Merck Equine Partners in Practice Magazine: Winter 2021

ISSUE NO. 3 | Winter 2021

MAGAZINE

PROTECTING HORSES DURING EQUINE FLU SEASON Data highlights importance of EIV vaccination choice and timing

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RON'S CAMPFIRE

HORSES HELPING AMERICAN HEROES

COVID-RELATED COMMUNICATION

The Remount Foundation

Boosting Vaccine Revenue

The Dancing Pigs

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PARTNERS IN PRACTICE | Winter 2021

Featured

PROTECTING HORSES DURING EQUINE FLU SEASON Data highlights importance of EIV vaccination choice and timing

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oronavirus continues to dominate headlines, but at this time of year, another virus makes news of its own: equine influenza virus (EIV). While EIV infects horses throughout the year, equine flu season has been clearly demonstrated as running from December through April, according to ongoing data (since 2008) from the Merck Animal Health Equine Respiratory Biosurveillance Program.1

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Proper vaccination is key to slowing the spread of EIV. Make sure you protect your patients this flu season by considering that: • EIV is mutating through antigenic drift • Not all vaccines are created equal • EIV vaccination timing may need adjusting An Evolving Virus Requires Updated Vaccines By analyzing samples submitted to the Biosurveillance Program, researchers at the University of California, Davis School of Veterinary Medicine observed that higher numbers of older, vaccinated horses were testing positive for EIV. This led to the hypothesis that the virus was slowly mutating and escaping vaccine-specific immunological responses. To determine whether this was due to the introduction of foreign EIV strains or to the natural selection of EIV strains (antigenic drift), UC Davis researchers compared the heterogeneity of circulating wildtype EIV strains in the United States with Ohio ‘03 (OIE recommended clade 1 influenza strain).

The conclusion: Foreign EIV strains have not been circulating in the United States. Only EIV Florida clade 1 strains have been circulating and have evolved separately from clade 2 strains.2 What does this mean for you and your patients? Horses should receive an EIV vaccination that has evolved along with the virus to account for the most up-to-date flu strains.

EIV vaccine failure occurs when the virus changes at certain immunodominant sites (i.e. sites that are important for the virus to escape the immune response). Ongoing EIV sequencing through the time of this article reflects that Florida ‘13 is representative of current circulating U.S. field strains.3 The PRESTIGE® line of inactivated influenza-containing vaccines from Merck Animal Health are the only EIV vaccines that include the Florida ‘13 influenza strain.

New Vaccine Timing for ‘Flu Season’ In addition to keeping vigil over mutating flu strains, the Biosurveillance Program also tracks EIV infection rates. Recent program data compels a critical new question: Are we vaccinating at the right time of the year and are the recommended guidelines of biannual vaccination providing optimal influenza protection?

Every year since the inception of the program in 2008, data shows increased flu incidence beginning in December and running through April, which is typically prior to when at-risk horses are receiving their biannual EIV vaccinations.1 Following that logic, an EIV booster in late November or early December may be more advantageous than late summer or early fall.

With data clearly pointing to an equine flu season, veterinarians may benefit from critically evaluating the optimal time to administer biannual EIV vaccines. Even a one- to two-month adjustment in EIV vaccination timing could make a significant difference for the horse. Additionally, ongoing (since 2008) Biosurveillance Program data indicates many horses are undervaccinated—receiving just one EIV vaccination per year (or less), further complicating efforts to contain this highly infectious virus. The ultimate goal of vaccination choice and timing is to keep EIV out of the equine industry’s headlines. Less news of EIV breakouts means fewer riders are losing time in the saddle and fewer horses are experiencing health issues. That’s an outcome worth prepping for during equine flu season—and any time of year.

Vaala W, Barnett DC, James K, Chappell D, Craig B, Gaughan E, Bain F, Barnum SM, Pusterla N. Prevalence Factors Associated with Equine Influenza Virus Infection in Equids with Upper Respiratory Tract Infection from 2008 to 2019.

AAEP Proceedings. 2019 Vol 65.

2 Lee K, Pusterla N, Barnum S, Martinez-Lopez B. Is Currant Vaccine Failure of Equine Influenza Virus Due to Evolution of Endemic Strains or Introduction of Foreign Strains? AAEP Proceedings. 2019 Vol 65.

3 Data on file. Merck Animal Health 2020.

4 Merck Animal Health and University of California, Davis School of Veterinary Medicine (Nicola Pusterla). Infectious Upper Respiratory Disease Surveillance Program. Ongoing research 2008-present.

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Merck Animal Health Merck Animal Health

HORSE TIPS Timely Health Tips to Share with Horse Owners Horse owners may know that traveling horses are at increased risk for equine influenza virus (EIV). If your patients are traveling less during the pandemic, don’t let that give clients a false sense of security. These talking points will help make sure they understand their horse’s risk of EIV regardless of whether they’re on the road or at home.

