Equine Metabolic Syndrome - Treatment

Equine Metabolic Syndrome: Treatment

 Before you get on line and Google Equine Metabolic Syndrome (EMS) and Treatment be sure to take some Advil because you are likely to end up with a headache! There are many companies marketing supplements aimed at horse owners desperate to help their insulin resistant laminitic horses, and it is very easy to become confused and tap out your checking account trying to help your horse and not really accomplishing much.

Try to keep going back to basics when you think about EMS:  it is a disorder of energy metabolism.  Any effective treatment should be directly related to diet, exercise, and/or the body's energy processing mechanisms.  Here I will go down the list of things that we KNOW, based on clinical and laboratory research, can help the EMS horse.

1) DIET.  

Most horses with EMS, unless their athletic activity  specifically increases caloric needs, should eat 1 - 1.5% of body weight daily.  For a 1000 pound horse this is 10-15 pounds total daily food (this includes EVERYTHING that passes their lips).  This diet should be low in high glycemic index food stuffs.  Grains have relatively high glycemic indexes, as do some hays which are high in certain sugars. All hay fed to insulin resistant horses should be analyzed for sugar content.  Sugars are complexed into carbohydrates and starches, which are converted to sugar during the digestive process.  Because or variations in each horse's digestive environment, it is impossible to precisely predict the amount of sugar a given hay will produce in each individual horse, therefore we follow certain guidelines in choosing hay to feed insulin resistant horses. These guidelines are based on the hay's carbohydrate and starch content.

Trying to interpret hay analysis lingo can be challenging.  For an excellent review, go to 

http://www.safergrass.org/pdf/testing_for_sugar.pdf

Historically, the recommendation for insulin resistant horses is to feed hay that is less than 10% non-structural carbohydrate (NSC).  

As hay analysis techniques advance, the reporting nomenclature has changed.  Instead of reporting NSC, you may find water soluble carbohydrate (WSC) and starch on your report.  Add these together to get NSC:

NSC = WSC + Starch

Most recently, WSC has been replaced with ethanol soluble carbohydrate (ESC) which measures a subset of the carbohydrates in WSC which are believed to be those with the highest risk of inducing laminitis in IR horses. If your analysis reports ESC and starch, then add these together to estimate your NSC.

Finding consistent sources of low carbohydrate hay is challenging.  The company most frequently used for analysis is Equi-Analytical.  They have a great website.  Try to establish a relationship with a hay broker, or hay grower who is willing to analyze their hay, and stick with that supplier.

2) Exercise
Regular exercise is a critical part of the management of horses with EMS.  Upcoming posts will be directed at specific conditioning recommendations for various types of sport horses.  Unless afflicted with active laminits, there is no reason your EMS horse cannot be an athlete, even if it is on a limited basis.   

3) Hoof Care
 Whether your EMS horse is laminitic or not, regular attention by an experienced farrier or qualified barefoot trimmer is essential.

4) Levothyroxine. 

Thyroid hormones are responsible for regulating your metabolic rate, or the rate at which you metabolize energy (back to basics: EMS is a defect in energy metabolism). An actual hypothyroid condition in horses has not been recognized, and in general, testing thyroid hormone levels (T3, T4) is not useful or recommended in EMS horses.  Thyroid hormone levels fluctuate throughout the day and unless a complex thyroid stimulation test is conducted in a hospital setting, it is impossible to interpret thyroid hormone levels drawn in the field.  As a result, horses are frequently misdiagnosed as "hypothyroid".

However, because insulin resistant horses do not utilize sugar normally, using thyroid supplementation to artificially increase the metabolic rate in overweight horses with EMS has been shown in a clinical research setting to be useful in improving metabolism and inducing weight loss.  Supplementing thyroid hormone is NOT specifically treating equine metabolic syndrome OR a hypothyroid condition.  It is simply helping your horse improve the utilization of energy which is disturbed by the underlying defect in metabolism inherent in EMS. Supplementation of levothyroxine is usually an intermittent treatment, based on an individual horse's body condition.  To be effective in a weight loss program, levothyroxine should be supplemented at a relatively high dose, under the direction of your veterinarian.

5) Metformin

Metformin is a human medication used to treat type 2 diabetes.  In humans, it lowers blood sugar, decreases glucose production by the liver, improves insulin sensitivity, and decreases glucose absorption from the gastrointestinal tract. Metformin activates AMP-activated protein kinase (AMPK), an enzyme that plays an important role in insulin signaling, whole body energy balance, and the metabolism of glucose and fats.

