Partners in Practice Magazine - Spring 2022

ISSUE NO. 6 | Spring 2022

MAGA ZINE

FOAL CARE: Make the Most of Timing and Technology

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RON'S CAMPFIRE

WELLBEING STUDY

FUTURE OF THE PROFESSION

How I Became the Best Vet Ever

Equine Veterinarians Better off Mentally, Emotionally

Five Ways to Keep Equine Veterinarians in Equine Practice

PARTNERS IN PRACTICE | Spring 2022

Featured

FOAL CARE: MAKE THE MOST OF TIMING AND TECHNOLOGY Digital options help you recommend well-timed care that leads to healthy foals—from preventing infectious disease to protecting against parasites.

E

ven in this time of technological advances, foals face age-old challenges. They’re more susceptible to parasites than adult horses. They contend with waning maternal antibody protection as their systems take time to develop an immune response to vaccination. They endure stressful events, such as weaning, possible sale to a new barn, and establishing a pecking order within a group of unknown horses.

The good news is that technology can make these demands more manageable. As you navigate parasite control and infectious disease prevention in your youngest patients, digital tools can support your ability to keep foals healthy and their owners engaged. Consider the following to build a wellness program founded in solid medicine and boosted by today’s technology.

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PARTNERS IN PRACTICE | Spring 2022

WARDING OFF INFECTIOUS DISEASE Infectious disease control comes down to prevention and containment, and technology plays a role in both. Address prevention first.

Critical timing of first vaccinations Administering initial vaccinations at the right time is crucial to giving foals a strong immunological start. The term immunity gap describes the interval when foals are more susceptible to infectious diseases because waning maternally derived antibodies are below protective levels but are still high enough to interfere with a foal’s response to initial vaccination. This immunity gap often coincides with weaning, an immunosuppressive event.

Thanks to technological advances in research and testing, the profession is better able to identify the viruses, such as equine herpesvirus type 1 and type 4 (EHV-1 and EHV-4), that are the greatest threat to immunosuppressed foals. Results from the ongoing Merck Animal Health Equine Respiratory

Spring 2022 | PARTNERS IN PRACTICE

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A Technology Time-Saver The Bio-Thermo® microchip, from Merck Animal Health, enables temperature to be measured in seconds within one-tenth of a degree.3 What’s more, it provides a 15-digit identification number, is about the size of a grain of rice and will last the life of the horse. The Bio-Thermo microchip combines the benefits of permanent identification with the ability to easily acquire temperature readings at home or on the road during competitions.

Coupling the Bio-Thermo microchip with the new EquiTrace® horse health management app boosts and streamlines foal care even further:

Biosurveillance Program confirm EHV-4 as the most frequently isolated pathogen, with peak incidence among youngsters less than a year old and seasonal incidence highest during late fall and early winter, coinciding with the post-weaning period.1 Therefore, it’s important to avoid administering vaccines immediately before or after weaning.

Foals with residual maternal antibodies generally produce a greater serologic response to killed vaccines when an initial series of three doses is administered rather than the two doses recommended by most vaccine manufacturers for older horses without maternal antibodies.2 Merck Animal Health supports the three-dose series for foals.

Daily digital temperature monitoring Identifying infectious disease early is vital to limiting illness among all horses, but especially in susceptible foals. To allow for early disease identification, experts recommend monitoring foals’ temperature twice daily.

This can be a time-consuming effort for caretakers and a stressful proposition for already immunocompromised foals. Implanting a Bio-Thermo® microchip saves time and sets foals up for a lifetime of health and well-being (see “A Technology Time-Saver,” at right).

• When used with a Bio-Thermo microchip, EquiTrace automatically records daily temperature trends in an easy-to-read graph.

• The secure app is accessible by login from any mobile device, so you and your clients can instantly see if a foal’s temperature is running abnormally high: simply scan the Bio-Thermo microchip with either the Global Pocket Reader Plus™ or the HomeAgain® UWSR+ microchip reader.

• Identifying a febrile foal lets you begin diagnostic investigation at the first sign of infectious disease to determine necessary treatments or biosecurity measures.