Rethinking EIV Risk While there’s no magic trick to keep horses from becoming sick, implementing a customized vaccination plan is the next best thing. In addition to the core vaccines recommended for every horse, every year, the plan may include risk-based vaccines recommended based on your horse’s lifestyle or the diseases circulating in your area. Since equine flu season is upon us, EIV is one risk-based vaccine to consider based on the following: • EIV spread occurs with or without travel. Even horses who don’t leave the farm are at risk of EIV—particularly if there are other horses coming and going.

• EIV affects both young and old horses.

• A farm-wide vaccination program is important to protect all horses.

• Herd immunity is best achieved by semiannual EIV vaccination, whether horses are traveling or staying at home.

• EIV evolves like human flu but much slower. That’s why using an updated EIV vaccine that accounts for the most recent strains is important.

Between July 2019 and July 2020, data from the Equine Respiratory Biosurveillance Program shows:4 • 50 percent of EIV cases occurred in non-traveling horses • 4 years old was the median age of EIV-positive horses, but horses as old as 24 years tested positive.

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Winter Spring 2019 2021 | PARTNERS IN PRACTICE

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Ron's Campfire

RON’S CAMPFIRE on a small acreage I have been on

shoulders as though we were the

many times before. As happens each

sightless ones. Chris went around

time I go, all the actions are different.

back where the black hid what was

I am the constant. It is always Amish.

to come. There was a momentary

It is a retreat of the young and

pause, noise of getting ready, then

unsettled or the old and soon gone.

… a series of small pigs, jumping

None the heroes of note, only the

through hoops, spinning flags,

minor players adding color.

walking tight ropes, jumping gaps, all carefully executed a quick, light

A ruddy-faced long-nosed man named

choreography with funny jokes and

Chris lived there then. He had deep

surprising abilities. The big finish

set wise eyes that were blind. He

was a pig who jumped in a pool,

moved and gestured in broad motions

swam in a circle with three flags

to create the appearance that he was

in his teeth and a bow on his tail.

not afflicted. I liked him deeply for his efforts and joyful enthusiasm,

The hours of training that must

here are no greater stories to be told than those of the practicing equine veterinarian. Pull a chair up to Ron’s Campfire to read some of the best from equine veterinarians who not only have scientifically gifted minds, but also are talented writers and storytellers. If you have a story or blog you’d like to share, we’d love to feature it. Please email Ron McDaniel (ron.mcdaniel@merck.com) to learn more or to submit contributions.

for he had no justification for it.

have been required were breathtaking.

Everything there was thin and

We genuinely were impressed and

poor, including his horse. An ancient

applauded enthusiastically. Chris

standardbred whose bones were tent

came out from behind and swung

poles for his skin.

his arms left and right to collect the

This installment of Ron’s Campfire is an original piece by L. Curnen Crisman, VMD.

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The Dancing Pigs I have worked so long in one county, in one part of the world, that sometimes the stage stays the same and only the actions and plots around me change. Yesterday, I was 4

PARTNERS IN PRACTICE | Winter 2021

accolades. I told him he had to let I helped him with his horse by

me pay for the show. He reminded

speaking well of him, more feed,

me that I had not charged him.

change the shoeing. There was

So, we left it. I left five dollars in

nothing I could do and he knew it.

the donation plate marked by the

Impossible to treat old and poor.

door anyway.

My boys Evan and Ben were with me and the scene had made them

The boys and I laughed with Chris

quiet and thoughtful. When Chris

and heaped our praises on him for

asked for the bill, I told him he owed

a remarkable show. A surprise of joy

me nothing, because I knew that is

on a small country road in a timeless

what I had given him. He burst with

landscape. Today I stand in the same

inexplicable joy. Chris, who said his

spot. Chris has died. There are no

name as two words “Cre-as,” said,

trained pigs. I am looking at a well-fed

“Well then your boys would love

Saddlebred that belongs to a young

my show.”

couple. He is a carpenter and they are just beginning. We talk: No, he never

By the side of the road there was

saw the pigs but he heard about them.

a long enclosure with hoops and

I speak highly of the show and the

rings and things that turned round.

training. He tells me that Chris was

He lined the three of us up in the

American Indian, adopted. He went

deep dust, guiding each of us by the

to Mennonite school out west

somewhere and chose to join the Amish church and had lived on this little plot with his pigs, unmarried for his whole life.

I am glad to know him and glad that he was part of my life and my childrens’ lives. He was suddenly at that moment very important to me.

The wind is blowing with a howling, cutting edge. It is sharp cold, the end of November and winter is on us. I am old now. I am tempered by endurance.