There is conflicting evidence for the efficacy of metformin in horse with EMS.  The problem is that metformin is not consistently absorbed from the gastrointestinal tract of horses, so the concentration of the drug that is reached in the bloodstream may vary significantly from horse to horse.  However, in at least one research trial, at a dose of 30 mg/kg twice a day, there was a beneficial effect on insulin levels and glucose handling in the group of horses tested.  Because metformin is affordable and has no significant negative side effects, it is widely used in laminitic horses with high insulin levels.

6) Pysillium

Feeding 4 ounces of psyillium daily may have beneficial effect on insulin regulation, based on a recent research trial at Montana State University in a group or normal horses.  Go to our HighDesertEquine Facebook page to find links to more on this topic.  This is another easy, safe addition to your EMS horse's diet that may have beneficial effects.

7) Chromium and Magnesium

Chromium and magnesium are involved in glucose and insulin regulation.  There is evidence in humans that supplementation can benefit people with type 2 diabetes.  Conflicting results with chromium supplementation exist in horses.  It is unlikely that supplementation will do harm, but cost and the quality of products must be taken into consideration.  If you decide to use a chromium/magnesium supplement in your EMS,  first be sure to buy from a reputable company,  be sure that the supplement does not contain additional carbohydrate, and ask the manufacturer for research or clinical trials conducted with their product.  If they cannot produce hard data supporting their product, don't buy it.

I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe the learning never stops.

Spring Vaccination Clinic Schedule and More

 

Spring 2013 News & Notes:

         v    Vaccination Clinic Schedule

         v    Update on Us

         v    Conditioning for Spring

         v    Learn About Metabolic Syndrome

We are eager to renew old relationships and create new ones as you prepare for a great riding season ahead.  Our goal is to help you keep your horses healthy.

Spring Vaccination Clinic Schedule 

Routine spring health care includes vaccination against E&W Encephalitis, West Nile, Rabies, Tetanus, Influenza and Rhinopneumonitis 
plus deworming or fecal exam, an oral exam and sheath cleaning.

Call the office to reserve an appointment.

BE SURE TO LEAVE THE FOLLOWING INFORMATION:

Name, Phone #, Date you request, Number of Animals, and the Services needed.

We will return your call three days before your clinic with an estimated time of arrival at your address.  Please be sure horses are caught and haltered 30 minutes beforehand.

Location                                                   Date

• Rancho Haven/Sierra Ranchos1             Sat  Mar 9 
• Rancho Haven/Sierra Ranchos2             Fri  Mar 15
• Red Rock North/Silver Knolls 1               Sun Mar 17
• RR North/Cold Springs/Silver Knolls 2     Fri  Mar 22
• SpanSprings/Palomino Valley 1               Sun Mar 1 
• SpanSprings/Palomino Valley 2               Fri   Mar 2
•  Antelope Valley                                         Sat  Mar 23
• Golden&Lemmon Valley 1                    Sat  Mar 23   
• South West Reno 1                                      Sun Mar 24 
• Golden&Lemmon Val/S&W Reno 2           Fri  Mar 29
• Sierra Valley/California                             Sun Mar 31

For additional savings, you can schedule your own mini-clinic as long as you have at least 10 horses at a single location.  Call the office to make arrangements.

Price List – Clinic day only

• Farm Call/Spring Exam           $18.00
• West Nile (Prevenile)               $32.00
• FluRhino                                $31.00
• Tetanus/ Encephalitis               $15.00
• Rabies                                     $22.00
• Intranasal Strangles                $30.00
• Ivermectin Deworm                   $14.00
• Fecal parasite exam                 $15.00
• Coggins Test                             $29.00
• Sheath Clean w/o sedation      $20.00 (with sedation $45.00)

Ask Dr. C what vaccines are best for your horse based on age, environment, and activity level.

DON’T FORGET TO CALL – WE DON’T WANT TO MISS YOU!

Update

On Us

This year we upgraded our digital xray system and purchased a new, state of the art ultrasound machine.  These tools are completely portable, and allow Dr. C to obtain stallside images of your horse’s soft tissue and boney structures that match the quality of in hospital equipment.  Our new ultrasound is extremely powerful,  making it possible to evaluate deep abdominal and thoracic organs, which can be of critical value in assessing your horse during colic and respiratory emergencies.  Consultation and assessment for complex lameness referrals are expedited by sending diagnostic images electronically to specialists.

