Virginia Equine Surgery & Sports Medicine

09/07/2026

Our office will be closed today, Monday, September 7th in celebration of Labor Day. We will be back in the office at 8:00am on Tuesday, September 8th.
As always, there is a doctor on call in case of emergencies:
(540) 955-5551

09/04/2026

Normal Anatomy of the Equine Upper Airway

Upper Airway
Due to their athletic nature, horses have a respiratory system capable of breathing large amounts of air quickly into their lungs to bring fresh oxygen to their tissues and out of the lungs to get rid of excess carbon dioxide. Their anatomy is designed to maximize airflow through the nasal passages and into the trachea (windpipe).

Horses are obligate nasal breathers, meaning that they can only breathe through their noses unlike other species such as dogs. Air travels through the nostrils and along the nasal passage where it is warmed and humidified before reaching the pharynx (back of the throat). In this area there are openings to the paired guttural pouches; the guttural pouches are outpouchings of the connection between the throat and middle ear, several important structures run through them (e.g. the internal carotid artery) and they can be important sites of bacterial and fungal infections.

In the back of the pharynx are the openings to the esophagus and trachea. The opening to the trachea includes several cartilages that open and close to regulate airflow, the vocal cords, and the epiglottis (a small flap of tissue that forms the bottom margin of the opening.) The soft palate forms a seal under the epiglottis effectively separating the mouth from the nasal passage and pharynx except for during swallowing, when the epiglottis flips up and protects the airway while food is directed to the esophagus just above the trachea. The trachea has rings of cartilage that keep it wide open to allow for air flow even at high negative pressures such as when a horse is breathing heavily during exercise. Where the trachea meets the lungs, it splits into smaller and smaller branches called bronchi to reach all sections of the lung.

Eventually, the smallest airways lead into air sacs called alveoli which are closely surrounding by capillaries carrying blood to and from the lungs. Here, oxygen and carbon dioxide are able to be exchanged between the air and blood before the air travels back the direction it came as the horse breathes out. There are several disease processes that can interrupt this normal airflow process in the upper portion of the horse’s airway. Many of these can be seen on an endoscopic exam (scope), allowing us to develop a treatment plan to address any issues.

09/01/2026

For the month of September we will be focusing on Upper Airway Diseases and Endoscopic Exams. The topics we will be discussing are the Normal Anatomy of the Equine Upper Airway, Exercise Induced Pulmonary Hemorrhage (EIPH), Dorsal Displacement of the Soft Palate, Pharyngitis, and Laryngeal Hemiplegia. We hope that you find these posts educational and insiteful. Thank you to Dr. Sarah Carter for her time, talent and knowledge as she is the one behind the scenes putting this months educational topic together as well as drawing some of the pictures.

Stay tuned for the first post 🐴🐎🏇

08/31/2026

Sub-Palpebral Lavage System

A sub-palpebral lavage system (SPL) is a specialized catheter system for treating eye diseases in horses. As many eye conditions can be painful, horses can grow to resent having medications put directly in their eye and these medications need to be administered frequently, often up to five times a day. Horses have powerful eyelid muscles that allow them to try to keep their eye closed when trying to apply ointment or drops, and they may also throw their heads risking you causing more damage to the already diseased eye or getting hurt yourself in the process when trying to treat them. In these cases, your veterinarian can place an SPL which has tubing that runs under the horse’s eyelid and then along their neck to their withers. The medications can then be injected through a port at the withers and travel up to the eye without having to touch the painful eye directly.

08/25/2026

We wanted to share🐴

If any of our clients would be interested in learning about Equine Herpesvirus (EHV-1) – the strains, the signs and symptoms, and prevention measures please check out this exciting opportunity that is specifically for educating horse owners.

Our friends at Boehringer Ingelheim Animal Health have shared an upcoming webinar for horse owners hosted by The Horse on Thursday, August 27th at 8 pm EST.

EHV-1: Understanding the Disease and Reducing the Risk
Presented by Dr. Nicola Pusterla, PhD, DACVIM, AVDC-Equine

If you’re interested please use the link below to register for the webinar;
Registration link:

Join us for this webcast to learn more about equine herpesvirus strains, clinical signs of infection, and potential effects on horses.

08/24/2026

What is Strangles?

Strangles is a highly contagious disease caused by the bacteria Streptococcus equi subspecies equi (S. equi). It is characterized by swelling of the lymph nodes and the formation of abscesses. Horses can contract the disease by coming into contact contaminated surfaces, people or equipment and infected horses.

The incubation period for strangles is 3 to 8 days; clinical signs include lethargy, anorexia (decreased or absent appetite), fever (>101.5F), nasal discharge, and swollen lymph nodes.

Severity of illness can vary depending on the affected horse’s immune status and the dose and strain of bacteria. Younger horses are often more severely impacted.

Prognosis is generally good, especially in cases of uncomplicated strangles and most horses make a full recovery. Death can occur in more complicated cases. Some horses are carriers who appear healthy and show no signs but intermittently shed the disease.

In most cases, treatment of strangles is rest and supportive care. Horses need to be closely monitored. Proper isolation of sick or exposed horses and thorough testing before reintroduction into a herd are of the utmost importance when dealing with Strangles. Nasal shedding can persist for up to 3 weeks and horses may be infectious for at least six weeks after nasal discharge has stopped.

