Merck Equine Partners in Practice Magazine: Spring 2023

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RON'S CAMPFIRE What's Time... UNCONDITIONAL UHVRC Awards 7,000 Vaccine Doses and Microchips for Horses in Need ISSUE NO. 8 | Spring 2023 UNCONDITIONAL CARE for Horses and You MAGAZINE 1 PARTNERS IN PRACTICE | Spring 2023 BUSINESS TIPS Solutions to Support Early-Career Veterinarians

UNCONDITIONAL CARE FOR HORSES AND YOU

From tracking infectious disease threats to championing equine veterinarians, everything we do is in support of the horse.

Our passion at Merck Animal Health is simple: do what’s right for the horse. That includes working tirelessly to support people like you who care for horses.

Passion for the Horse

We work tirelessly to continually refine and improve the products and programs that impact the health and wellbeing of horses.

• Vaccinations and pharmaceuticals that set the standard in safety and efficacy

• $1 million+ in vaccine donations through the Unwanted Horse Veterinary Relief Campaign, a 15-year (ongoing) nonprofit partnership with AAEP. Meet a horse who’s benefited on page 7.

Passion for People Who Care for Horses

The unique trust between horses and people fuels our commitment to creating premium equine health solutions, backed by a team of knowledgeable equine professionals

• Partnership with the EquiTrace® app enables our Bio-Thermo® microchips to provide instant temperature monitoring and health records management

• Merck Equine Research Fellowship through the Gluck Equine Research Center supports advanced study of equine disease

Commitment to Sustainability

We’re making critical investments in the health and longevity of the equine veterinary profession through multiple initiatives.

• The Merck Animal Health Veterinary Wellbeing Study III was expanded to include veterinary technicians

• A founding sponsor of MentorVet, an evidence-based approach to empowering healthy veterinary professionals

• A founding partner with Sustainability in Equine Practice Seminars to help veterinarians achieve greater wellbeing, productivity and peer collaboration

Commitment to the Equine Industry

We champion programs that strengthen the bond between human and horse.

• Annual Merck Animal Health Foundation for the Horse Scholarship

• Ongoing infectious disease tracking and sequencing through our Equine Respiratory Biosurveillance Program shapes disease response and enables us to update vaccines to account for current circulating strains

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Featured
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Spring disease threats

Our Unconditional commitment comes to life this season in particular through the ongoing Equine Respiratory Biosurveillance Program. Insights from the program are constantly advancing, and some of the latest are included in a recently published study, “Frequency of Detection and Prevalence Factors Associated with Common Respiratory Pathogens in Equids with Acute Onset of Fever and/or Respiratory Signs (2008-2021).”1 It documents a period of 13 years in which 10,296 U.S. horses with acute onset of fever and respiratory signs were tested via nasal secretion (qPCR) for detection of equine influenza virus (EIV), equine herpesvirus-1 (EHV-1), equine herpesvirus-4 (EHV-4), equine rhinitis A and B viruses (ERVs), and Streptococcus equi subspecies equi (S. equi). A few timely highlights include:1

• Together, EIV and EHV-4 made up 63% of all single infections.

• S. equi was detected in 22%, ERV in 11% and EHV-1 in 4% of all positive samples.

• There was a distinct seasonality to EIV and EHV-1 (more likely in the spring), as well as to EHV-4 (more likely in the fall).

- Update: Figure 1 features the most current cumulative data (through 2022) on seasonality of infectious diseases since the paper was published.

• When compared to all horses with known respiratory infections, clinical signs were fairly consistent across pathogens. However, coughing was a clinical hallmark of EIV infection (Figure 2).

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250 200 150 100 50 0 Positive Cases JANUARY FEBRUARYMARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER S. equi EHV-1 EHV-4 EIV ERAV/ERBV
FIGURE 1: Comparing Seasonality Among Respiratory Pathogens (2008-2022)2
100.0% 90.0% 80.0% 70.0% 60.0% 50.0% 40.0% 30.0% 20.0% 10.0% 0.0% Lethargy Coughing Anorexia Nasal Discharge % Occurrence EHV-4 EIV S. EQUI * Median temperature for each pathogen: 103.0°F, occurring >87% of the time.
FIGURE 2: Comparing Clinical Signs Among Top 3 Respiratory Pathogens (2008-2021)1*

Updates in Your Inbox

Infectious disease trends equip you with information to better anticipate your patients’ risk factors and guide your recommendations for vaccination programs and biosecurity measures. Sign up to receive the program newsletter via the Merck Animal Health Biosurveillance Program web page. We publish it twice a year as part of our Unconditional commitment to supporting you in caring for horses.