Dr. Chrysann is a new member of the American Endurance Ride Conference Veterinary Committee where she will sit through 2015.  Ensuring the safety and well being of endurance racing horses and the education of riders and veterinarians are the primary goals of this committee.  As a large animal diplomate of the American College of Veterinary Internal Medicine with a doctoral degree in physiology, Dr. C is excited about combining her advanced training with new knowledge of exercise physiology and conditioning for the benefit of endurance horses.

Amanda Presing joined us this winter from New Jersey.  Amanda has been a veterinary technician for 10 years, and is an avid equestrian enthusiast.  When she isn’t helping Dr. C

she enjoys riding her reining horse Sklyer, a leopard appaloosa, or preparing for her upcoming wedding!

Hayley is finishing her first year of vet school in Utah, Jessie is heading to Littleton, Colorado for her vet tech internship, and Jessica will be applying to vet school this year.

Getting

Your

Horse

Ready for

Spring Conditioning

We had a taste of true cold this winter.  As pipes thaw and ice recedes, we look forward to getting our horses out more regularly in the months ahead.  Whether is it barrel or endurance racing, show jumping or trail riding, we all should put a little thought into preparation before asking our mounts to go out and take up where they left off in the fall.

Hoof Care  First and foremost: feet!  I see lots of frog erosion, low heels and long toes this time of year.  Environmental cleanliness is a challenge during the winter, and many horses are standing in manure that goes through repetitive freeze/thaw cycles.  When frozen, the footing can abrade and bruise soles.  When the surface thaws, fecal bacteria seep into small defects on the sole and frog, where they become trapped and create the perfect setup for thrush or subsolar abscessation. 

1)     Now is the time to get those pens scraped out and dry.

2)     Be sure your horse’s feet are properly trimmed and balanced by an experienced farrier before you start riding. 

3)     Get out your hoof pick and a wire brush and clean your horse’s feet daily.  Clorox is a  excellent disinfectant to use for thrush. 

Body Conditon As you get your horse’s feet in shape, start grooming!  Get that winter hair loose, check for any skin conditions and feel your horse’s back and barrel – is their body condition what you hope for?  Many horses gain or lose unnoticed weight under winter hair coats and blankets. Your spring clinic appointment is a good time to ask  Dr. Chrysann about your horse’s nutrition program.

Conditioning  If you have never walked or run as a form of exercise, I suggest you start your horse’s first conditioning outings on foot!  I do not intend to make marathon runners out of you all, but honestly, if you can walk 2 miles up and down hill through the desert with your horse you will be a healthier person, you will have the opportunity to develop your relationship with your horse on the ground, and you will begin to have just a hint of appreciation for the fitness of our athletic partners whether jumping that final fence, turning the last barrel or steer, finishing mile 50 or a perfect half pass, or a long day trail riding. 

There are two keys to bringing your horse back from time off.  The first is to recognize the importance of rest. For every serious exercise event, there is some associated stress and inflammation of skeletal tissues.  Improved fitness results from adaptation to this stress.  This takes time, and the time allowed between work sessions should be in proportion to the degree of exercise.  The second key to spring conditioning is a gradual increase in work over time.  For more on conditioning, follow HighDesertEquine on Facebook or at the Blog link on our website home page.  There will be an upcoming series with specific recommendations for conditioning various types of sport horse.

Equine Metabolic Syndrome Also on our Blog/Facebook Page: Read the recent posts on this challenging condition.  An important Spring subject!

I look forward to seeing you this month,

Dr. Chrysann

Schedule your clinic appointment today!

 


I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe the learning never stops.

Equine Metabolic Syndrome: Diagnosis

 Diagnosis of Equine Metabolic Syndrome (EMS) is primarily based on clinical signs and body type.  The classic EMS horse has a heavy, cresty neck, and abnormal fat distribution with excess fat accumulated at the tail base and in the sheath or mammary gland region.  While we tend to think of metabolic syndrome horses as overweight, this is not always the case.   

The use of insulin testing to diagnose and monitor response to treatment is widely discussed, but in practice is very difficult to interpret accurately. Here's the problem: most horses first present to the veterinarian with EMS during a bout of clinical laminitis.  Once in pain, the horse enters a stress state, which is characterized metabolically by an increase in circulating cortisol levels.  When we are in stress, our bodies respond by preparing to fight or run - it is the natural survival mechanism which keeps animals alive in the wild.  To fight or run we need energy - one of the major actions of cortisol is to raise blood sugar. By now you have learned what high blood sugar causes: that's right: increased insulin!  So the EMS horse with active foot pain typically has an elevated insulin and blood sugar.  But so do many NON EMS horses with laminitis.  It is impossible to interpret the significance changes in insulin in a horse that is experiencing activie laminitis.  So, even though insulin and glucose frequently are measured in such horses to get a baseline idea of their status, it is critical to come back when the laminitis has been managed successfully to obtain a fasting insulin level and even perform a glucose tolerance test when the horse is not physiologically stressed.