I will always miss the dancing pigs and the thought of an old, blind Amish Indian. All too much thought in one small space. We shall never again see such dancing pigs.

Dr. Crisman owns and operates Gum Tree Veterinary Clinic in Conestoga, Pennsylvania.

Winter 2021 | PARTNERS IN PRACTICE

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Did You Know?

HORSES HELPING AMERICAN HEROES

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onnecting with a horse can elicit exhilaration, joy and peace all at once.

Jeanne Springer and Billy Jack Barrett experienced this firsthand. Barrett managed the U.S. Air Force Academy (USAFA) Equestrian Center in Colorado Springs, Colorado, for over 30 years and Springer was on staff for 20 years. While working with military members at the riding stables, Springer and Barrett realized the horses were helping injured veterans. So, they created the Remount Foundation to provide active-duty military, veterans, first responders and their families with equine-assisted therapeutic activities.

With the horse playing such an important role in these warriors’ health, Merck Animal Health wanted to help the horses themselves stay healthy. Over recent years, Merck Animal Health veterinarians and team members have visited the USAFA Equestrian Center, to administer vaccinations and deworming medication to Remount Foundation therapy horses. The Merck Animal Health team was planning its 2020 visit when the pandemic hit.

COVID-19 requirements forced the USAFA to restrict access to its facilities, including the Equestrian Center. The Remount Foundation stepped up. Working with the USAFA, Remount Foundation was able to help some warriors and their therapy assistants to come on base so the warriors could spend time with the horses that help them get through their personal crises. During this time, the Remount Foundation also secured horses and facilities off the USAFA base for safe and secure contact between horses and those in need.

The Foundation and USAFA Equestrian Center management also helped arrange for three Merck Animal Health equine team members to visit the Academy this past spring to administer vaccinations and deworming agents to help protect the horses that give so much to American warriors. With steady resolve, the Remount Foundation continues its important service work in the midst of the ongoing pandemic.

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“Even though we provided vaccinations and dewormers, it seems team Merck got more from the Remount folks and horses than they got from us,” said Dr. Earl Gaughan, a Merck Animal Health Equine Professional Services Veterinarian who’s pictured here vaccinating a USAFA Equestrian Center and Remount Foundation miniature horse.

He’s joined by other Remount volunteers.

Remount Foundation Mission Provide active-duty military, veterans, first responders and their families with free equineassisted therapeutic activities within a healing, natural environment and a supportive community to empower them to heal physically, mentally and spiritually.

Remount program participants • M ore than 4,500 warriors, veterans and their families have received help • 43% female, 57% male • Veterans from all eras including the Vietnam War • Many suffer from post-traumatic stress disorder (PTSD), including suicidal thoughts Learn more about the Remount Foundation at remountfoundation.org

Merck Animal Health Business Tips

COVID-RELATED COMMUNICATION CAN BOOST VACCINE REVENUE

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f COVID-19 has a silver lining, it’s that it’s spurring a lot of discussion about vaccinations—and that can spur your business.

Clients may be more receptive now to learning why vaccinations are critical and why your involvement is important.

Rabies Infographic Share this infographic with horse owners as a way of reminding them that vaccinations are important to help prevent common and rare diseases alike.

Step one is ensuring clients understand the need for vaccination, even when a disease hasn’t been seen locally. Rabies is a great example. (Start the conversation by downloading this rabies infographic and sharing it with clients as a friendly reminder.)

Rabies, like a few diseases, is common in wildlife. Just because you aren’t seeing rabies in horses, doesn’t mean it’s not there.

RABIES

QUICK FACTS General Facts

Most Commonly Infected Animals

Rare, but terminal, rabies is contracted through the bite of an infected or “rabid” animal.

It manifests through unpredictable clinical signs and results in fatal brain swelling.

An unvaccinated horse will not survive infection, and its saliva poses a risk to humans and other animals.

That’s why the American Association of Equine Practitioners (AAEP) Vaccination Guidelines classifies the rabies vaccine as “core.” Remind clients that when a vaccine is designated as “core,” every horse should receive it every year regardless of geography or the presence of diagnosed disease. As for risk-based vaccines, your involvement is critical because you understand the horse’s age, lifestyle and environment.

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Fewer than 100 cases are reported in horses each year, but 100% of them are fatal1

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Horses are typically bitten on their face, muzzle or limbs after investigating the rabid animal

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The number of rabies cases is increasing due, in large part, to urbanization of areas where wildlife is infected

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Stalled horses are at risk as wildlife is drawn to feed rooms and barns

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Due to serious threat for human exposure, any suspected case of rabies should be handled as if it were positive until proven otherwise

Raccoons

Foxes

100% fatal. Always preventable.