Merck Animal Health

HORSE TIPS

Timely Health Tips to Share with Horse Owners

Cases of Streptococcus equi subspecies equi were on the rise throughout 2022, according to data collected through the Equine Respiratory Biosurveillance Program.2 Learn more about the potential causes in this recently released study,3 and help protect your patients by sharing the following strangles-related reminders with your clients.

Combating an uptick in strangles

Strangles is affecting more and more horses, according to ongoing data collected through the Equine Respiratory Biosurveillance Program. Strangles can impact any horse at any time of year, but data points to seasonal and situational increases. Keep these key facts in mind:3

• Quarter horses were more likely to test positive for strangles than other breeds

• Middle-aged horses (the median age was 8) are more commonly impacted

• Competition and ranch and farm horses were more likely to test positive than horses used for other activities

• Strangles is more common in the spring and winter, though positive cases were reported in all four seasons

• Nasal discharge, fever and lethargy were the most common clinical signs reported, which may look similar to the signs of other upper respiratory infections

• Diagnosis is an important step to ensure treatment plans and biosecurity measures are appropriate and effective

• Isolation of horses with strangles remains the best method to prevent disease spread

11, 759. https://doi.org/10.3390/pathogens11070759.

78. https://doi.org/10.3390/vetsci10020078

Share this easy-to-read infographic with clients for more quick facts on strangles.

Merck Animal Health
1. Pusterla, N.; James, K.; Barnum, S.; Bain, F.; Barnett, D.C.; Chappell, D.; Gaughan, E.; Craig, B.; Schneider, C.; Vaala, W. Frequency of Detection and Prevalence Factors Associated with Common Respiratory Pathogens in Equids with Acute Onset of Fever and/or Respiratory Signs (2008–2021). Pathogens 2022, 2. Merck Animal Health and University of California, Davis (Nicola Pusterla). Infectious Upper Respiratory Disease Surveillance Program. Ongoing research 2008–present. 3. Jaramillo-Morales, C.; James, K.; Barnum, S.; Vaala, W.; Chappell, D.E.; Schneider, C.; Craig, B.; Bain, F.; Barnett, D.C.; Gaughan, E.; et al. Voluntary Biosurveillance of Streptococcus equi Subsp. equi in Nasal Secretions of 9409 Equids with Upper Airway Infection in the USA. Vet. Sci. 2023, 10, LEARN MORE
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Download Infographic

WHAT'S TIME...

This installment of Ron’s Campfire is an original piece written by Ron

The only other job I’ve held before my career of selling vaccines and medicine to veterinarians was that of a feed salesman. This was back in the early ‘80s and I was selling hog feed that was “amino acid balanced.” I would stand up at producer meetings and extol the virtues of my high-powered feed, how it would improve feed conversion and average daily gain. After one of those meetings, a farmer came up to me and, hoping to make a sale, I explained to him that we could shave a week to 10 days off the time it would take to get his hogs to market. He looked squarely at me and said, “What’s time to a hog.”

I recently attended a funeral, a celebration of life, for a fine young man in our community who passed away from a heart condition he lived with all of the 20 years he spent on this earth. Our families have been friends for years, so we had the privilege of watching this young man grow up. He loved horses and roping. It would not be unusual to see him and a group of young men in the grocery store parking lot after hours roping the dummy under the lights.

As folks shared memories, this gathering of teenagers roping the dummy was often mentioned. After the funeral, someone I hadn’t seen for a few years came up and said hello. He was a young man with a job in town now, but the last time I’d seen him, he was a teenage boy who lived with his mother out in the country across the road from us.

