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Monday 8am - 5pm Tuesday 8am - 5pm Wednesday 8am - 5pm Thursday 8am - 5pm Friday 8am - 5pm

Double X Veterinary Services, 136 CR 1793, Sunset, TX (2026)

10/13/2026

We’re swapping out pink for red…

From Pink Buckle to The Texan!

Double X will be at The Texan 14th-17th. Call the clinic at 940-514-9500 to get on the schedule!

10/08/2026

‼REMINDER‼

The Double X team is at Pink Buckle in Guthrie Oklahoma right now, we are unable to do Coggins (EIA) papers until they get back.

We also DO NOT have a small animal tech in the clinic the remainder of this week to do vaccines or testing. If you need to schedule an appointment please be aware it will need to be scheduled for when we do!

Thank you, XX

10/07/2026

We talk suspensory tears, deep digital flexor tears, strains, holes... etc. But what is another word owners often hear when dealing with soft tissue injuries in performance horses? Desmitis.

Desmitis simply means inflammation or injury of a ligament. In horses, we commonly hear the term associated with the suspensory ligament, but desmitis can affect other ligaments throughout the body as well.

And this is where some of the terminology can get confusing.

Desmitis, a suspensory tear, and a deep digital flexor tendon tear are not necessarily the same thing. Desmitis describes injury or inflammation within a ligament. A suspensory tear is a more specific description of structural fiber disruption within the suspensory ligament, so a suspensory tear can fall under the broader diagnosis of suspensory desmitis. A deep digital flexor tendon tear, however, involves a tendon, not a ligament. Tendons connect muscle to bone, while ligaments primarily connect bone to bone and stabilize joints. Injuries of the DDFT are therefore described as tendinitis/tendinopathy or tendon tears rather than desmitis.

The common ground? All of these structures are made largely from highly organized collagen fibers, and all are asked to withstand tremendous forces in an equine athlete.

Running, stopping, turning, jumping, accelerating and repeatedly loading the limbs place substantial mechanical stress on tendons and ligaments. These structures are designed to tolerate that load, but repetitive strain can contribute to microscopic collagen damage over time. Research into equine tendon injury has shown that acute tendon injuries are often preceded by microscopic collagen damage. This means the process leading toward a larger injury can begin before there is an obvious tear, swelling or dramatic lameness.

With suspensory injuries, particularly when both limbs are involved, a horse may show more of a performance or change in action than a clear head-bobbing lameness. Suspensory branch injuries can even exist without obvious lameness. Horses may simply feel different to the rider without looking dramatically lame.

So what does desmitis actually look like?

Ultrasound is one of the primary tools veterinarians use to evaluate accessible ligament and tendon injuries because it allows us to evaluate the size, shape, fiber pattern and organization of the structure. A healthy ligament generally has a relatively uniform appearance. When viewed longitudinally, its fibers create an organized, parallel pattern. In cross-section, the structure should have a relatively consistent shape and echogenicity.

With injury, ultrasound may show:

• Enlargement or thickening of the ligament
• Hypoechoic, or darker, areas
• Changes in overall echogenicity or "brightness"
• Disruption or irregularity of the normal fiber pattern
• Changes in the shape or margins of the ligament
• A distinct lesion or area of fiber disruption with more significant injury
• Fibrosis and remodeling associated with chronic injury

Imaging findings have to be interpreted alongside the horse's clinical examination, lameness localization, history and comparison with the opposite limb.

Does desmitis end a performance horse's career?

There is an enormous spectrum between mild ligament injury and catastrophic disruption of the suspensory apparatus. Location, severity, chronicity, which limb is involved, concurrent injuries and rehabilitation all influence prognosis.

For example, veterinary literature reports a very favorable return to function for many horses with acute forelimb proximal suspensory desmitis when appropriate rest and controlled rehabilitation are followed. Hindlimb proximal suspensory desmitis generally carries a more guarded prognosis for return to performance. Suspensory branch injuries can require six months or longer to improve and can recur.

One of the most important parts of managing these injuries is respecting how slowly tendon and ligament tissue heals and remodels, and doing the rehabilitation the right way. It's a marathon. Not a sprint.

10/05/2026

We’re here to listen. To you AND your horses.

We want to hear about the little things you’re noticing, because sometimes those little changes are exactly where we need to start looking. You ride them. You are around them daily. The chances are you feel or notice things long before they're actually visible.

