Muzzle Management For Your Horse

Muzzles are very helpful in keeping ponies and horses at a healthy weight. Please make sure you are using them safely!

* Always use muzzles with some type of safety release in case the muzzle gets caught. Use a muzzle with a quick release built in or attach the muzzle to a leather halter or one with a leather headstall.

* Train your horse gradually to the muzzle. Make sure they will and can drink with it on before leaving it on for 12 hours.

* Check for rubs daily and pad as necessary.

* In hot weather (over 85 degrees), remove the muzzle during the day. Put your horse in a stall of sacrifice paddock if needed for weight control. Horses can have heat stroke when left in their muzzles during hot weather.

* Wash the muzzle weekly in soapy water.

* Replace your muzzle as needed. The hole at the bottom can become quite large with use, allowing your horse or pony to overeat even with the muzzle on.

Vaccinating Your Horse Yourself

There has been a lot of discussion lately on this topic. Most horse owners prefer to have veterinarians vaccinate their horses, but many are comfortable doing it themselves and have done so for years without any complications. This can save some money and can be more convenient for those people who have been trained to do it. This growing trend has caused some vaccine companies and more recently, insurance companies, to respond to the increased potential for possible problems that could arise. They have started an awareness campaign to let the horse-owning public know that there are advantages to having veterinarians administer the vaccines and potential adverse consequences if owners elect to  vaccinate their horses themselves.

First, the reasons for concern:  vaccines obtained through retail channels may have suffered from improper temperature control or handling making them less effective or potentially harmful. Additionally, poor administration technique or timing may also decrease the effectiveness of the vaccine or cause significant reactions such as abscesses or anaphylaxis. These all lead to more complaints to the vaccine companies, which could result in losses for the vaccine manufacturer in the form of complications costs covered and more adverse drug reaction reports to the FDA. These same concerns exist for the equine insurance companies and have led some insurance companies to stop covering  medical expenses or mortality claims if a horse has a problem associated with vaccines administered by someone other than a veterinarian.

Now, for the advantages of having a veterinarian vaccinate your horse: your veterinarian is well trained in the appropriate timing and technique for vaccinating your horse and has access to the latest information on the best vaccines to use and any emerging diseases that may need to be considered. If your horse does have a reaction, he or she is capable of responding and treating rapidly, especially in the case of anaphylaxis. Vaccine companies have stated that they will guarantee their vaccines and will reimburse expenses associated with any vaccine break or injection site complication, but only if the vaccine was given by a veterinarian. The wellness programs associated with other equine products also often require that a veterinarian administer vaccinations in order for reimbursement in the event that the horse were to colic. Finally, many horse venues now require proof of vaccination from your veterinarian in order to compete.

As always, we are here to help and hope you will call us with any questions you may have.

Farriers And Veterinarians Collaborate At Blue Ridge Equine Clinic

Blue Ridge Equine Clinic hosted a great turnout of 25 farriers on March 19. The farrier/veterinarian discussion went on for 2 hours and touched on improving communications and understanding. It was a diverse group of farriers from the greater Charlottesville area, the Valley and Hanover county. The subject for the evening was low palmar angles and the management of lameness associated with this finding. A number of cases were presented and everyone had an opportunity to express their ideas. The farriers asked that we have more of these and we welcome input as to subjects to cover. We plan to hold another in May or June. Farriers and veterinarians, please call if you’d like us to let you know about the next event.

Equine Ophthalmology: Focus For Virginia Veterinarians On Saturday

The weather may have been dreary, but Saturday was far from dull for fifty equine veterinarians at the Boar’s Head Inn in Charlottesville. Blue Ridge Equine Clinic’s 9th Annual Equine Practitioners Seminar featured Dr. Amber Labelle, DVM, MS, Diplomate ACVO presenting an in-depth look at all aspects of equine ophthalmology.

Dr. Labelle covered:

* Eye exam tips and tactics

* Study of the cornea: anatomy, wound healing, ulcers, treatment, complicating factors, disease

* Equine recurrent uveitis: role of Lepto, relationship to breed, clinical signs, ocular ultrasound, treatment and goals

* Equine ocular neoplasia: squamous cell carcinoma, diagnosis and treatment, third eyelid treatment, periocular sarcoids, eyelid melanoma, extraocular lymphoma, hemanglosarcoma, equine intraocular melanocytic neoplasia, intraocular neuroectodermal tumors, orbital extra-adrenal paraganglioma and orbital neoplasia

*  Case studies

Dr. Katy Cilinski, Secretary of the Virginia Association of Equine Practitioners

(VAEP) gave an overview of the group’s educational offerings and encouraged everyone to take advantage of membership opportunities. The new VAEP board was elected and looks forward to serving equine veterinarians in the 2015.