Prevention is key; isolation and quarantine of any new horses on the farm for at least 2 weeks and monitoring for fevers of any signs of illness and always quarantining any horses who show upper respiratory signs or fevers. Proper biosecurity, including cleaning of equipment.

For more information on Strangles;
https://www.equinediseasecc.org/strangles
https://ceh.vetmed.ucdavis.edu/health-topics/strangles
https://aaep.org/wp-content/uploads/2024/03/Strangles_DZ_Guidelines_FINAL_2020.pdf

08/17/2026

This week we want to wish the best of luck to all of our patients and clients participating in the Jefferson County Fair. We hope the weather is beautiful, the animals are healthy, new friendships are made and that the barns are flooded with ribbons.

The fair runs this week from August 16 -August 22 and is located at:
The Jefferson County Fairgrounds
1707 Old Leetown Pike
Kearneysville WV 25430

So if you are out and about and looking for something fun to do, go check out the fair. There will be plenty of livestock shows, ice cream, truck/tractor pulls, good food, games and rides. Support the youth exhibitors, Jefferson County 4H and FFA. These young men and women are the future of agriculture and work hard all year to showcase their animals and projects one week a year.

https://jeffersoncountyfairwv.org/

08/13/2026

Rhodococcus equi is a bacterium that lives in the soil and can cause pneumonia in young foals. A foal can inhale airborne bacteria into their respiratory tract or ingest contaminated soil. The infection progresses slowly and foals often do not show clinical signs until the disease becomes severe. Infected foals can shed the bacteria in their f***s, leading to the pathogen becoming endemic on the breeding farm, leading to disease recurring yearly in the new foals born.

Clinical signs can include fever, labored breathing, cough, a rattling sound in the trachea and depression. Diagnosis is often via ultrasound or radiograph of the lungs to evaluate for abscessation. Bloodwork and identification of the bacteria via culture or PCR testing. Extrapulmonary disease can occur (abscesses in areas other than the lungs). It is also important to note that on endemic farms, many foals can be infected and subclinical. It is very important to screen foals on these farms.

Treatment of Rhodococcus with antibiotics such as clarithromycin combined with rifampin and supportive care. Therapy is often for 4-6 weeks. Foals with Rhodococcus should be handled in low stress ways and kept in well-ventilated areas.

In the first week of life hyperimmune plasma can be administered IV to high-risk foals for help in prevention. There is no vaccination for Rhodococcus. Good management is also important – housing in well-ventilated areas, minimizing dust, avoiding dirt paddocks.

For more information:
https://aaep.org/wp-content/uploads/2017/01/Rhodococcus-equi-Disease-Guidelines-Final.pdf
https://ceh.vetmed.ucdavis.edu/health-topics/rhodococcus-equi
https://www.ivis.org/sites/default/files/library/aaep/2001/91010100456.pdf

08/10/2026

We want to wish the best of luck to all of our patients and client participating in the Clarke County Fair this week. We hope the weather is fabulous, the bleachers are packed and the ribbons are hanging in abundance.

The fair runs from August 9 - August 16 and is located at
890 West Main Street
Berryville VA 22611

So to all of the FFA and 4H members, congratulations on completing another year of hard work and spending this week showcasing your animals and projects. If you are in the area, stop by and check out all the fun you can have at the Clarke County Fair.

https://clarkecountyfair.org/fair/

08/06/2026

Equine Asthma

While you may have heard multiple names for this condition, including asthma, heaves, and COPD, they all refer to the same thing: inflammatory airway disease that is related to allergens rather than an infectious cause (e.g viral or bacterial).

Signs of asthma in horses can include coughing, nasal discharge, breathing more rapidly, and more effort breathing, sometimes to the point where they have to push or heave with their abdominal muscles to push air out, hence the term “heaves.” When listening to the lungs of these horses with a stethoscope, you can often hear crackles and wheezes in addition to the normal flow of air through the lungs.

Normal allergens in the air including certain types of grasses, weeds, pollens, dust mites, and molds get into the horse’s airway and can cause an overreaction of the horse’s immune system. In addition to clearing the particles, a horse with asthma often produces increased mucus that clogs the lower airways, and inflammation causes swelling and irritation of these small airways; combined these processes make the horse have to work harder to pass air through their swollen and clogged airways.

There are three main factors for treating asthma: decreasing allergen exposure, anti-inflammatories, and bronchodilators. The most important way to prevent asthma flare ups is by managing the horse’s environment; this can include decreasing dust exposure through soaking hay, wetting down dusty areas, and cleaning the barn when horses are turned out. Round bales are not ideal for asthma horses as they can burrow into them and inhale lots of particles while eating. Anti-inflammatories for asthma are typically steroids either given by injection, orally, or inhaled. There are risks associated with steroid use, especially if your horse is at risk for laminitis, so inhaled administration can be a way to target the affected area with less side effects. Bronchodilators open up the smaller airways by relaxing the muscles in the airway walls, they can be administered orally or inhaled. This allows easier movement of air and also allows inhaled medications to get deeper into the lung so they are often given in concert with inhaled steroids. There are special adaptors for human inhalers to make them easier to administer via horse nostril, and there are also nebulizers that aerosolize liquid meds that are then administered through a mask that fits over the horse’s muzzle.

If your horse is diagnosed with asthma, it is a lifelong disease that will require commitment as the owner to managing that horse’s lifestyle to decrease the need for medications while maintaining the best possible quality of life.