Clinical Signs

Diagnosis

The signs of rabies infection can be nonspecific and confusing. Veterinarians often say it can “look like anything,” making diagnosis challenging and initial misdiagnosis common. However, at some point during the course of the disease, most rabid horses exhibit: •

Sensitivity to touch

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Fever

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Paralysis or impaired balance

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Skunks

There is no definitive test to diagnose rabies in a live animal

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Diagnosis is made by examining the Bats

brain of the deceased animal

Note: Any mammal can contract and spread rabies.

Prevention

Treatment and Recovery If an unvaccinated horse is bitten by a rabid animal, contact your state animal health official. Protocol varies from state to state, but often the bitten animal must be euthanized immediately or quarantined for 6 months.

Prevention through vaccination is the best way to protect your horse against rabies.

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revaccinated annually •

Reinforce the need for veterinary involvement by explaining how vaccines work. Share that vaccines help prime the immune system so, when a horse gets exposed to a disease, the immune system can respond, ideally before the horse shows any clinical signs. Clients should understand that priming the immune system takes some time, which means horses aren’t immediately protected after a vaccination is given. That’s why timing is key.

Veterinarians play an important role in ensuring horses receive the right vaccines at the right time. Partnership is especially important when creating a booster vaccination schedule that helps ensure horses, especially foals, are properly protected.

Adult horses previously vaccinated against rabies should be

No treatment options are available to animals showing clinical signs.

All confirmed equine rabies cases are fatal.

Important! If a human comes in contact with a rabid animal’s saliva via bite or handling of an infected animal, seek medical treatment immediately.

Rabies is considered a core vaccination that every horse should receive every year2

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If a previously vaccinated horse is bitten by a rabid animal, please contact state animal health officials immediately

Talk to your veterinarian to ensure your horse is current on rabies protection.

ADDITIONAL INFORMATION: www.AAEP.org/guidelines www.aphis.usda.gov

Brought to you by:

For more information on the PRESTIGE® EquiRab® rabies vaccine, visit PrestigeVaccines.com.

REFERENCES: Ma, X, et al. Rabies Surveillance in the United States in 2017. J Am Vet Med Assoc 2018;253:1555–1568.

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AAEP Core Vaccination Guidelines (aaep.org).

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2 Giralda Farms • Madison, NJ 07940 • merck-animal-health-usa.com • 800-521-5767 Copyright © 2020 Intervet Inc., d/b/a/ Merck Animal Health, a subsidiary of Merck & Co., Inc. All rights reserved. US-RBV-200300001

4503_Rabies_Infographic_v4.indd 1

3/19/20 6:03 PM

CLICK TO DOWNLOAD

Talking with clients about vaccinations is time well spent, especially now. By helping your clients understand that vaccination is a critical component of disease prevention, you’ll not only help them keep their horses healthy, but you’ll also help keep your business healthy.

Winter 2021 | PARTNERS IN PRACTICE

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Meet the Team

Q&A CHRISSIE SCHNEIDER DVM, MS, DABVP (EQUINE PRACTICE), cVMA Columbus, Ohio chrissie.schneider@merck.com

Tell us a little bit about your horse background.

I begged for horseback riding lessons as a young girl and was lucky to ride at a farm that allowed me to help with chores in exchange for lessons. I soon learned I loved caring for horses as much as I loved riding them. I took a long hiatus from riding, but I recently started up again. I am thrilled to be back in the saddle and rediscovering my original love of riding.

Outside of the equestrian world, what is your favorite hobby?

I really enjoy hiking in the woods. Anytime I can be outside exploring new places, I’m happy.

If you were a horse, what type of horse would you be?

I would be the willing adventure buddy—as long as the terrain wasn’t too steep or scary and you gave me lots of treats.

Best horse advice you’ve ever received?

Every interaction with a horse is training, so be mindful of your actions.

What is your favorite part of being an equine veterinary professional services team member?

I haven’t been part of the equine veterinary professional services team for very long, but so far my favorite part is working with the other members of the equine team.

Everyone has been so welcoming, and I can’t wait to get out in the field with them!

Best veterinary advice you’ve ever received?

A veterinary degree provides many opportunities.

There are so many things we can do with our Doctor of Veterinary Medicine.

If there was one thing you would want customers to know about you, what would it be?

I’m here to help you help your patients and clients any way I can. Please don’t hesitate to reach out if I can assist you.

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PARTNERS IN PRACTICE | Winter 2021

How long have you been working for Merck Animal Health?

I joined the equine veterinary professional services team in July 2020.

The Science of Healthier Animals 2 Giralda Farms • Madison, NJ 07940 • merck-animal-health-equine.com • 800-521-5767 Copyright © 2021 Intervet Inc., d/b/a/ Merck Animal Health, a subsidiary of Merck & Co., Inc. All rights reserved. US-PRT-210200005

Winter 2021 | PARTNERS IN PRACTICE

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