Lameness exams don't always just reveal obvious soreness, sometimes a little insight on the horses day to day behaviors or changes, offer up insight on exactly what to start digging for

We’re here to listen to what you’re telling us and what your horse is telling us, too. ❤️

10/02/2026

Lets test your knowledge (or what your horses have had done 😆)
Name the injection.

Bonus points for why Dr. Lee is utilizing the ultrasound machine, and what the point of the injection is.

09/30/2026

There are a million different things you can do for maintenance…

A million different injections.
A million different therapies.
A million different supplements.
A million different medications.
And so on…

But nothing replaces a well-placed lameness and physical exam with your veterinarian.

Performance horses are athletes, and soreness doesn’t always show up as an obvious head bob or a horse that is visibly lame.

Sometimes it’s much quieter.

A horse starts dropping a shoulder in a turn. They’re a little slower to engage behind. They suddenly struggle with a lead they’ve never had trouble with. They’re not stopping as hard, leaving as confidently, or clocking quite like themselves. Maybe they’re simply having an “off” day more often than they used to. To the average eye, that horse may look completely sound.

Small changes in comfort can create changes in the way a horse uses their body. When something hurts, they compensate. When compensation continues, other structures can begin carrying loads they weren’t meant to carry.

That’s one of the reasons routine veterinary exams can be so valuable, even when nothing appears to be “wrong.”

Think about it a little like having your farrier out. We don’t necessarily wait until a horse is missing 2 of four shoes, one is hanging with one nail, and they look like their feet may as well be platform shoes... You have a routine. A schedule. When you know they are ready to be done, before they need it because problems are rising.

Performance, and preventative, maintenance works the same way.

Some of our futurity trainers and professional rodeo athletes bring horses in every few months. Others may only need to come in twice a year, and some once a year. Sometimes we see a horse more frequently in the beginning while we learn what their body needs, how they respond to different medications or injections, where they tend to get sore, and what schedule keeps them feeling their best.& ;

The goal isn’t to inject everything, treat everything, or throw every therapy and supplement available at a horse. It's not a "one size fits all." The goal is to find the RIGHT program for that individual horse.

That might involve joint care. It might involve regenerative medicine, shockwave, chiropractic work, rehabilitation, changes in shoeing, conditioning, nutrition, recovery time, or something completely different. And sometimes the answer is simply that the horse looks and feels great and doesn’t need anything beyond continuing to monitor them.& ;

A good maintenance program should evolve with the horse, their workload, their age, their discipline, and what their body is telling us.

Routine exams give us a baseline. They let us learn what is normal for that horse and make it easier to recognize when something starts to change. Maintenance isn't supposed to just be about fixing soreness once it becomes impossible to ignore.

Find your baseline. Make sure you are on top of it to keep them feeling like the winner you want them to be.

09/28/2026

It’s been a little busy around here. ❤️

Thank you to all of our incredible clients who continue to trust Double X with your horses. It’s truly a pleasure getting to work with each and every one of you. Dr. Lee and Dr. Vermillion work as hard as they do because they genuinely LOVE this. They’re invested in your horses’ success almost as much as you are… or at least, they’re pretty close. 😆

And it isn’t just the veterinarians. The entire crew here at XX is cheering on every horse and rider combination that walks through our doors. We love seeing where you’re headed, hearing how your horses are doing, and celebrating the wins right alongside you.

Which brings us to…

Where are YOU headed this week/weekend?! Drop it in the comments so we can cheer you on!

XX will be headed to Pink Buckle end of this week, and if you’re there, we’d love to see you and cheer you on in person. 💗 And if you want to sneak in an appointment while we’re there, please call the clinic to get on the schedule!

Good luck to everyone headed down the road this week.

09/25/2026

Fractured withers.

Terrifying to hear. Surprisingly forgiving to heal.

You would think it’s a wildly uncommon injury, but fractured or “crushed” withers happen more often than many horse owners realize, and the prognosis can be MUCH better than the diagnosis sounds.

These injuries classically happen when a horse rears or flips over backward, especially when they come down hard on an unforgiving surface.

And, well… horses do seem to have a death wish sometimes, so the accident itself isn’t exactly unheard of. 😅

But what exactly are they breaking?

The withers are formed by the long dorsal spinous processes extending upward from the horse’s thoracic vertebrae. When we talk about fractured withers, we’re typically talking about fractures of these tall bony projections, commonly around T4 through T10, rather than a fracture through the main body of the vertebra or spinal canal.

That distinction is what makes fractured withers different than kissing spine or things directly effecting the vertebrae or spinal cord. That is also part of the reason a fractured withers diagnosis can have such a surprisingly good long-term prognosis.