After briefly catching up, he looked me square in the eye, and with a hint of some emotion said, “I want to thank you for teaching me how to rope the dummy years ago when I used to come over to your house. Because of that, I got to hang out with the guys in town, roping the dummy and making friends.”

That had quite an impact on me. Driving home I recalled a similar situation years before that. A couple in our rural community had a son just a year older than my boy. They lived about a mile from us, which is no distance at all. Our boys played together and were both in the 4-H Youth Shooting Sports. Sadly, his mother was diagnosed with cancer and less than a year later, she passed.

At her funeral service, her husband came up to me and said, “Ron, I wanted to thank you for taking my son squirrel hunting and helping him bag and clean his first squirrels.”

Two unrelated scenarios and yet two individuals, processing their grief expressed thanks for random actions that cost me nothing but time.

That hog that has no idea that he’s even going to market, let alone when he’s going to market. And even though I know my days are numbered, I don’t know when I’ll be called to my heavenly home. Best use my time wisely.

Besides, what’s time to a hog or an old cowboy.

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 writersand 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.

6 PARTNERS IN PRACTICE | Spring 2023 Ron's Campfire

UHVRC AWARDS 7,000 VACCINE DOSES AND MICROCHIPS FOR HORSES IN NEED

This Old Horse, a Hastings, Minnesota-based provider of rescue, retirement and recovery support for older and special-needs horses through their farms and foster network, is among 223 nonprofit horse care facilities to receive complimentary vaccines and microchips through the Unwanted Horse Veterinary Relief Campaign (UHVRC).

The longstanding partnership between Merck Animal Health and the AAEP provided 7,000 of the company’s HomeAgain® TempScan® Microchips and 7,000 doses of both Prestige® 5 + WNV and EquiRab® to help protect horses against Eastern and Western equine encephalomyelitis, equine rhinopneumonitis (EHV-1 and EHV-4), West Nile virus, equine influenza, tetanus and rabies. Since inception of the UHVRC in 2008, Merck Animal Health has generously provided more than 53,000 doses of core vaccines valued at over $1 million.

“On any given day, we support more than 200 horses in our facilities, all of them requiring regular vaccination as part of their ongoing health maintenance,” said Nancy Turner, founder and president of This Old Horse. “Microchipping plays a big role in our safety net program to assure that any of ‘our’ horses placed in adoptive homes can always find their way back home if their circumstances change. The generous award of vaccines and microchips will reduce our health and safety expenses for each horse, enabling the savings to be reallocated to help horses in other ways.”

Dr. Dale Magnusson of Magnusson Veterinary Services in Hudson, Wisconsin, coordinated This Old Horse’s application for free vaccines and microchips.

The annual application deadline is Feb. 1.

Learn more at aaep.org/horse-owners/unwanted-horseveterinary-relief-campaign.

Bunny, a 27-year-old American Paint Horse who was a successful show horse and broodmare until her retirement, is among the equine residents at This Old Horse to benefit from Merck Animal Health vaccines and microchips through the UHVRC.

Spring 2023 | PARTNERS IN PRACTICE 7 Unconditional

SOLUTIONS TO SUPPORT EARLY-CAREER VETERINARIANS

Integrating a new graduate into your practice is an exciting and rewarding, yet challenging, prospect. All doctors, regardless of experience level, face challenges when starting at a new clinic.

These challenges are compounded for new graduates adjusting to workflow and interpersonal dynamics outside a university setting.

The following approaches will help you support new doctors growing in your practice and their careers.

Staffing solutions

Technicians

Pairing an experienced technician with a new graduate speeds the processes of finding medications and supplies in the practice vehicle, setting up and using equipment, and navigating practice software. What’s more, when faced with a stressful situation, an experienced assistant can offer reminders like, “Dr. Wright, would you like me to clip this wound for you?”

Doctors

Asking a senior clinician to check medical records and billing upon case completion helps the new graduate learn your practice’s policies and medical-record style, which is likely more abbreviated than the university setting. It also allows the doctors to discuss the case and appointment outside of clients’ earshot.