Foal-safe larval-stage deworming Foals’ naïve immune systems mean recommended deworming protocols in the first year of life are more intensive, especially during the first six months. Foals are susceptible to a wide range of parasites, including ascarids, cyathostomins, large strongyles,

CONTROLLING PARASITES, ESPECIALLY ASCARIDS

tapeworms, pinworms and threadworms. Parascaris species

Just as technology supports infectious disease management in foals, it also supports parasite control.

First, consider tried-and-true deworming practices.

horses generally develop acquired immunity by 8 to 18 months of

(ascarids) are the most pathogenic parasite for foals. Although age, effective larvicidal anthelmintics are often needed to ensure adequate control of all stages of ascarid infections in weanlings and yearlings.

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PARTNERS IN PRACTICE | Spring 2022

Foals benefit from an average of four properly timed anthelmintic treatments, with the first treatment performed no earlier than 2 months of age, unless there is a medical indication to treat at an earlier age. Include at least one larvicidal treatment, such as fenbendazole, for small strongyles and ascarids during the foal’s first year.

Completing a fecal egg count (FEC) on a subpopulation of foals before their first anthelmintic treatment will help you determine the level and intensity of early parasite exposure for foals on a particular farm. If most foals have negative or low eggs counts, you may decide to recommend delaying the first treatment until foals are slightly older. Remember to treat all horses less than 2 years old as high shedders. Using biannual FECs in weanlings and yearlings helps you evaluate the efficacy of your recommended parasite control program on a farm.

Deworming tracking You can help your clients easily keep track of deworming (and vaccination) reminders with the Merck Animal Health Foal Care ProgramSM. This web-based resource provides a comprehensive list of key foal health milestones, helping horse owners stay organized and comply readily with your recommendations. See “Timely Health Tips” at right for more.

With so much at stake in a foal’s first year, it makes sense to make the most of the preventive treatments and technology available to you and your clients. Foal care is a complex endeavor that you can simplify with well-timed vaccinations and anthelmintic treatments organized via accessible technology. Best yet, today’s digital offerings are flexible and easy to use. They’re a smart way to reinforce your foal care recommendations and lay the foundation for a lifetime of equine wellness and wellbeing. For more information on the tools mentioned in this article, contact your Merck Animal Health representative or visit merck-animal-health-usa.com/species/equine

Merck Animal Health Merck Animal Health

HORSE TIPS Timely Health Tips to Share with Horse Owners Keeping track of a foal’s vaccination schedule and deworming treatments can be a lot for your clients to manage. Bolster compliance by encouraging them to use the digital features of the Merck Animal Health Foal Care ProgramSM.

Never miss a deworming — or any healthcare milestone To take advantage of the Foal Care Program’s benefits, clients visit the website and enter the foaling date. They’ll automatically receive: • A recommended schedule of appropriately timed deworming treatments and vaccinations based on AAEP guidelines for the foal’s first year of life • The option to add the recommended dates to their calendar, so they receive timely reminders • Bonus: The program also provides mare care reminders

CLIENTS CAN ACCESS THE FOAL CARE PROGRAM FEATURES AT MERCK-ANIMALHEALTH-EQUINE.COM/PROGRAMS/FOAL-CARE

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

2 Vaccination and passive transfer. In: AAEP Vaccination Guidelines. https://aaep.org/guidelines/vaccination-guidelines/ vaccination-and-passive-transfer. Accessed March 10, 2022.

3 Langer F, Fietz J. Ways to measure body temperature in the field. J Therm Biol. 2014 May;42:46-51. DOI: 10.1016/j. jtherbio.2014.03.002.

Spring 2022 | PARTNERS IN PRACTICE

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Ron's Campfire

HOW I BECAME THE BEST VET EVER This installment of Ron’s Campfire is an original piece by L. Curnen Crisman, VMD

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

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PARTNERS IN PRACTICE | Spring 2022

T

o be honest, I’m not yet the best vet ever, but it will happen soon enough.

I have practiced 30 years now, and I’m dancing with the gray of medicine. When I started people wondered what the heck I was doing. I graduated to wondering myself what the heck I was doing. I moved quickly through “I think I know what I’m doing.” And I finally arrived at “I look like I know what I’m doing.”

“Does that really do that?”

Through it all, I’ve tried to own the vastness of what I do not know. This has been broadly encouraged by the people surrounding me.

