Horizon Equine Integrative Medicine-Renschler Veterinary Services, LLC

01/29/2026

https://www.horizonequineintegrative.com/post/equine-temporomandibular-disorders-review-of-the-current-literature-and-experiences-of-an-integrati
I took advantage of time off clinical work due to the arctic blast, and have published a new TMJ review article on our blog.

Janelle S. Renschler, DVM, PhD, Dipl ACVP, cVMA, CVMMP, IAED/C Equine temporomandibular joint (TMJ) disorders have historically been classified as “rare” by the academic community. Integrative/holistic veterinarians have had a much different view, although they were lacking scientific evidence t...

11/17/2025

Great learning experience with veterinary colleagues this past weekend at Denali Equine hosting Sharon May-Davis for a horse dissection.

09/28/2025

Just wrapped up 2 days learning at Denali Equine Rexos Inc about the implications of poor saddle fit, and best practices to avoid saddle damage to horses. WOW, this is critical information that every horse rider needs to know! I will provide some tips in a follow up post.

09/23/2025

What is the difference between skilled dentistry and “floating”? Here is a recent case that we saw of a donkey living at a rescue/sanctuary. He has had routine floating, and the caretaker is very concerned with his welfare. At first glance in his mouth, I saw a “shear mouth” and very large ramps/overgrowth of the last molars on the bottom arcades. Clearly, nobody had worked on these for quite some time.

Shear mouth is a condition where the angle of the cheek teeth becomes so steep that chewing effectively cannot occur on that side. It often originates from pain/pathology/tooth fractures on the affected side. A thorough exam with the mirror did not reveal any obvious pathology (although we might take radiographs later, but he was quite the difficult patient to sedate). He also had atrophy of the temporalis muscle on the R side, confirming that he has not been using that side of his mouth.

The ramp on the last molar on the R side was embedding into the soft tissue, so possibly pain from that was causing him to avoid chewing on that side. This donkey seemed to realize that I was helping him, as despite his difficulty with sedation, he allowed me to work on that side of his mouth.

I made the first of a series of corrections to reduce the ramps and correct the table angle, and we will continue seeing him every 3 months.

09/07/2025

We are excited to announce that our haul-in clinic space at the farm in Bloomington is nearly complete! This will allow us to have a conditioned working space for dentals and acupuncture, as well as expand to future sports medicine diagnostics and treatment. The clinic is also adjacent to our indoor arena for gait analysis and evaluation of horses under saddle.

08/15/2025

A patient getting into his treatment!

08/06/2025

Two consecutive days of acupuncture posts! What is going on in these photos??? This horse had a proximal suspensory injury, and we already treated him with PulseVet shockwave therapy. I decided that he might also benefit from electroacupuncture to move stagnation from the area. Here we are treating the Small Intestine (outside of the leg) and Large Intestine (inner leg) channels. I had also placed a dry needle in PC-9 (endpoint of pericardium channel, between the heel bulbs). Blood freely poured out of that point when the needle was removed--release of stagnant energy!

08/05/2025

Treating with acupuncture after a dental--this is "integrative dentistry"! Horses with TMJ issues often have tight fascia in the head and poll. After I correct the structural issues in the teeth, I will often put in a few acupuncture needles to treat the fascia. Here I used Da feng men, GB-20, and BL-10.

07/25/2025

Visiting Chi University in FL for the advanced equine acupuncture course, so I will bring home some new techniques and principles to apply to patients. If you aren't continuing to learn, stagnation will occur!

07/08/2025

Amazing--The first known steel acupuncture needles from 2000 years ago were found in an emperor's tomb! The diameter (0.3-0.5 mm) was even close to what we use today.

The 2,000-year-old tools represent a crucial moment in Chinese medicine.

04/24/2025

Come to The National Drive Spring Drive this weekend at Hoosier Horse Park! I will be speaking on Body Lameness in Horses at 2PM Saturday.

Join other carriage driving enthusiasts for fun, friendship and learning. Take advantage of informative talks, fun activities and social gatherings.

03/26/2025

Let's talk about INCISOR DIAGONAL bites. I love finding these in a new patient's mouth, because I know that I can correct it and the horse's body will improve.

Unlike the cheek teeth, owners can easily see the incisors by lifting their horse's lips. However, the majority of my clients seem to be unaware of the situation until I point it out. So LIFT YOUR HORSE'S LIPS and take a look.

Here are a series of diagonals that I saw just in the past month. Note that most of them (66% upon my review of records) have a slant to the left side of the horse. These are associated with a shift in the lower jaw to the side of the slant, so that the central incisors no longer line up. Consequently, the upper incisors overgrow on the opposite side, blocking the forward jaw motion. The situation will continue to worsen over time.

A shift in the jaw will put tension on the hyoid apparatus (connected to the tongue), causing downstream effects in the poll, sternum, lower neck, diaphragm, lumbar spine, pelvis/sacrum, stifle, and basically everything in the body. Horses with a DGL-3 are typically restricted in a left sidebend at the poll, and weight the left front foot more. This creates a larger, lower foot on the left front and a more contracted foot with a higher heel on the right front.

Occasionally, a diagonal bite can be caused by a primary dental issue (e.g., fractured tooth) leading to the horse chewing only on one side. However, more of them are likely caused by body asymmetry causing tension patterns on the TMJ. This explains why there is a higher prevalence of left slants, as most horses bend easier to the left for a variety of reasons.

Despite the inciting cause, leaving a diagonal bite will make it challenging, or impossible, to straighten the horse through bodywork or classical training. So many horses have monthly chiropractic, acupuncture, massage therapy, craniosacral, etc., for the issues to keep returning. Few people seem to realize that correcting the structural issues in the mouth (alone) will get the horse further than adjusting them over, and over, and over again.

Even more challenging is that most of these horses (all of the horses with incisors pictured here) have had dental care regularly by otherwise competent veterinarians. Therefore, dental issues have been "ruled out" as cause of their body or behavioral issues. There is an irrational fear among some veterinarians about working on the incisors; therefore, most just do not touch the incisors unless some pathology is present. I learned almost nothing about balancing incisors from conventional veterinary continuing education.

Reductions in diagonal bites can be done safely by monitoring the color of the secondary dentin overlying the incisor pulps. Incisors should never be cut down, but rather a disk can be used to make micro-adjustments. Millimeters matter here, and the correct incisor angle must be maintained. Incisor work is an art, as well as a science, and is an important part of the standards for International Association of Equine Dentistry (IAED)-certified practitioners.