Many thanks to Dr. Labelle for an informative, entertaining presentation and to our program sponsors: VAEP, Boehringer-Ingelheim, Zoetis, Henry Schein, Merck, Platinum Plus, Abaxis, Sound, Idexx, Adequan and Equine Partners of America. Without their support, this level of quality continuing education for equine veterinarians would not be possible.

 

How Much Do Hock Injections Cost For A Horse?

Have you ever noticed a substantial range in the cost for hock injections performed by different veterinarians? Ever wondered why that is? Not all “hock injections” are the same, so when your horse is having its hock injected, it helps to be educated on which joints are being injected and with what substance they are being injected.  Prices for hock injections may vary depending on what medications are being injected and how many joints are being injected.

The “hock joint” in the horse is actually comprised of several separate joint spaces –with long medical names –  but for ease, most vets refer to them for injection purposes as the lower, middle and upper hock joints.

In regards to the upper hock joint, it is the one responsible for most of the motion of the hock joint, so when the hock bends, this is the joint that makes that happen. It is pretty uncommon for show horses to have primary upper hock issues, but it can happen. OCD of the upper hock joint can also be a significant issue in young horses just starting into work, often presenting as a very swollen hock.  OCD’s should be evaluated for possible surgical removal, and upper hock joint injections can be done to keep the horse comfortable and reduce swelling.

In most show horses, the most common place that is injected are the lower and middle hock joints. The lower and middle hock joints are two very low motion joint spaces. Basically, they are comprised of several tarsal (hock) bones that are stacked one on top of the other like blocks.  These bones have some cartilage between them and synovial joint capsule surrounding them. While they are technically joint spaces, they only comprise a small amount of the motion of the entire hock joint and are considered low motion joints. Basically, they have just enough cartilage and joint fluid to slide around on top of each other a little bit as the horse puts its foot on the ground.

With horses in work, these lower and middle hock joints undergo a huge amount of stress and strain every time the horse puts its hind leg on the ground.  Genetics (including conformation and breed), along with the stresses/forces we put on our horses when we do things such as ask them to rock back on their hind end, make those tarsal bones twist, slide and grind over each other.

Cartilage is the cushioning between the bones.  When a horse starts to have thinning and degeneration of the cartilage in the lower and middle joint spaces, pain is often the result because there is bone grinding on bone. Horses will also start to form bone spurs along the edges of the bones that are evident on radiographs. This is the beginning of the fusion process in the lower and middle hock joints.

To help relieve pain during the degeneration process, injection of the lower and middle joint spaces is often done.  Often trying to encourage the fusion process in the lower and middle hock joints is a good thing, because if we can get them to fuse, they don’t slide, and therefore they don’t hurt anymore.

There are different combinations of medicines to use in joint injections. In a young horse with hock pain that has minimal changes on xrays, we may use a HA product (hyaluronic acid-both a lubricant and anti-inflammatory) possibly combined with triamcinalone (kenalog) which is more cartilage-preserving than the other steroid choices.

If a horse is older and already showing signs of the fusion process beginning, we may use methyprednisolone only (Depo-medrol-another steroid). Depo is a great drug for these types of joints because it has longer acting pain killing properties and it is thought to speed up the cartilage degradation process and may help speed up the fusion process.  Again, different veterinarians may have different medication preferences depending on the horse’s age or amount of radiographic changes in the hock.  While steroids +/- hyaluronic acid are most commonly injected into the hock joint, other options include IRAP and intra-articular adequan.

Lastly, horses that are not helped by the steroid injections or helped only for a short period of time with injections, may be helped with ethyl alcohol injections in fusing lower and middle hock joints. This is a relatively new procedure that is being done, and must be done after xrays and appropriate contrast dye studies of the lower and/or middle hock joints are done, proving that the joint spaces are not connected to the upper (high motion) joint. In a small percentage of horses there may be communicating joint spaces – so while getting a little steroid in the upper joint during a routine steroid or HA injection is not a problem, getting alcohol in that joint space would be devastating and possibly life ending for the horse.

The ethyl alcohol works in two ways.  It has both a pain-killing property which can make the horse more comfortable, and it can also chemically speed up the fusion process.  More and more veterinarians are becoming familiar with and are performing or referring out for this procedure.

If your horse is getting its hocks injected, discuss with your veterinarian the different options to help choose the best treatment for your horse.

 

Equine Facial Lump Has Unusual Origin

Thanks to Equus magazine for letting us share this story. We are always happy for positive outcomes with complicated cases like this one.