Ideally, if you have a horse with the fat distribution suggestive of  EMS, you should ask your veterinarian to perform a fasting insulin level, or a simple oral glucose tolerance test, BEFORE your horse ever develops laminitis.  As horse owners become more educated about EMS, hopefully this practice will become more common.  If you are able to detect insulin resistance in your horse before clinical signs of the problem are present, then by careful dietary management you may never have to experience the heartbreak of laminitis.  

Please spread this information to all your horse owning friends, especially if you see a horse with the typical EMS body type.  Early diagnosis and careful dietary management is the key to preventing laminitis in EMS horses.

In the early stages of EMS, affected horses may have normal resting blood insulin.  These patients may benefit from a glucose tolerance test.  This can be performed in a hospital setting, where  a glucose load is administered intravenously, followed by a dose of insulin, and the horse's blood glucose is measured serially over time.  This test is useful, but is expensive and labor intensive, and should be conducted in a hospital because of the risk of  hypoglycemia following insulin administration.

In a field setting, there are two levels of insulin testing that can be performed safely and efficiently.  The first is a simple fasting insulin level, where blood is drawn 10-12 hours after a hay meal the night before.  The second is a modified glucose tolerance test.  The horse is fed a hay meal the night before, then in the morning the owner gives a dose of karo syrup (15 ml/100 kg BW - your veterinarian will calculate this and tell you how much to give). Your veterinarian comes 60 - 90 minutes later and draws blood for insulin and glucose.  

In summary, remember that the typical EMS horse, pain free and at rest, has a normal blood glucose and an elevated insulin.  Early diagnosis, before the onset of laminitis, is our goal.  Spread the word, and help prevent laminitis.

I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe the learning never stops.

Equine Metabolic Syndrome & Laminits: What's the Connection?

Now that we have discussed the role that energy metabolism plays in Equine Metabolic Syndrome , let's take the next step in understanding this potentially devastating condition.

Many of you out there with Equine Metabolic Syndrome horses are doing battle with laminitis.  Laminitis, commonly called founder, is an inflammatory condition of the horse's foot.  The outer hoof wall is connected to the deeper, sensitive tissues of the foot by layers of interdigitating tissue. Picture it in your mind as a tongue and groove floor, where each layer interlocks like repeating pieces of a puzzle. Unlike a floor or a puzzle, the horse's foot is alive and in motion.  Weight bearing and athletic activity are constantly stressing the bonds between the interlocking hoof layers.  The horse remodels and repairs these bonds as part of the body's daily work.  Just like any other job, this maintenance work requires ENERGY.  The hoof utilizes glucose at an exceptionally fast rate compared to other tissues.

• At this point if your brain is saying, "hey, this sounds familiar - didn't the last blog say that Equine Metabolic Syndrome had something to do with energy, glucose, and insulin?" then you are right!
• Insulin triggers the uptake of glucose from the blood into tissues
• Horses with EMS do not respond normally to insulin, they are "insulin resistant"
• Horses with EMS have high resting insulin levels and respond to sudden increases in blood sugar with abnormal insulin responses.

For the foot to remain healthy, glucose must be able to reach the tissues cementing the hoof layers together. Anything that disrupts the blood supply, or interferes with the complex cellular mechanism of energy metabolism, puts the normal foot at risk.

In an experimental setting it has been shown that artificially maintaining a high resting insulin level for 48 hours in ponies will induce the onset of laminitis.  In addition, the administration of a high carbohydrate load to ponies increases the number of insulin receptors in the hoof tissues. So here is the link between Equine Metabolic Syndrome and Laminitis:  

•  Insulin causes changes in the body's ability to supply energy to tissues of the hoof
• This occurs through alterations in blood supply, as well as inflammatory changes mediated by insulin
•  When horses with EMS consume high carbohydrate meals, their already high blood insulin increases even more, thereby increasing their risk of laminitis.

And thus the circle closes: energy/insulin/hoof tissue metabolism/carbohydrate intake.  All are interconnected in an incredibly complicated  process that leads to painful, inflamed feet that are very difficult to resolve, despite good management and veterinary care.  And now we begin to understand why these cases occur at certain times of year.  In mid-winter, when an EMS horse is inactive, and an owner increases energy intake thinking that this will combat the effects of severe cold.  Or in the spring, when seasonal hormonal changes put affected horses at risk, and spring pasture becomes available.  