Initially, these horses can absolutely be painful. There may be significant swelling, sensitivity, reluctance to move the neck or lower the head, and sometimes an obvious change in the shape of the withers. Once the acute injury has healed, many horses can go right back to successful performance careers with little to no limitations.

A small study followed eight Thoroughbred racehorses diagnosed with withers fractures. Every horse returned to racing at a level equal to or better than before the injury. That’s obviously a small number of horses, but it helps demonstrate just how capable these injuries can be of healing without ending an athletic career. Similarly, horses we have had walk through the clinic, we have watched many with this injury come back with shining reports of continued success in the arena. It also isn’t uncommon for fractured withers to be diagnosed later in life long after the injury has healed.

This is also very different from what we commonly think about with kissing spine. Kissing spine generally involves adjacent dorsal spinous processes being too close together, touching, or overlapping, often farther back beneath the saddle. That relationship between the bones can contribute to repeated irritation, inflammation, and pain as the back moves.

A healed withers fracture does not automatically create that same ongoing bone-on-bone relationship.

So while BOTH conditions involve dorsal spinous processes of the thoracic spine, they are very different problems.

Does that mean fractured withers never cause complications?

No.

One potential complication is a sequestrum. Sometimes a fractured piece of bone loses its blood supply, separates from healthy bone, and essentially becomes a piece of dead bone that the body cannot incorporate normally into the healing process. Instead of healing quietly, that fragment can remain irritating, contribute to persistent inflammation or infection, and sometimes require surgical removal. Fragments may also require surgery if they are impinging on surrounding structures or interfere with normal saddle placement. However that is considered a complication, and not the expected outcome of every fractured withers case.

For many horses, once the initial fracture heals and inflammation settles, the injury itself may have little to no lasting effect on athletic ability. Some horses may be left with a change in the shape of their withers that requires careful saddle fitting, and others may occasionally develop soreness or inflammation around the area that needs to be addressed based on what is actually causing discomfort.

The important part is treating the HORSE, not simply treating an old finding on an X-ray. Fractured withers can sound catastrophic. They can LOOK catastrophic.

But given appropriate diagnosis, adequate time to heal, good saddle fit, maintenance, and treatment of complications if they arise, many horses can return to full athletic careers without the fracture defining the rest of their performance life.

09/24/2026

A quick communication update from Double X Equine!

We want to make sure we’re staying on top of every call, voicemail, text, and message coming into the clinic.

Many of our clients also have Dr. Lee’s personal number and reach out to him directly to schedule appointments or ask questions. While we absolutely understand the convenience of being able to contact him directly, he receives a high volume of calls and texts throughout the day while also seeing patients, traveling, and working in the clinic. Occasionally, a call or text can get missed in the shuffle.

If you have called the clinic, left a voicemail, or contacted Dr. Lee directly and have not received a response, please also email us at [email protected]. This gives our office another way to see your message, follow up, and make sure nothing has slipped through the cracks.

For non-emergency calls and voicemails, our goal is to return your call within 24 hours if we aren’t able to take your call when you initially called in.

If it has been longer than 24 hours and you haven’t heard back from us, please let us know! We want to know when something gets missed so we can address it and make sure you’re taken care of.

As always, if you are dealing with an emergency, please make that clear when contacting the clinic so we can assist you appropriately.

We appreciate everyone helping us keep communication running as smoothly as possible! ❤️

09/24/2026

Once you become a “neck person,” there’s no going back.

Wobblers, ECVM, Arthritic changes in vertebrae.

What are the signs and symptoms?
How are they diagnosed?
How is the prognosis for affected horses?
What is the difference?

Neck problems aren’t the end be all they used to be. There are surgeries. Injections. Many options to give horses the opportunity at continued performance careers, and just arthritic changes can be managed with proper veterinary care to manage a horse’s comfort long term.

-

Cervical arthritis / arthritic changes in the neck

Arthritis usually involves the cervical facet (articular process) joints. Some horses have significant X-ray changes without obvious symptoms, while others become painful or neurologically affected if inflammation/enlargement encroaches on nearby nerve structures. This varies horse to horse in severity of the changes.

Common signs can include:

- Neck stiffness or reduced range of motion
- Resistance to bending one direction
- Pain when the neck is flexed, extended, or palpated
- Difficulty bringing the head/neck around
- Reluctance to lower or raise the head
- Resistance under saddle, especially collection or lateral work
- Head tossing, bracing, or suddenly becoming difficult in the bridle
- Shortened or abnormal front-limb stride
- Muscle wasting around the neck/shoulder
- Unexplained forelimb lameness
- Difficulty grazing from the ground in more painful cases

If arthritic enlargement or inflammation begins affecting nerve roots or the spinal cord, you can also see weakness, stumbling, abnormal foot placement, or ataxia.