Alternative Therapies Learning Day At Amethyst Acres

 

Thank you to Deb and Mark Burke, owners of Amethyst Acres Equine Center, Inc. in Buchanan for inviting Drs. Julia Hecking and Tabby Moore to speak at their Alternative Therapies for Horses learning day on November 8.  The doctors very much enjoyed a day of learning and fellowship with horse enthusiasts from Southwest Virginia.

Dr. Hecking is certified in equine acupuncture by the Chi Institute in Florida. She gave a PowerPoint presentation, answered questions and explained how successful acupuncture can be for treating painful and/or stressed horses, before demonstrating on the lovely Shady Lady.
Dr. Moore is certified by the American Veterinary Chiropractic Association and gave a presentation on the benefits and uses of equine chiropractic therapy. She demonstrated an adjustment on Shady Lady, who was no doubt feeling relaxed, loose and thoroughly pampered after serving as the equine volunteer for the day.

In fact, Deb shared that when she was turned out the next morning, the 28 year old mare took off running and bucking – a true testimony to the effectiveness of these therapies, according to Deb. We appreciate the Burkes dedication to educating horse lovers on best practices in equine care and for inviting our doctors to be a part of this great learning experience.

Zoetis Update On Parasite Protection: Moxidectin Tops Fenbendazole

zoetisFrom Zoetis, maker of Quest dewormer:  Small strongyles are the most prevalent and important internal parasites to adult horses. Unfortunately, effective control presents challenges because of persistent exposure, anthelmintic resistance and encysted stages in the life cycle of small strongyles. A recent Zoetis-funded study compared a single dose of moxidectin (QUEST® Gel) with five consecutive days of double-dose fenbendazole (Panacur® PowerPac) in reducing and suppressing small strongyle fecal egg counts (FECs) in a mare herd originating from 21 different states across the United States.

Researchers analyzed FEC data 14, 45 and 90 days following treatment. At 14 days post-treatment, the mean FEC reduction was 99.9% for moxidectin-treated mares and 41.9% for fenbendazole-treated mares. Statistically significant differences were observed 45 and 90 days post-treatment, as well. This confirms small strongyle resistance to fenbendazole to be widespread, while moxidectin remains effective for controlling these harmful parasites. The rapidly dissolving formula of QUEST PLUS (moxidectin/praziquantel) Gel and QUEST (moxidectin) Gel are proven effective against encysted and larval stages of small strongyles and safe for use in horses and ponies, and foals 6 months of age and older.

IMPORTANT SAFETY INFORMATION: Do not use QUEST Gel or QUEST PLUS Gel in foals less than 6 months of age or in sick, debilitated and underweight horses. Do not use in other animal species, as severe adverse reactions, including fatalities in dogs, may result.

This study was funded by Zoetis the makers of Quest. This study was reviewed and provides valuable information for your veterinarian to use to help make decisions regarding your horses health care. It does not mean that Quest should always be used instead of Panacur but suggests that the potential for resistance should be considered when determining which dewormer is right for your horse. Talk with your veterinarian to decide which dewormers you should be administering to your horses.

Rescue Horse Success Story!

Thank goodness there are horse “angels” in our midst, like our client Becky Moore.  Becky shares her journey with her rescue horse, Raven, in her own words:

“Raven is a 12 year old Tennessee Walker gelding that arrived at our farm on 6/14/14. I picked him up only knowing that he was underweight but looked better than he did over the winter. He is an owner surrender- the former owner not having a good place to keep him and not able to afford the proper feed. A couple of weeks prior to picking him up I sent sweet feed home with the owner and directions on how to start feeding it. When I picked him up, I was unsure if he had the energy to withstand the trailer ride back to my farm as he was severely malnourished. Upon arrival at my farm he weighed 848 lbs, we dewormed him and introduced him to our herd. Dr. Hecking came out after he had been with us for about two weeks and floated his teeth and checked him over and agreed that it seemed to be a malnourishment issue only and his ideal weight should be somewhere between 1000-1100 lbs. Once his weight increased, Ray received all of his shots and proper deworming medications. Ray’s feeding schedule was quite intense. He was fed a combination of two different sweet feeds, beet pulp, alfalfa, cocoa soya, a weight supplement and free range hay. Ray was extremely nervous and during feeding times I had to stand with him so that he would not leave his food- for the first 2 ½ months I spent a total of 3 hours per day feeing him. I do not know exactly how many pounds of food he was consuming per day but he received 4 – 8 qt buckets of the beet pulp/alfalfa mixture and one 8qt bucket twice a day.

Raven is now 1020lbs and the leader of herd. He has a great personality and is super friendly with most people. He still has some weight left to gain but he is eating an almost normal diet and feeding time is down to a total of 45 minutes per day. Raven seems to be very happy in his forever home, he has lots of energy and likes the attention from my children. Over the next few weeks I do hope to take him for a test drive as I am told he was an excellent trail horse.