Horses with Equine Metabolic Syndrome without laminitis have been described as "prelaminitic metabolic syndrome".  Insulin levels in such animals have been measured at twice normal blood concentrations when grazing winter pastures.  In the spring, when lush pasture was available, the same animals developed laminitis and had even greater insulin concentrations.

In our next segment, we will look at what YOU can do to protect your horse with Equine Metabolic Syndrome from developing laminitis. In subsequent segments I will describe diagnostic tools available to detect the syndrome, both in pre- and post- laminitic horses and ponies, and tackle the Pandora's Box or treating the laminitic horse with Equine Metabolic Synbdrome. 

 I believe that education is the key to evolution.
I believe that animals are the key to compassion.
I believe the learning never stops.

What is Equine Metabolic Syndrome?

What is Equine Metabolic Syndrome?

Spring is right around the corner, and it is sure to be a beauty after our snow rich winter.  For those of you with horses on the plump side, who live in areas like that pictured here in Washoe Valley, that means lush green pasture is on its way.  I have one word for you all:  BEWARE!

Equine Metabolic Syndrome (EMS) is a disturbance in the energy balancing system in your horse's body.  As we discuss the syndrome,  keep this in mind.  Diet and exercise are the keys to managing this problem because horses with EMS do not handle sugar and carbohydrate normally. 

Horses with metabolic syndrome have a typical appearance.  They tend to be overweight, but more importantly, they have an abnormal distribution of body fat.  A cresty neck, soft fatty lumps at the tail base, and an enlarged sheath or mammary gland are the tell tale signs.  The problem can occur in any breed, but has been reported more commonly in Peruvian Pasos, Morgans, Saddlebreds, Tennessee Walking Horses, Arabians and Quarter Horses.  In our area, the problem also is seen commonly in Mustangs.  These horses are at high risk of laminitis, and often are first presented to a veterinarian with a complaint of sore feet.

Our bodies use sugar (glucose), carbohydrate, and fat to provide the fuel we need to operate our internal machinery.  The hormone insulin determines the balance between these various fuels depending on our  body's demands and our food intake.  Carbohydrates are long chains of sugar molecules which exist both in the hay and grain we feed our horses.  When your horse eats, his blood glucose rises.  In response, his body produces insulin.  The insulin signals cells to transport  glucose from the blood into the tissues where it fuels energy needs.  Excess glucose is converted to carbohydrate and fat and stored to be used as fuel in times when the immediate supply of energy is insufficient to meet demands.  

Horses with EMS are insulin resistant.  For some reason the receptors on cells which normally are activated by insulin to take up glucose do not respond.  The body makes additional insulin in an effort to maintain normal energy balance.  Horses with EMS keep making insulin until they have enough to overcome the low sensitivity of cell receptors.  The result is a horse with normal blood sugar, but high insulin. As you can imagine, these horses are not very good at handling sudden changes in blood sugar.  This is why diet and exercise are the key factors in successful management of EMS.

So why is high blood insulin a problem?  Because insulin does a lot more than just direct the uptake of glucose into cells.  Insulin is a hormone which also plays important roles in blood vessel tension and inflammation.  The high circulating insulin in horses with EMS is necessary for them to control blood sugar, but we now know that secondary effects are related to damaging inflammation and vasoconstriction.  When EMS horses eat food high in carbohydrates (long chains of sugar molecules), they experience surges in insulin which can cause severe inflammatory responses in other tissues in the body.

Which brings us to the topic of our next blog: EMS and laminitis - what is the connection?

Future blogs in this series will be:
Treatment options for the EMS horse
Treatment options for laminitis in the EMS horse


I believe that education is the key to evolution.I believe that animals are the key to compassion.I believe the learning never stops.

More on Vetericyn

Vetericyn Products - Are they everything they claim to be?

You may have seen the Warning Letter from the FDA which I posted on our HighDesertEquine Facebook page.  The letter was written to the manufacturer of Vetericyn because the company is making claims for the product without having a license or adequate research data to support those claims.  In addition, the FDA states that the manufacturer of Vetericyn has inadequate quality assurance regarding the water used in product formulation, according to FDA regulations.

So, is Vetericyn bad?  Should you stop using it?

