Equine Practice: EPM Diagnosis Still A ChallengeMay 3, 2012 The difficulty in diagnosing equine protozoal myeloencephalitis, or EPM, is a source of investigation and consternation for veterinarian Stephen M. Reed. But the challenge really hits home when he encounters a particularly vexing case like the one he treated on familiar turf. A horse being ridden at Dr. Reed’s home clinic, Rood and Riddle Equine Hospital in Lexington, Ky., appeared to be dragging a toe, even as it was able to clear the fences. The owner brought the horse in two days later for an exam. “His gait was a bit off, so we did a lameness exam, and there were some subtle changes but nothing so dramatic to think there was a neurological problem,” said Reed, DVM, Dipl. ACVIM. A blood test for EPM revealed barely any antibodies, “So it didn’t look like a recent big exposure to a causative organism,” Dr. Reed said. “Because we couldn’t make a diagnosis, we recommended that we see the horse back in a week or two.” Six days later, the horse was down and unable to rise. The owner struggled to get him into a trailer and to the hospital, where a serum test was a strong …
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Equine Practice: Seasonality, Age, Stress Play Roles In Susceptibility To IURD InfectionsMay 3, 2012 A cold winter followed by rainy spring weather can create the perfect storm for an outbreak of infectious upper respiratory disease, or IURD. Many horse owners will be moving young horses to indoor facilities for training and sale preparations. Subsequently, horses that are already more susceptible to IURDs due to their age are exposed to environments with a lower air quality and more irritants, such as dust and ammonia. In addition, the stress of training could lead to an increased potential for a respiratory outbreak. The Latest Research A recent study at the University of California, Davis, funded by Merck Animal Health of Summit, N.J., revealed that this perfect storm plays a role in the risk of an IURD outbreak. In this study, veterinarians throughout the U.S. were enrolled in a voluntary surveillance program. They were asked to collect blood and nasal secretions from their equine patients that presented with signs of acute IURD and/or acute onset of neurologic disease. In all, 761 horses, mules and donkeys were enrolled and tested via real-time PCR testing for the four major IURD pathogens: equine herpesvirus-1 (EHV-1); equine herpesvirus-4 (EHV-4); equine Influenza virus (EIV) and Streptococcus equi subspecies …
Equine Practice: What Clients WantMay 2, 2012Equine practitioners constantly face diagnostic challenges. Without hesitation they invest in the knowledge, resources and equipment needed to meet these challenges, because it is their passion. But very few practitioners take the time to diagnose the health of their business. Good business and good medicine must work together for practices to truly succeed. One important component of good business and client service is to understand and implement an effective services marketing plan. Sample 1 The services marketing mix considers seven P’s: product, price, promotion, place, participants, physical evidence and process. When marketing veterinary services, all seven P’s should be considered. To put this into familiar terms: • Determine the service products horse owners want; • Set the price for those services; • Promote those services; • Decide where services will be offered (in the field, clinic, race track, etc.); • Manage the participants (clients and staff); • Provide physical evidence of these services; and • Control the process of service through procedures and flow of activities Sample 2 Beyond a “Gut Feeling” One of the most important of the seven P’s is product, and in the case of veterinary medicine, services are the products sold. In …
Supplements Fill Gaps In Equine DietApril 9, 2012 Supplements are not always necessary to complement a healthy horse’s diet, according to equine veterinarians and nutrition specialists. However, when a balanced diet isn’t possible, supplements can help stave off mineral deficiencies. A good grass pasture is best, followed by hay and grain, experts say. Hay makes up 50 to 100 percent of a healthy equine’s diet, serving as a source of energy, protein, vitamins, minerals and the fiber necessary for normal equine gastrointestinal function. Supplements help balance any deficiencies of pasture, hay and grain in an individual animal. “Virtually all commercial grain mixes are supplemented,” says Eleanor M. Kellon, VMD, owner of Equine Nutritional Solutions in Robesonia, Pa. “When diets are not correctly supplemented and balanced, common problems include skin and hoof issues, which then have owners looking for a supplement to correct that.” Good Hay The nutritional value of hay varies widely. Hay can be measured by its qualitative and quantitative characteristics, which may include a visual exam and chemical measures of nutrients and other components that influence nutrient levels and digestibility. “Most owners do not understand complete and balanced nutrition,” says Stewart “Chip” Beckett, DVM, a senior veterinarian at Beckett …
When Considering Supplements, Just Focus On FactsApril 9, 2012 Giving supplements to heavily-worked, high-performance or older horses is similar to following a vitamin and mineral regimen in a human. Many people take nutritional supplements to improve their health, so trying to improve an animal’s performance is a natural step. For the most part, the supplement industry is self-regulated, so it is up to consumers and their veterinarians to research and choose products that match their needs. Veterinarians are being taught more about nutrition than in years past, so they are in a better position to help clients, says Phil Brown, DVM. “Look at supplements as fine-tuning a horse’s health,” says Dr. Brown, senior vice president of research and development at Nutri-Vet LLC of Boise, Idaho. He says most supplements go beyond multivitamins and are condition-specific. Joint dysfunctions, as well as performance conditioning, can be helped by supplements, he says. “Supplements, or nutraceuticals,” he says, “can help prevent problems, though they can’t treat a disease. “I would tell veterinarians to tell horse owners to do their homework when choosing supplements,” Brown says. “Science-based research is imperative.” Equine practitioner David Pugh, DVM, MS, Dipl. ACT and ACVN, agrees. “Equine supplement products may be very good, …