Thank you to Blue Ridge Equine for promptly visiting Raven and examining him so quickly and providing me with information on ways to achieve his ideal weight. Floating his teeth and shots have been a key part in his recovery.”

Equine Medication Prices: Why Can’t I Get Something Cheaper?

Probably every horse owner has had the experience of feeling sticker shock when the cost of treating a horse’s malady is revealed by the veterinarian. The cost of pharmaceuticals is high because of development and production expenditures, and horses are really big patients (generally 10 times the size of the average adult human). But often, cheaper alternatives exist, and are often touted as “generic” formulations. Veterinarians may be reluctant to prescribe these less expensive alternatives, which may lead clients to wonder why they have to pay more for name brand medications. There are actually a number of reasons, and they all boil down to providing safe, effective medication to our equine patients.

First, it is important to clarify the terminology. Both name-brand and generic PrascendFDA approved medications are manufactured and labeled according to standards set by the Food and Drug Administration, a government agency charged with, among other things, assuring that medications are safe and effective. Compounded medications are either drugs that are somehow altered from their FDA approved formulation (for example, adding flavoring to children’s antibiotics to make them more palatable), or are formulated from the chemical grade drug or substance in other than FDA approved processes or facilities. The important part of this distinction is that medications with FDA approval are required to adhere to FDA standards for manufacture and labeling. Because compounding pharmacies are not under these requirements, the standards for manufacture are lower and label claims are not under the regular scrutiny of a regulatory body. Why does this matter? Let’s review a few examples.

In April of 2009, 21 polo ponies died as a result of the administration of a selenium product that, because of a clerical error, was 10 times more concentrated that it should have been according to the label. Similarly, this year, 4 horses died and 6 more were sickened when they received a pyrimethamine/toltrazuril combination in which the amount of one of the drugs was inappropriate. (Toltrazuril is not approved for use in the United States, so any complications from the use of these drugs could potentially put the prescribing veterinarians in an awkward spot with the FDA.

Compounding concerns are not limited to veterinary medicine, however. In the fall of 2012, reports began to surface of people suffering from fungal meningitis after having spinal injections with compounded steroids. Sixty four people have died, and 700 more are under long term treatment for persistent infections. The fungus was isolated out of the room in which the drug was prepared.

In addition to safety concerns, the formulation of compounded medications does not always provide the active ingredient in a form that the body can use properly to achieve the desired effect. There are a few important examples of this in equine medicine one of which is omeprazole. The FDA approved omeprazole products (GastroGard® and UlcerGard®) are very expensive to use, driving the desire for a less expensive alternative. Unfortunately, omeprazole is very difficult to formulate in a way that it is useful to horses. In order to be useful, the drug must pass through the stomach to be absorbed in the small intestine, then travel through the blood to the acid-producing cells in the stomach, where it blocks the cellular pumps that produce acid. The challenging part of this is the fact that omeprazole is inactivated by acid, which fills the stomach. GastroGard® is made using a patented process that encapsulates the drug into enteric-coated microspheres that are kept in suspension; the omeprazole is protected from the acid in the stomach so that it can be absorbed in the small intestine. Other formulations of omeprazole which use antacids and buffers in an attempt to protect it through the stomach have consistently failed to achieve blood levels of omeprazole that are sufficient to be effective. (Birkmann et. al, J Vet Int Med 2014) Another related issue is that there is no assurance that the concentration of active ingredient listed on the label is what is actually in the product. Variations from label claims have been documented in numerous compounded medications.

Furthermore, the veterinarian her/himself is bound by law. It is permissible to compound medications, which is good, since it is also necessary in many occasions. However, it is not permissible if an effective FDA alternative is available. Conditions that allow for using compounded products include availability (when pergolide was first off of the human market, only compounded pergolide was available for horses) and patient factors (an infant can’t take a pill, an individual is allergic to a dye or filler in an approved product). The cost of a medication is NOT legal justification for using a compounded product. A doctor or veterinarian who prescribes a compounded medication inappropriately bears all of the legal responsibility for that medication, and is 100% culpable if something goes wrong.

All this is not to say that there is no place for compounding pharmacies in human and veterinary medicine. There are many very reputable pharmacies that have high standards for production and are very concerned about product quality. These pharmacies make available to practitioners medications that, for one reason or another, are not available in an FDA approved form. However, it is important to realize that when a veterinarian prescribes such a drug, he or she is personally taking on the full responsibility of standing behind that product, and there may be a number of very good reasons not to do so in a particular circumstance. If you have a question about a product, the best way to learn more is to open a dialogue with your veterinarian to determine the best, most cost effective product for your horse.