The dairy farmer: “Why, old Doc Raven, he

“Are you sure that’s how that goes?”

The goatherd: “Why, Doc Raven would

“That vein is a little to the left.”

“I have to wait two weeks? Can I pay more for a faster visit?”

And my favorite: “Is this guaranteed to work?”

Today these comments bounce off a thick hide. But when I started, my skin was paper.

Each of the cuts hurt, and they were made more raw by reminders of the best vet ever.

“You remember old Doc Raven? That man was crackerjack! Smart as a whip he was!”

could tell you that cow was pregnant from across the room. He could read the twinkle in that cow’s eyes.”

reach right in there and tell you to your face

holds me protected, giving me the strength

you have two does and a buck. Just for good

to battle against the stopping heart.

measure, he would tell you that the does have black spots and the buck has a white

It’s spring and I feel the warmth again. I

foot. And sure enough, when they were

like the first hint of the warm sun. I have

born, he was right! First came the white

settled into knowing I can help many

foot, then like a banker’s watch, out came

and reach out for help from others with

the does with black spots.”

different experiences from my own. I am

Dr. Raven had died 12 years before I started, but he remained my constant consultant. I was condemned to hear the constant patter: “I thought it would die, but it miraculously lived!” Doc Raven followed me for years. His accomplishments were legend. I was dwarfed by his greatness.

When would I even come close?

Slowly, I settled into a comfortable place in my small town. I had lived here long

never alone. My community has expressed its appreciation.

Finally, I know this: when I can no longer work, I will die. The line of men and women who follow me as veterinary doctors of strength and grace will have to endure my reputation—the best doctor ever in this small place. As the sun goes down, you can almost hear the murmurs.

enough, helped enough people and

“That horse is certainly broken, hurt or

given away as much work as I billed for. I

lame, but you know who could have fixed

brought life back from death. I accepted

that horse? Old Dr. Crisman. He coulda

the gratitude of the creatures I saved that

fixed that horse!”

I didn’t deserve and burned with joy for the lives I fought for. With the larger world

I’m sure all those poor young vets to come

distilled into my small community, my

will endure it with grace. And this is how I

interactions with the people and animals

will become the best vet ever, if only for a

around me are a glove that grips me and

few years. Wherever I am, I will smile.

There 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 to learn more or to submit contributions.

Spring 2022 | PARTNERS IN PRACTICE

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Did You Know?

EQUINE VETERINARIANS BETTER OFF MENTALLY, EMOTIONALLY THAN SMALL ANIMAL PEERS Merck Animal Health recently released the findings of a comprehensive study completed in partnership with the American Veterinary Medical Association that examines the wellbeing and mental health of U.S. veterinarians Conducted in the fall of 2021, the Merck Animal Health Veterinary Wellbeing Study III is the most recent of a series launched in 2017 and the first to highlight the wellbeing of veterinary team members in addition to practitioners.

One potentially surprising finding? Equine (and food animal) veterinarians’ wellbeing is better than that of small animal veterinarians. In fact, about three-quarters of equine veterinarians report that they’re “flourishing,” compared with just half of companion animal practitioners (see “Veterinary Wellbeing by Practice Type”).

Of course, we know equine medicine has its share of challenges—boundaries between work and personal life and

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PARTNERS IN PRACTICE | Spring 2022

Veterinary Wellbeing by Practice Type Equine and food animal veterinarians have higher wellbeing than companion animal and mixed.

Equine

Food Animal

Companion Animal

Mixed Animal

73%

74%

52%

61%

16%

19%

34%

30%

11%

7%

13%

9%

Flourishing

Getting By

Suffering

Source: Merck Animal Health Veterinarian Wellbeing Study III, January 2022

retention of associates in equine practice being just a couple. In addition, the proportion of equine veterinarians who say they’re “suffering” is close to that in small animal medicine, at 11% and 13%, respectively.

Impact of a Healthy Coping Method Veterinary professionals who say they have a healthy approach to dealing with stress are far less likely to be psychologically distressed than those who say they don't.