Not necessarily.  The product does in fact have a sound physiologic basis and may be an excellent tool for use in wound care.  However, the FDA says that the company's claim the the product kills almost all bacteria within 30 seconds of contact has not been substantiated with adequate laboratory data.  You should ask yourself: are the FDA regulations for product manufacture and label claims reasonable?  If they are, then the producers of Vetericyn need to do some additonal work before making the label claims currently on their product. 

Most importantly - is their danger that you will do harm using this product?  I believe the best way to answer this question if by following these recommendation regarding wounds:  If there is signficant swelling, heat, redness or pain associated with a wound, or if ANY deep wound is located on a horse's distal limb (below the knee or hock), consult a veterinarian before initiating treatment.


The following is copied directly from Vetericyn's information to veterinarians about their products.  
The FDA takes issue with the claim that "this revolutionary antimicrobial wound treatment even kills antibiotic-resistant strains of bacteria, like MRSA, as well as fungi, viruses and spores."



"Vetericyn products assist in the mechanical removal of cellular debris, senescent cells, necrotic tissue,
and foreign material from the skin and wound surface through debridement. Wounds that are clean,
well maintained, and moist have shown faster healing than wounds left on their own.

 Vetericyn® VF is a special veterinary formulation of Microcyn® Technology. At nearly double the potency of the original over-the-counter formulation, Vetericyn VF provides 3-4 times the efficacy of our consumer formula and offers licensed veterinarians a powerful new treatment option that works naturally with animal immune systems to fight infection and speed healing time.

Based on Microcyn Technology, Vetericyn is the world’s first non-toxic, broad spectrum antimicrobial. Now, formulated exclusively for use and dispensing by licensed veterinarians, Vetericyn VF is even better at managing the organic load of a wound bed than our over-the-counter Vetericyn. It is still completely non-toxic, biocompatible, and safe as water. It may be used to treat a wide variety of topical wounds and infections of the skin, eyes, ears, nose and mouth.
 
This revolutionary antimicrobial wound treatment even kills antibiotic-resistant strains of bacteria, like MRSA, as well as fungi, viruses and spores.

Vetericyn VF Liquid Contains:
Electrolyzed Water (H20): 99.816%
Sodium Chloride (NaCI): 0.023%
Sodium Phosphate (NaH2PO/Na2HPO4): 0.015%
Hypochlorous Acid (HOCI): 0.011%

Vetericyn VF HydroGel Contains:
Electrolyzed Water (H20): 96.245%
Sodium Magnesium Fluorosilicate: 2.987%
Boric Acid (H3BO3): 0.462%
Sodium Sulfate (Na2SO4): 0.295%
Hypochlorous Acid (HOCI): 0.010%
Sodium Hypochlorite (NaOCI): 0.001%
Hypochlorous acid

Heals by Mimicking the Immune System
Vetericyn is an oxychlorine compound similar to that produced by the animal’s own
immune system. Oxychlorine compounds are released by neutrophils, which are
the most abundant type of white blood cells in the immune system. Neutrophils use
oxychlorine compounds to attack and kill pathogens. Vetericyn is a similar pathogen
fighting solution that can be applied locally to an infection site. In-vitro results show
that Vetericyn can safely kill 99.999% of most single-cell pathogens within 30
seconds of contact or less, including tenacious pathogens like MRSA, staph and
pseudomonas.


Vetericyn products assist in the mechanical removal of cellular debris, senescent cells, necrotic tissue,
and foreign material from the skin and wound surface through debridement. Wounds that are clean,
well maintained, and moist have shown faster healing than wounds left on their own."


Decisions regarding your animal's care are your responsibility, so be sure you are informed, and are doing no harm, before you choose a treatment for your horse.  I welcome comments on this entry regarding your experiences with wound care and Vetericyn products.  Remember, I am not condemning the use of Vetericyn - in fact the product has an excellent theoretical basis for a safe, effective wound treatment.  Just make the decision to use it from an informed position.






I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe the learning never stops.

Fall 2012 News & Notes

High Desert Veterinary Service

Chrysann Collatos VMD,PhD,DipACVIM

775-969-3495 (Office) 742-2823 (Emergency)

hidvet@gmail.com

HighDesertEquine.com

 

Fall 2012 News & Notes:

Ø Vaccination Clinic Schedule

Ø Special Alert: West Nile & Flu

Ø Understanding Immunity

Another season changes-

     Here I am enjoying the view with Washoe, a 9 yo Arabian gelding, during the 50 mile Bridgeport Endurance ride a few weeks ago.  This was my first “50” and we proudly finished with all “A’s” for Washoe’s condition at every vet check.  When the ride vet said Washoe looked ready for another fifty miles, I looked at her and asked, “but what about ME?”      Endurance riding is a fascinating sport.  I am avidly devouring the literature on conditioning, electrolyte balance, hydration, metabolic and musculoskeletal challenges from a veterinary view point.  My experiences over the years as a participant in the worlds of Thoroughbred racing, show jumping, foxhunting, and now endurance riding  provide invaluable knowledge to me as a veterinarian.  Understanding equine athletes of various disciplines and the sports they “play” from an insider’s perspective gives me special insight into their injuries, illnesses and daily stresses that makes me a better clinician for them.

