In September 2021, Fureina, at the time an 11-year-old KWPN Dutch Warmblood mare owned by Christin Jonas and her daughter from Upper Marlboro, Maryland, visited the Marion duPont Scott Equine Medical Center (EMC) for an emergency lameness evaluation.

At the beginning of August, Fureina developed a swelling on her right front carpus (knee) despite sustaining no notable trauma or having a history of any kind of obvious wound. The swelling was seen from the carpal area down the leg and was warm to the touch and mildly reactive to palpation.

Nancy Reams, DVM, from Southern Maryland Equine Veterinary Service took radiographs of the area on the farm, which were within normal limits. Ultrasound revealed subcutaneous edema, a swelling of tissue under the skin and dilated vasculature, and a widening of blood vessels due to the inflammation from local infection. There was also mild effusion or swelling of the carpal sheath – the tendon sheath that extends from just above the knee to the cannon area.

Cellulitis was suspected and treated with regional limb perfusion – a catheter was placed and systemic antibiotics were slowly administered. Ten days later, her lameness worsened in her right front, with additional swelling in the affected area. After further treatment, no improvement was seen and she was referred to the Equine Medical Center for further diagnostics and treatment.

 “My daughter is a talented rider who has had perpetual bad luck with horses that she has owned and leased and was looking for a reliable competition horse that could move up in jumper heights with her,” Jonas said.  “From the first ride, Fureina fit the bill perfectly – a great match, two small but mighty and feisty girls with lots of personality and intelligence!

The pair had a successful spring and summer show season, competing in the Low Child Jumper Division up to 1 meter (just over 3 feet), but when the pair returned from Tryon, North Carolina, Fureina had severe swelling in her front right leg.

“Despite treatment on the farm, Fureina’s condition was declining daily and Dr. Reams referred her to Dr. Jennifer Barrett specifically,” Jonas said.


When Fureina arrived at the EMC, Jennifer Barrett, Theodora Ayer Randolph Professor of Equine Surgery, noted that Fuereina was bright, alert, and responsive, seeming to be in good overall health.  Normal digital pulses were found in all limbs except for a mild increase in the right front foot. Fureina’s right front leg was severely swollen from the antebrachium (below the elbow) to the fetlock joint and the area was warm and sensitive to palpation. Ultrasound at that point showed blood clots had formed in some of the large blood vessels supplying her limb. It appeared she had an adequate blood supply, however, the inflammation and clotting of her blood vessels were a serious concern.

Fureina was diagnosed with chronic vasculitis and cellulitis of the right front limb. Aggressive medical treatment and conservative management were recommended. Fureina was hospitalized and her systemic oral antibiotics were adjusted for better penetration into the synovial structures and bone. Anti-inflammatory, anticoagulant, and vasodilation therapies were also started. This included using a drug that breaks up blood clots that were injected using ultrasound guidance directly into her blood clots. Within 24 hours, Fureina’s swollen leg had improved significantly and there was little response to palpation of the area. 

“Dr. Barrett’s daily calls with updates on her condition were appreciated and it was evident how much she cared about her patients” explained Jonas. “It was a great comfort to my daughter and me that she was in such caring hands. We were fully aware at that point that Fureina might never come home let alone have any chance of an athletic career.”

Photo courtesy of Paws and Rewind LLC

When Fureina was released from hospitalized care, Christin Jonas was provided with a comprehensive plan for rehabilitation at home under the watchful eye of her primary care veterinarian Nancy Reams.

“After two weeks of treatment at the Equine Medical Center, Fureina stabilized, and Dr. Barrett was comfortable with her returning home for continued rehabilitation and care, it is a true blessing that we live and work at a small boarding barn 30 minutes outside of Washington DC.,” Jonas said.

“Strict instructions were provided to keep track of all her medications that needed to be administered every two hours throughout the day and night as well as frequent bandage changes. We monitored her temperature, respiration, and heart rate at least four times a day and she returned to the Equine Medical Center for regular checkups. We massaged her entire body, especially her afflicted leg daily to combat stiffness and stimulate blood flow.

During the winter of 2022, Jonas and her daughter continued with the slow and steady rehabilitation program outlined by Barrett.

 “When Fureina re-entered the show ring at the end of the spring and heard the buzzer go her joy of life returned,” Jonas said. “She sprang back to life and it was evident at her first show that her physical and mental state was better than ever.

“Fureina, my daughter, and I spent the summer and fall of 2022 traveling and competing in several states in the High Children’s Jumper Division, winning important competitions as well as prize money and finally reaching their ultimate goal of qualifying for the Washington International Horse Show”.

Although the team didn’t come home with a ribbon, the experience and sheer joy of being there with a horse that a year before had a very small chance of ever seeing the inside of a competition ring again was evident!

 “Fureina benefited from having two humans in her life who were wholly dedicated to her recovery,” Barrett said. “Their hard work paid off and I am delighted to hear of her success in the show ring!”

Written by Sharon Peart for the Virginia-Maryland College of Veterinary Medicine.