I Have a Healthy Method for Dealing with Stress in My Life

Not Distressed

Distressed

16%

4%

29%

Strongly Agree

16%

Agree

10%

27%

38%

Slightly Agree

8%

36%

Slightly Disagree

2%

15%

Disagree

Strongly Disagree

Source: Merck Animal Health Veterinarian Wellbeing Study III, January 2022

Still, in a report on the study presented during WVC 2022 in Las Vegas, Merck Animal Health researchers noted that the higher sense of wellbeing was true for equine veterinarians despite the fact that pay is higher on average for small animal veterinarians. So what’s going on here? A couple of possibilities: • Money isn’t the top factor when it comes to professional (and personal) fulfillment—as workplace wellbeing experts have long asserted.

• Equine veterinarians have a deep passion about their profession, which drives a sense of satisfaction when they’re doing what they feel called to do.

Finding the Balance Having a life outside of veterinary medicine is associated with lower levels of psychological distress. And socializing with family and friends is especially important to a healthy life.

Spending Time with Family

86% 67% 75%

Exercise

52%

Hiking, Walking, Sports or Similar Activities

76% 50% 65%

Read for Pleasure

Along these same lines, study researchers said they found little correlation between personal wellbeing and revenue.

Case in point? For the time period 2019-2021, incomes for all veterinarians increased, but so did serious psychological distress.

To combat this distress, the study’s authors recommend veterinarians develop strategies to cope with stress, including engaging a financial planner. They noted that those who say they have a stress-management strategy are less distressed than those who don’t (see “Impact of a Healthy Coping Method”). Some specific tools for finding work-life balance, along with their association with veterinary wellbeing, are listed in “Finding the Balance.”

For more resources and complete results from the Merck Veterinary Wellbeing Study, visit vetwellbeing.com

48% 65%

Spend Time on a Hobby

48%

Socialize with Friends

66% 37%

Sleep at Least 8 Hours a Night

63% 39%

Travel for Pleasure Volunteer

Meditate Participate in Yoga

54% 24% 31%

14% 21% 17% 16% 15%

Not Distressed Distressed

Source: Merck Animal Health Veterinarian Wellbeing Study III, January 2022

Spring 2022 | PARTNERS IN PRACTICE

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Merck Animal Health Business Tips

5 WAYS TO KEEP EQUINE VETERINARIANS IN EQUINE PRACTICE

By Amy L. Grice, VMD, MBA

The facts are alarming. Less than 2% of veterinary school graduates are currently choosing a career in equine medicine,1 and significant numbers are transitioning to other sectors or retiring each year. Many equine veterinarians cite specific pain points causing them to want to leave the profession. To attract and keep equine associates—and to build a sustainable future for this profession—we need new paradigms and innovative ways of thinking. Here’s where we should start.

More Ideas for Keeping Equine Associates This article is adapted from Dr. Amy Grice's VETgirl webinar "Keeping Equine Practitioners in Equine Practice," sponsored by Merck Animal Health.

Check out the webinar (available free through July 20) for additional insights.

1. Create a family-friendly culture With the equine profession becoming increasingly female, the workplace must adapt to accommodate women who want to start families at the same time they’re launching their careers.

Practices must also allow mothers (and fathers) to attend to family needs as they develop and mature as veterinarians.

Practices that offer a “hard stop” to the day, with no routine appointments scheduled after 3 or 4 p.m., can often provide the time young parents need. A shortened workday or workweek can also help a practice attract and retain associates. Good communication, a collaborative approach and lots of flexibility are all key to generating loyalty and job satisfaction in associates.

2. Establish workplace boundaries Setting some limits can help veterinarians achieve and safeguard work-life balance and physical as well as mental health. Examples of workplace boundaries include: • Expecting to be called “Dr. Last Name” by colleagues, clients and staff • Saying no to scheduling routine appointments on weekends • Refusing to answer nonemergency emails, calls and texts after work hours • Teaching clients not to expect responses to nonemergency communications after hours • Utilizing paid time off for illness, vacations, personal matters such as funerals or horse shows, and so on.

When equine veterinarians believe in the validity of their own personal workplace boundaries, others typically will too. You teach what you tolerate.

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PARTNERS IN PRACTICE | Spring 2022

Equine Practice Pain Points Why have you left or considered leaving your equine practice?