            Enough about me – Hayley, my assistant you all have known for the past 6 years, was accepted into Washington State Veterinary School and began her first semester last week.  Please join me in wishing her all the best as she continues onward in her veterinary career.  And Jessie is just now returning from Nicaraugua, where she volunteered as a veterinary technician in training with an international veterinary non-profit organization working both with small animals and equines in third world countries.  She will finish her vet tech program at TMCC this year while continuing to work part time between classes.

          Join me in welcoming Victoria and Jessica, my two new assistants, to the practice.  Victoria is a student at TMCC and plans to pursue a career as a Licensed Veterinary Technician.  Jessica, already a LVT, is finishing her final year at UNR.  After graduating she plans to spend  a year working with me as she applies to vet school for Fall 2014 start date.

That’s the latest news from us.  I look forward to hearing your summer adventure stories when I see you at your Fall Clinic.

Gratefully,

Chrysann
Dr. Chrysann
HighDesertEquine.com
or e-mail hidvet@gmail.com

Special Alert Concerning Fall Vaccinations

Significantly increased occurrence of two diseases may affect your decisions concerning Fall vaccinations this year.  First, human cases of West Nile Virus are the highest nationwide since 1999, with 693 cases reported as of the 2^nd week of August, including cases in CA and one asymptomatic human carrier in NV.  Horse cases also are on the rise nationwide, with 77 cases including horses in AZ, CA, CO, NM, WY and one fatality here in Nevada in Churchill County.  So, if you were economizing this spring and failed to have your horses vaccinated against West Nile Virus, I strongly recommend a West Nile Virus vaccine as part of your fall horse care.  Mortality in horses with West Nile Virus Encephalitis can reach 40% and vaccination is safe and effective.  Late summer/early fall is the highest risk period for West Nile Virus disease in horses.

Secondly, there have been multiple outbreaks of high fevers and respiratory disease in horses due to Equine Influenza Virus both in the North Valleys and Washoe Valley this summer.  Interestingly, Dr. Nicola Pusterla from the UC Davis PCR diagnostic center contacted me because the virus strain in one of these outbreaks was genetically identical to a strain identified in a group of horses in Oregon.  We were unable to identify any travel that connected the two groups of horses.  While we know that West Nile virus travels across the country in migrating bird populations, we still do not understand how Equine Influenza virus seems to appear suddenly in areas without any identifiable vector, or means of transportation.

Here are my specific recommendations for 2012 regarding these two diseases and fall vaccinations:

West Nile Virus – If your horse has not received a West Nile Virus Vaccine in 2012, I strongly recommend fall vaccination against West Nile Virus.

Influenza/Herpes (Flu/rhino) - I recommend a flu/rhino vaccination for your horse this fall if it meets any of the following criteria:  1)Your horse is 5 years of age or less,  2) Your horse lives in a neighborhood with lots of horse movement along streets/trails or with a shared horse arena, 3)Your horse lives in a boarding stable.

Understanding Flu and Immunity

Equine influenza shares many similarities with the human flu virus we all fight every fall.  The equine virus exists worldwide, except in New Zealand and Iceland.  Clinical signs include fever, depression, poor appetite, cough and nasal discharge.  The virus only lives a short time in the environment and is susceptible to common disinfectants.  In most cases the virus is spread from horse to horse in aerosolized particles generated when an infected horse coughs.  Unfortunately, virus replicates in the horses upper respiratory tract and is shed into the environment for a few days before clinical signs become apparent, making control of disease outbreaks challenging, especially in larger groups of horses.

The virus has many serotypes, and these strains change frequently.  The horse must have antibodies specific to each serotype to prevent disease.  I imagine the flu virus as a secret agent – every time he appears he is wearing a different hat and coat so I don’t recognize him until it is too late…..and here I am coughing and sneezing, or watching my horse cough and hang his head.  Both we and our horses manufacture antibodies that are shaped to fit the “hat and coat” of each flu strain that infects us – when exposed to a virus strain wearing a new “hat and coat” the old antibodies may not eliminate the new virus effectively and we get sick all over again.  Don’t get confused here – equine influenza virus and human influenza viruses share the same infection tactics, but not the same host – we cannot get flu from our horses, or visa versa.

