Tuesday, August 20, 2013

2013 Fall New & Notes

 High Desert Veterinary Service
Fall 2013 News and Notes:
Chrysann Collatos VMD, PhD, DACVIM
775-969-3495 (Office)          742-2823 (Cell)
  • Vaccination Clinic Schedule   
  • Interstate Travel Regulations
  • Colic: Thinking Ahead
End of summer greetings to you all!
The smoke is clearing and it is time to prepare for great autumn riding and oncoming winter months.  Don’t shortchange your equine companions.  Schedule your clinic appointment so we can be sure they are ready for the season change.  For the health of the horse,

Fall Vaccination Clinic Schedule
I am always here to answer your questions.. 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 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 6 
Rancho Haven/Sierra Ranchos2         Sat Sep 14
Red Rock North/Silver Knolls 1            Sun Sep 8
Red Rock North/Silver Knolls 2            Sat Sep 21
Span Springs/Palomino Valley 1        Sat Sep 7
Span Springs/Palomino Valley 2        Fri Sep 13
Antelope/Golden/Lemmon Valley 1    Sun Sep 15
Antelope/Golden/Lemmon Valley 2    Fri Sep 20    
South & West Reno 1                Sun Sep 22 
South & West Reno 2                Fri Sep 27
Sierra Valley/California                       Sat Sep 28

Reduced Prices - Clinic Dates Only
Farm Call/Fall Exam                   $18.00
West Nile                                   $32.00
FluRhino                                     $27.00
Rabies                                        $21.00
Tetanus/ Encephalitis                $18.00
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!

Interstate Travel Regulations
I am fielding lots of calls about increased scrutiny of paperwork at the California border.  I spoke with an official at the California Department of Food and Agriculture (CDFA)  last week to clarify their enforcement policy regarding horse transport.  First of all, despite a lot of buzz on the internet earlier this year, there has been NO CHANGE in the law regarding interstate horse transport.  The federal government is gearing up to get involved in regulating animal movement, but that HAS NOT YET HAPPENED.  Interstate transport of horses is still regulated at the state level. 
Both Nevada and California require a Coggins (Equine Infectious Anemia) test current within 6 months, and an interstate health certificate of veterinary inspection (CVI) issued within 30 days. Nevada also requires a brand inspection.
The people at the California border inspection stations are not authorized to detain you or fine you if your paperwork is not in order.  They do have a form which they are supposed to fill out that identifies you and establishes that your brand inspection, CVI, and coggins are in order.  If they find that your paperwork is not correct, then they contact a CDFA Health Inspector and pass along your information.  It is the Health Inspector’s job to track you down and issue a warning or citation as they see fit.  In Nevada, brand inspectors travelling on the highways can pull over any vehicle transporting horses and ask to see paperwork and issue warnings and fines.
The CDFA official I spoke with explained that the California inspection station border guards can use their discretion regarding completion of the livestock identification form for horses. If they are busy, they may verbally question you, ask to see Coggins or CVI, or just wave you on through. However, they do have the right to ask you to pull over, come inside, produce your paper work and supply personal identification information which they will record. 
Bottom line: if you chose to transport your horse across state lines without current Coggins, CVI, and brand inspection, you are liable to be fined.  You are required to pull over and answer questions at the California border stations at the border guards’ request.
Finally, there is a certificate of veterinary inspection (CVI) issued in Oregon, Washington, Idaho, and Montana that is good for 6 months.  California does not issue 6 month CVI’s but they do accept them.  Nevada does not issue or recognize the 6 month CVI.  

Just like you, I dread the thought that one of my horses may show signs of colic one day.  I spent 4 years studying equine colic completing my PhD research, I accepted literally hundreds of colic emergencies into the hospital during my clinical residency, and I now have 20+ years experience treating colic in the field.  And still, I can’t guarantee that your horse with colic will not experience a serious complication.
Treating colic can be expensive.  A routine after hours colic call in my practice costs about $250. This includes an emergency call fee, physical exam and rectal palpation, sedation,  medication to reduce pain and enhance gastrointestinal motiliy , and nasogastric intubation.  About 80% of horses recover uneventfully after a single visit, if that visit occurs within the first hour of onset of signs.  More serious cases, or those in which initial treatment is delayed, can require multiple visits or warrant hospitalization.  Complicated medical cases and surgical colics can cost $6000-$10,000.
Early intervention is the key to successful treatment.  So what can YOU do to help ensure that your horse recovers from a colic episode and save money at the same time?  Be observant, and learn to do a basic physical examination!  Get a cheap stethoscope at the local nursing supply store. Buy a digital thermometer at the drug store.  And then ASK ME to teach you during your fall clinic appointment.  How many  of you “experienced horsemen” know how to do a physical??
If you can get temperature, pulse , respiration, and evaluate gut sounds and oral mucous membranes you can convey critical information on your first call to me at the onset of signs of colic. High heart rate, no gut sounds, and escalating pain indicate the need for intensive veterinary treatment.  In milder cases, after we review  your clinical findings it may be reasonable for you to administer medication orally to your horse.  Discuss the option of having oral Banamine paste on your property with me. 
When I evaluate your colicky horse, in addition to history and physical exam findings, I will perform a rectal palpation and pass a stomach tube.  This will provide me with information that you cannot obtain which  will guide specific treatment decisions.
Until I teach you how to do a complete physical examinantion, here are the basics:
v  What to watch for (in order of severity):
Ø  Poor appetite
Ø  Reduced manure production
Ø  Lying down more than normal
Ø  Stretching out as if trying to urinate
Ø  Pawing, getting up and down, looking at flank
Ø  Rolling violently
v  What to do:
Ø  Take food away
Ø  Walk your horse if he attempts  to lie down/roll

Colic is serious, but in most cases treatable.  When a serious colic strikes, it happens very quickly.  I urge you to think ahead – establish a savings account for your horses if you can, look into equine medical insurance and Care Credit (CareCredit.com), and decide now how much you can afford to spend in a critical situation.  Planning in advance makes those difficult decisions a little easier in times of crisis.
 Take advantage of your fall clinic appointment to ask me more specific questions about colic prevention and treatment, and to get your physical exam training!

Educate yourself, for the health of the horse.

See you in September,
Dr. Chrysann

Saturday, March 2, 2013

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 

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.

Wednesday, February 27, 2013

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.
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.


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.

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.

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