Lifestyle and Number of Work Hours

27.5%

Emergency On-Call Duty

17.9%

Mental Health and Stress

11.5%

Low Salaries and Compensation

10%

Culture of my Practice

9.8%

Culture of Equine Veterinary Industry

6.5%

Having Children

6.3%

Physical Injuries or Wear and Tear High Educational Debt Desire to Work Part-Time Care of Parents or Family Members Some Other Reason

3.7% 2.6%

appointments or make callbacks. If the doctor drives, a welltrained assistant can accomplish most of these tasks. When driving time is productive, the workday shortens because there is less to do at the end of the day. This is good both for the practice’s financial situation and the doctor’s wellbeing.

5. Get creative with emergencies Emergency cooperatives are increasingly filling the need for manageable emergency coverage, with small practices in a region banding together to share responsibility. Veterinarians of more recent generations seem to find the collaboration, cooperation and camaraderie a positive addition to their lives. Doctors in these cooperatives can also cover maternity leave for each other and step up when a colleague is ill or injured. Those who meet regularly also provide a community that imparts a sense of belonging.

1.1% 0.2% 2.8%

Takeaway Message If the equine profession is to prosper in the future, we must attract and retain dedicated equine veterinarians.

New paradigms must evolve to allow our changing workforce to have the flexibility and support they need while still keeping practices financially healthy. We must all contribute to bringing about changes that will keep the equine veterinary industry viable for the future.

Total Respondents: 459

Source: Amy L. Grice, "Leaving Equine Practice," Proceedings of the AAEP Convention, Dec 5-9, 2020.

3. Capture all revenue Failing to account for all services and supplies on invoices is common in equine practice, and discounting is widespread.

When all revenue earned is not invoiced and received, a practice won’t have the funds needed to pay competitive salaries.

What’s more, when bills are reduced for clients who complain or threaten, morale falls. Good clients who are grateful for the service pay full price without discussion, and the unfairness of rewarding bad behavior affects everyone in the practice.

Practices also sometimes make special deals with clients who are friends or insinuate that their veterinarian is “like family.” When an associate charges the list price and the practice owner gives a discount, negative effects multiply.

Forming clear financial policies and abiding by them will increase clients’ and associates’ respect for the profession and the practice.

4. Boost efficiency Equine ambulatory practice generally involves many hours driving from client to client. A technician can make these hours more efficient. If the employee drives, the veterinarian can prepare laboratory forms, finalize invoices, look up history for the next call, schedule

Dr. Amy Grice practiced ambulatory equine medicine for 25 years and now offers consulting and professional leadership services through Amy Grice Veterinary Business Consulting.

1.

Bain B. Employment, starting salaries, and educational indebtedness of year-2019 graduates of US veterinary medical colleges. J Am Vet Med Assoc. 2020;257:292-297.

Spring 2022 | PARTNERS IN PRACTICE

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Meet the Team

Q&A AMY LENHART INSIDE SALES SPECIALIST Arlington, Nebraska amy.lenhart@merck.com

How long have you been working for Merck Animal Health?

I’ve had the privilege of serving in this position for 21 years.

Tell us a little bit about your horse background.

I do not come from a horse family; the neighbors started it all when I was 4 years old. When I was 10, I walked up to my dad with all my saved money and told him I was going to buy a pony.

And I did! She was with us until she died of an accident when I was in my early 20s.

What excites you most about the horse world right now?

Science and technology helping horses to live longer, healthier lives. A condition that may have been a death sentence for a horse years ago is now treatable.

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

A little girl’s first pony. You get all the treats you want, groomed all the time, fancy braids with ribbons, and even glitter on your hooves.

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PARTNERS IN PRACTICE | Spring 2022

What’s the best horse advice you’ve ever received?

There are only two emotions that belong in the saddle: one is a sense of humor and the other is patience.

Which songs are in your barn music heavy rotation right now?

Everything! I like all music. George Strait, Elton John, Bob Marley, Miranda Lambert, Mumford & Sons, Snoop Dogg, Louis Armstrong. You name it I probably have it.

What’s your favorite part of being on the equine team?

We are a small but mighty team. There are different working styles. There’s deep experience. We all try to help each other out and learn from each other.

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

I am a kind, helpful old soul.

The Science of Healthier Animals Copyright © 2022 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

Spring 2022 | PARTNERS IN PRACTICE

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