Presidio Equine Sports Medicine & Rehabilitation

06/15/2026

When is a splinter, just a splinter? Well, that depends on where it is. This horse sustained a small puncture wound in its lateral heel bulb. The small shard of wood was removed, the tendon sheath flushed out of an abundance of caution, and the horse returned to work.

About a month later, a waxing and waning lameness had been noted. Initially, the horse would work out of the asymmetry, but as time went on a subtle lameness persisted. The cause? An adhesion (fibrous soft tissue union) had formed between the deep digital flexor tendon (DDFT) and the wall of the tendon sheath.

It’s important to remember that the structures in the limb are extremely dynamic. When the leg is in motion, as it was when the splinter became lodged in the heel, the soft tissue planes, skin, tendons and ligaments, are all in a different orientation and location than they are at rest. The splinter in the lateral heel had penetrated the lateral lobe of the DDFT mid pastern. The adhesion and subsequent granuloma were debrided tenoscopically, and the horse returned successfully to compete over fences.

05/01/2026

Wonderful weekend with a great group of veterinarians, horses and riders! All for the love of the horse.

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04/06/2026

"Ursini described three main components of back issues: weakness; hypomobility or stiffness; and generalized pain. While horse conformation can lead to dysfunction, incorrect plantar angles that cause hind-limb lameness also can contribute by altering spinal motion patterns."

Common causes of topline dysfunction in horses and how to evaluate and address them.

03/18/2026

Have you ever seen the finish of the cross-country phase in three-day eventing? The finish box, aka the vet box, is a mandatory holding area where veterinarians and officials monitor the horse’s fitness, soundness and recovery before the horse returns to the barn.

This area is used for immediate, aggressive cooling of the horse to bring down its heart rate, respiratory rate, and body temperature which can be upwards of 104 degrees.

The finish box is fast paced, with riders and grooms aiding in immediate tack removal, iced cooling, walking and rehydration of their horse.

03/03/2026

Dr. Mills was featured in the Spring 2026 edition of The Horse, “The Equine Lameness Exam Workup Explained”.

02/04/2026

Zycosan is the disease-modifying osteoarthritis drug pentosan polysulfate. In recent years, it has gained popularity as an alternative to Adequan and Legend due to a number of controlled studies showing its ability to improve both clinical lameness and cartilage damage via intramuscular administration.

“Osteoarthritis (OA) remains the leading cause of lameness in horses, affecting an estimated 80% of horses older than 15.” .... “Unlike therapies that only target symptom relief, pentosan polysulfate is also intended to influence the disease process itself by supporting cartilage metabolism and joint health.”

In one study utilizing the carpal chip model “…treated joints demonstrated significantly reduced cartilage fibrillation (advanced stage of damage), improved histologic cartilage scores, and increased concentrations of the CS-846 biomarker, which is associated with cartilage repair activity, said Hunt.”

“In a larger placebo-controlled clinical trial of 237 horses with radiographically confirmed OA and single-limb lameness, 58.9% of PPS-treated horses improved by at least one lameness grade…” Researchers believe pentosan polysulfate supports cartilage metabolism, improves joint microcirculation, and might help reduce cartilage breakdown.

“In experimental models, researchers have demonstrated [pentosan polysulfate, Zycosan] provides superior cartilage histologic outcomes compared with intramuscular polysulfated glycosaminoglycans [Adequan] and hyaluronic acid [Legend].”

https://equimanagement.com/research-medical/pentosan-polysulfate-an-evidence-based-option-for-managing-equine-osteoarthritis/?lid=hswqg6i6qrzc


Lameness

01/27/2026

"In experimental models, researchers have demonstrated [Pentosan] provides superior cartilage histologic outcomes compared with intramuscular polysulfated glycosaminoglycans and hyaluronic acid." such as Adequan and Legend.

Pentosan polysulfate appears reasonably safe for equine OA management with label use.

01/06/2026

Delayed-onset muscle soreness (DOMS) is a well-characterized phenomenon in human sports medicine yet remains relatively underexplored in the context of equine physiology.

Recognizing DOMS in horses matters because of its often-subtle presentation, and it could be misinterpreted as behavioral resistance, lameness, or other more serious conditions, such as rhabdomyolysis (tying up).

Researchers describe DOMS in horses as muscular discomfort and stiff ness that generally emerges 24 to 72 hours after undergoing unusual exercise to which the body isn’t accustomed1. “DOMS typically occurs in muscles used more intensely or for a longer duration than normal, and this increased activity results in some muscle (micro) damage,” explains Michael Lindinger, PhD, editor-in-chief of the European Journal of Applied Physiology and president of the Nutraceutical Alliance, in Guelph, Ontario, Canada. “The amount and duration of soreness are generally proportional to the amount of muscle damage.”

What causes delayed-onset muscle soreness in horses, and what does its occurrence tell us about our horses’ fitness levels?

12/20/2025

“One key concept helps guide that process: A neurologic horse’s gait is “irregularly irregular,” while a lame horse’s gait is “regularly irregular”…”

Learn how veterinarians differentiate neurologic conditions in horses from musculoskeletal lameness and how exams, imaging, and technology help guide diagnosis.

11/13/2025