Some How-to’s Of Field AnesthesiaMarch 22, 2012 The horse’s unique physiologic characteristics make field anesthesia a challenge. Aside from its fight-or-flight mentality, which multiplies the risk of injury to patient and personnel, the lack of a sterile surgical environment and the possibility of prolonged recumbency extra medical precautions when anesthetizing a horse in the field. Douglas O. Thal, DVM, Dipl. ABVP, would prefer to perform surgery in his equine hospital, but he says, “There are times a practioner just has to lay a horse down in the field.” “More difficult and involved procedures are better in a hospital,” he says. “First consideration should always be transporting the horse to the nearest equine facility.”Dr. Thal owns Thal Equine LLC, a regional equine hospital in Santa Fe, N.M. But there are unspoken standards as to what practitioners do in the field, Dr. Thal says. “You’d never do emergency colic surgery in a field—you’d euthanize the horse if you couldn’t transport it to the hospital,” he says. “And though wound repair is certainly more diffcult in the field, it is probably the most common cause to use standing anesthesia in the field.” Thal would use infiltration of lidocaine or nevidicaine to anesthetisize the …
IV Anesthesia Often Associated With Improved OutcomeMarch 22, 2012 New procedures in equine anesthesiology have led to fewer problems and reduced mortality, according to two veterinary anesthesiologists. William Muir, DVM, a consultant for Woodland Run Equine Facility in Grove City, Ohio, is seeing more standing anesthesia for abdominal, head, sinus, tooth and orthopedic procedures. “We’re not knocking as many horses down,” he says, using the term to describe full-out anesthesia that makes a horse recumbent. Dr. Muir, Ph.D., ACVA, Dipl. ACVECC, VPPCS, is the co-author of “Handbook of Veterinary Anesthesia” (December 2006) and “Equine Anesthesia” (December 2008). He served as an anesthesiology professor at Ohio State University for 37 years and now works as a consultant to the animal pharmaceutical industry and several veterinary referral centers. He says many surgical procedures can be completed in standing horses “still heavily sedated, with sedatives and analgesics.” Doing it this way “reduces the cardiorespiratory depression associated with general anesthesia and the problems that can occur during recovery,” Muir says. An attendant can have trouble controlling a horse’s behavior and cardiorespiratory function during general anesthesia because of the animal’s anatomy and very nature. Most problems occur during the induction and recovery phases. “Horses usually protect …
Unwanted Horses And Hungry HumansMarch 22, 2012 A friend recently wrote: “Horse meat ... why would anyone in their right mind want to eat it??? Very important issue. … Boo on Canada.” Attached was a link to a video. My friend’s attitude and this video made me imagine a possible win-win solution to end some of our world’s misery. I love and respect horses. As former president of the American Association of Human-Animal Bond Veterinarians and the current president of the Society for Veterinary Medical Ethics, I have carefully examined the sad situation that has inadvertently developed for unwanted horses since the ban on slaughter took effect five years ago. My empathy and grief for these horses spurred me to organize a two-hour equine ethics session at the American Veterinary Medical Association last July. My guest speaker, Dr. Robert M. Miller, an equine behaviorist as well as cartoonist and philosopher, spoke of major equine ethics problems from many viewpoints. Dr. Miller discussed horses’ roles as beloved companion animals, private sport horses, race horses, work horses—all the way down the human-animal bond scale to being livestock. Wild horses have it worse, because they forage on …
Gear Trends: Smaller, Wireless, PortableFebruary 8, 2012 From the farm to cloud computing, the sky seems to be the limit for the latest in portable digital equipment for the equine practitioner. Wireless capability, remote access to medical records and high-quality in imaging are just some of favored examples of the latest digital technology. David Frisbie, DVM, Ph.D., Dipl. ACVS, associate professor of veterinary clinical sciences at Colorado State University in Fort Collins, considers a micro-arthroscope inserted in an 18ga needle a technological breakthrough. The needlescope enables the practitioner to perform procedures under partial sedation and with local blocks, rather than the traditional method that requires full anesthesia. Local anesthesia may be used and the horse remains standing, which Dr. Frisbie said lessens complications all around. For the past year, Frisbie has evaluated a number of horses’ stifle injuries with this new equipment, first developed for human medicine. “When you are trying to diagnose stifle problems,” he said, “X-rays and ultrasound can’t give you an accurate view and the joint is too big for an MRI. And there is not really a general arthroscope that practitioners can carry around. Needlescope vs. Arthroscope “We know that we can medicate the stifle with …
Hard-to-Heal Equine Wounds Push VetsJanuary 10, 2012 By definition, a hard-to-heal wound hasn’t healed despite several treatment attempts and multiple approaches. Equine practitioners say they’re always open to trying something new, especially when a lingering wound can mean euthanasia for a patient or months of ineffective or slow healing. “If you take 10 people, you’ll get 10 opinions on how to treat wounds,” says David Levine, DVM, Dipl. ACVS, clinical associate at the University of Pennsylvania’s New Bolton Center in Kennett Square, Pa. “Just about any treatment has a 60 to 70 percent chance of working, but the best option is closing the skin, if possible. Even if the skin doesn’t survive, the biological Band-Aid provides good results.” Dr. Levine says proud flesh or excessive granulation is a common problem presenting with equine patients, a condition other species don’t get. “There are theories as to why proud flesh occurs, but none help in resolving the problem,” Levine says. “We have to remove or trim this tissue, use topical products to get rid of it and apply a skin graft.” Lower leg wounds tend to be the most frustrating to heal, says Dean Hendrickson, DVM, MS, Dipl. ACVS, director and professor at the …
