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.

Wednesday, February 20, 2013

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.

Monday, February 11, 2013

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.

Tuesday, February 5, 2013

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.

Ask a Horse Vet Online

We have partnered with JustAnswer so that you can get an answer ASAP.