinarians who do not perform what is considered to be "performance" dentistry. There are also some lay people who perform either inadequate or excessive work on equine teeth and misrepresent themselves to be some sort of "professional" to unsuspecting horse owners. It is important to remember a few things: First, in order to perform a thorough dental exam, one must have a sedated horse. In order to safely sedate an animal (or person for that matter), one must have a thorough understanding (I would say education in) of physiology, pharmacology and pathology. This understanding (formal education) is not part of a short course in floating teeth nor an apprenticeship. Secondly, veterinarians are trained to evaluate the health of the whole horse, not just of the teeth, which may affect not only the sedative protocol, but also the procedures performed. Thirdly, the field of equine dentistry is in a very exciting period of change and discovery. New anatomic studies coming out of Germany and Scotland, among other Universities, are elucidating the structures of the equine tooth more than ever before, and enhancing our understanding of the health and diseased states of these teeth. New instruments make our job easier and faster. However, the science in determning which procedures are appropriate and/or necessary are still underway. At this point in equine dentistry, many opinions of what constitutes "good work" are just that, opinions. We have seen horses that their teeth have been damaged by overenthusiastic (or maybe "aggressive" ) procedures, and their health has been damaged by insufficient dental examinations and care. The bottom line is that dentistry is part of veterinary medicine, just as your horse's teeth are part of his or her whole system. Elizabeth Schilling, DVM and Lynn Caldwell, DVM

For any infertile mare it is important to examine her first. Baseline information would include an ultrasound of her uterus, culture and cytology. You could also do a uterine biopsy that would tell you, after microscopic examination, what the odds were of her carrying a foal to term.

BUT - if she's normal, many infertility issues are due to incompatibility of the mare/stallion combination. Even if the stallion has normal APPEARING semen, he may not be able to penetrate the mare's egg and form a viable embryo. These can present as failure to concieve OR loss of embryos. I, personally have bred thoroughbred mares six times in one breeding season to the same stallion, switched stallions on the 7th cycle and gotten pregnancy.

Evaluate the mare, if she's normal, switch stallions. Ben Espy, DVM, DACT

Blood vessels can be engorged in the vagina and udder during late gestation. A rupture of one of these is no cause for concern. It's not how everything is supposed to work but sometimes it happens. Your veterinarian is right. Be careful about manipulating the udder too much right before foaling because stimulation of that part of the body is a VERY strong stimulus for oxytocin release, which leads to uterine contraction. Ben Espy, DVM, DACT

This was a mummified fetus. This was the live foals twin that died in the uterus. The mare will often encapsulate these objects so they do not harm the surrounding tissue and since the uterus is a sterile environment, it is not an infectious process. No treatment is needed. Ben Espy, DVM, DACT

There are blood tests to determine whether testicular tissue remains in your horse. The HCG Challenge test is exceptionally cheap and specific. Your veterinarian will pull blood, give a medication, then pull blood a number of hours later to see how high the progesterone has risen.

Behaviorally, in even stallions that are castrated correctly to become geldings, up to 60 to 65 percent will retain their behavior because of learned experiences.

I would recommend you get the HCG Challenge test performed. Ben Espy, DVM, DACT

Since the teeth are not being held in their place by the lip and have drifted, I wonder if they are in occlusion with the upper incisors on that side. Are they now causing ulceration to his lip that some minor smoothing of the incisal edges might eliminate? If these teeth are still in some sort of occlusion, or could be reduced in some way to achieve some occlusion, I would tend to want to leave them. I might extract them if they have become excessively mobile or affected by periodontal disease due to the drifting and exposure. However, if these teeth are extracted, you now have his upper incisors unopposed, if they are not already. A close-up of the area would be helpful. Lynn A. Caldwell, DVM

I would strongly recommend NOT stimulating her cervix in any fashion. This causes prostaglandin AND oxytocin release enough to induce foaling. If the suspense is killing you, using a speculum is not ideal, but safer than checking the cervix with your finger.

Bleeding varicosities in the vagina are common in late-term mares, and also are most common when mares lie down because of increased pelvic blood pressure.

Coincidentally, you can verify these with a vaginal speculum exam as well.

If you are concerned about placentitis, which does not cause bleeding anyway, you could measure the combined thickness of the uterus and placenta (CTUP) using an ultrasound unit. Ben Espy, DVM, DACT