Common approaches of treatment include NSAIDs such as phenylbutazone or firocoxib; ultrasound-guided corticosteroid injection of affected cervical facet joints; sometimes regenerative therapies such as PRP depending on the lesion and veterinarian; rehabilitation/physical therapy; controlled exercises to improve cervical and topline strength; and management of contributing issues such as saddle fit, hoof balance and workload.

-

Wobbler syndrome / cervical vertebral compressive myelopathy (CVCM)

This is specifically a neurologic problem caused by compression of the cervical spinal cord. The compression can be static, present regardless of neck position, or dynamic, meaning the amount of compression changes with neck position.

The classic signs are:

- Ataxia: the horse doesn’t accurately control where its limbs are going
- Hind limbs often more obviously affected than front limbs
- Swaying or weaving of the hindquarters while walking
- Crossing the hind legs unexpectedly
- Stepping on itself
- Toe dragging or excessive hoof wear
- Stumbling/tripping
- Abnormally wide or narrow limb placement
- Delayed correction when a leg is placed in an unusual position
- Difficulty backing normally
- Difficulty walking with the head elevated
- Difficulty negotiating slopes, curbs, or tight turns
- Circumduction aka swinging a limb outward rather than bringing it straight forward
- Weakness when the tail is pulled while walking
- Difficulty recovering from a stumble
- In more severe cases, falling or difficulty getting up

One important distinction: Wobblers doesn’t necessarily hurt. A horse can have relatively normal neck movement but significant neurologic deficits because the primary issue is the spinal cord. The neurological problems are usually graded using a 0-to-5 grading system (based on Mayhew's grading system) to measure the severity of neurological deficits. 0 being lack of any neurological signs, 5 being recumbent (down) and unable to stand.

Treatment is very dependent on what is physically compressing the cord. When there is substantial mechanical compression, surgery may be considered.

One of the best-known procedures is cervical vertebral stabilization/fusion, commonly referred to as ‘basket surgery’. A surgical implant is placed between affected vertebrae to stabilize/fuse the motion segment. This is particularly relevant to dynamic compression because abnormal movement between vertebrae contributes to the cord being compressed. Stabilizing that segment can reduce that movement. Prognosis depends heavily on severity, duration, location, number of affected sites and degree of existing cord damage.

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ECVM / Equine Complex Vertebral Malformation

ECVM describes congenital/developmental anatomical variations involving the lower cervical vertebrae, most notably C6 and sometimes C7, and potentially associated first-rib/sternal-rib abnormalities.

This one gets complicated because finding ECVM anatomy does not automatically prove that it is causing a horse’s clinical signs. Research into its clinical significance is still developing, and horses with cervical anatomical variations can have very different presentations.

Reported or suspected clinical findings may include:

- Neck stiffness or asymmetrical neck movement
- Reduced ability to bend one direction
- Muscle asymmetry around the base of the neck/shoulders
- Abnormal development or attachment of muscles associated with C6
- Malformed or Missing Ribs, frequently exhibit partial malformation, severe asymmetry, fusions, or the complete absence of the first sternal rib
- Unusual posture
- Performance difficulties
- Problems with balance or coordination in some horses
- Difficulty with certain movements under saddle
- Abnormal forelimb movement
- Unexplained stumbling
- Sensitivity around the lower neck/withers
- Difficulty maintaining straightness
- Problems with collection or carrying the neck normally
- Behavioral changes or problems that are unexpected

ECVM itself should not automatically be equated with Wobblers. A horse can have an ECVM-type anatomical variation without having spinal-cord compression.

There isn’t a surgery or medication that makes an ECVM vertebra anatomically normal. The abnormal anatomy developed that way. Treatment therefore depends on what secondary problem the anatomy is actually producing. Management might include targeted rehabilitation and strengthening, physical therapy, modification of workload, anti-inflammatory medication when painful, treatment/injection of secondary arthritic facet joints, and management of compensatory muscular problems.

Neck problems tend to be one of the most undiagnosed of lameness/performance issues as they can cause a multitude of problems that ‘look’ like something else.

Double X Veterinary Services

10/13/2026

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Monday	8am - 5pm
Tuesday	8am - 5pm
Wednesday	8am - 5pm
Thursday	8am - 5pm
Friday	8am - 5pm