Pharmaceutical companies making vaccines against Equine Influenza know that in order for their vaccine to be effective, it must contain the most up to date viral strains in a given location.  They weigh this against the cost of introducing new strains into their current vaccine.  Currently, the newest equine influenza virus strains predominant in the US include viral antigens (the “hat and coat”) from strains A/South Africa/2003 or A/Ohio/2003.  The Merck influenza vaccine used in our practice contains A/KY 93, KY02, and NM2/93 strains. Merck Animal Health serological data suggest that these strains provide cross protection against Ohio 03 and South Africa 03. So Merck has not yet taken the financial dive to replace the strains of influenza virus in their vaccine, but they have tested them and claim that there is cross protection – in other words the antibodies created in response to their vaccine will recognize newer influenza strains in our horses’ environment.

You can see that Equine Influenza Vaccines are not perfect – so why should we use them?  They are an important part of disease prevention in specific settings.  If only  part of a population of horses is vaccinated, these individuals may have partial immunity which protects them from showing signs of disease but does not completely eliminate their shedding of virus.  Horses, especially younger ones, living in groups without diligent vaccination rapidly spread virus from one to another making it very difficult for humans in charge to stay ahead of disease spread.  In larger barns, the outcome is usually quarantine of the entire facility for 21 days or longer, or until 7 days after the last horse has any clinical signs or fever.   As you can imagine, such an outbreak has serious impacts, both on horses’ health and humans’ pocketbooks. The risk of pneumonia and other serious complications increases dramatically in such settings.

If a group of horses ALL are vaccinated against influenza the consequences of infection with flu virus are greatly reduced.  Although equine influenza vaccines may not be absolutely protective, they do reduce the virus’ ability to replicate in each horse, and therefore reduce the number of virus particles released into the environment and passed from horse to horse.  If EVERY horse in a given population is vaccinated, then the viral load in the vicinity is kept low, fewer horses actually contract disease, and the outbreak event is over much sooner, with fewer sick horses.  

Fall Vaccination Clinic Schedule

I am always here to answer your questions, and offer routine health care services on clinic days. Fall health care includes Flu/Rhino vaccination plus deworming or fecal examination, an oral exam,  and sheath cleaning.  Also West Nile Vaccination if not given in spring!

To reserve an appointment, call the office (775-969-3495) and leave:

Name, Phone #, Clinic Date,

Number of Animals, and Services requested.

We will return your call three days before your clinic with an estimated time of arrival at your address.  Please be sure horses are caught and haltered 30 minutes beforehand!

Location                                               Date

Rancho Haven/Sierra Ranchos1 -  Fri  Sep 14        

Rancho Haven/Sierra Ranchos2 - Sat Sep 22

Red Rock North/Silver Knolls 1 - Sun Sep 16          

Red Rock North/Silver Knolls 2 - Fri Sep 21

SpanSprings/Palomino Valley 1 - Sat Sep 15           

SpanSprings/Palomino Valley 2 - Fri Sep 28

Antelope/Golden/Lemmon Valley 1 - Sun Sep 23      

Antelope/Golden/Lemmon Valley 2 - Thur Sep 27

South & West Reno 1 - Sun Sep 23                        

South & West Reno 2 - Fri Sep 29

Sierra Valley/California - Sat Sep 30

 For additional savings, you can schedule your own mini-clinic as long as you have at least 6 horses at a single location.  Call the office to make such arrangements.

Discounted Price List – Clinic day only

Farm Call/Fall Exam                    $15.00

West Nile                                     $32.00

FluRhino                                      $27.00

Rabies                                         $21.00

Tetanus/ Encephalitis                    $15.00

Intranasal Strangles                      $32.00

Ivermectin Deworm                       $14.00

Coggins Test                                $27.00

Sheath Clean w/sedation               $45.00

Fecal parasite exam                      $18.00

Oral Exam (w/o sedation)              No charge!

 

If I offer an educational seminar series this winter will you come and participate?  I need your input – send suggestions for location and topics.  I am, as always, grateful for your patronage.

Don’t forget to make your clinic appointment today !

775-969-3495                hidvet@gmail.com

I believe that education is the key to evolution. I believe that animals are the key to compassion. I believe that learning never stops.