Scheduling solutions

Implementing a graduated appointment schedule helps the new doctor, as well as the staff who schedule appointments. Allotting about 15 extra minutes for routine appointments at the start of employment allows the new graduates to sharpen their exam routine, basic technical skills, and client communication skills. With this background, they’ll be more likely to succeed on future “fire-engine days.” It also decreases the likelihood that new grads run late to scheduled appointments.

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Merck Animal Health Business Tips

Feel free to modify this example graduated schedule to best suit your practice:

• Phase 1: Shadow other doctors for both routine and emergency cases, meet clients, learn farm locations, practice using software, write medical records and billing for cases seen with senior clinician; senior clinician to revise/edit for completeness of record and accuracy of charges.

• Phase 2: Schedule solo basic wellness and simple appointments, such as vaccines, routine dentals, bandage changes, lasers and shock waves.

º A senior clinician double-checks records/billing for completeness.

º Add emergency coverage once all parties feel comfortable and the new doctor has appropriate backup if needed.

º Real-life example: New doctors in my former practice accompanied senior clinicians on emergencies for four months. Then they began to take primary emergency coverage, with a senior clinician always available by phone and to meet on the farm if needed.

• Phase 3: Schedule complex cases (lameness, gastroscope, etc.) with senior clinicians, while increasing the frequency of solo appointments.

º A senior clinician provides final review of medical records.

º The newer doctor takes charge in appointments when possible with the senior clinician present for support.

Communications solutions

Routine appointments

Start new doctors talking to clients by allowing them to communicate during callbacks on routine cases. This way they can speak with clients without the pressure of communicating a diagnosis and treatment plan. When working with senior clinicians, ensure new doctors are present for the entire appointment rather than cleaning or putting away equipment. Remember, a new doctor is not a technician. Witnessing another clinician’s client conversations is the best way to pick up case-related communication skills.

Emergencies

Triaging ER phone calls takes time and practice and is often stressful for new doctors. Answering daytime emergency calls lets new doctors engage with clients while staff and other clinicians are available for assistance.

Skill-building solutions

Case workups.

Limitations of equipment in the field, client budget and practicality of treatments are all topics that can cause insecurity in a new graduate. Discussing the available on-farm options helps create confidence. Directing new doctors to medical records of similar cases is a low-effort way to compare notes. Holding weekly or bi-weekly case rounds allows for case discussion and questions that may arise once off the farm.

Feedback solutions

Providing constructive and timely feedback is the cornerstone of growth and improvement. Although varying personality types will respond to feedback differently, following general guidelines is helpful for mentors. First, ask if the doctor is open to hearing some feedback. This ensures an open mindset for constructive thoughts. Then provide feedback with a structure that reinforces the good while providing suggestions for improvement. To help the new doctor see areas of strength, use affirmative statements such as “patient assessments were accurate” or “identified appropriate treatments for likely diagnosis.” When debriefing, ask questions such as “What did you do well?” “What do you wish you had done differently?” and “What did you learn?”

By using the solutions outlined above, you can successfully integrate a new graduate into your practice. The new doctor will become an integral part of your practice sooner rather than later—and hopefully for many years to come.

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This article is an excerpt from the AAEP Proceedings of
1. Core Competencies for New Veterinary School Graduates in Equine Practice. https://aaep.org/sites/default/files/2021-02/AAEP_Core_Competencies_2020.pdf Accessed July 15, 2020.
a topic Dr. Wright originally presented at AAEP 2022 in San Antonio.

Q&A

AMANDA COMPTON, BS, CVT, RVT, LVT

SENIOR TERRITORY REPRESENTATIVE

Lehighton, Pennsylvania

amanda.compton1@merck.com

How long have you been working for Merck Animal Health?

I joined the team in July 2022. I feel very lucky to be a part of such a diverse and talented team of people, and I’m looking forward to a long career with the company!

Tell us a little bit about your horse background.

I was the quintessential horse-crazy little girl, reading horse books, drawing horses and dreaming of having my own. When I was 10 years old, my dad purchased a 4-year-old green broke Arabian gelding on a whim from a local auction, and that horse changed the course of my life. I subsequently bred, trained and competed two of his siblings to national championships in sport horse carriage driving. I was always drawn to veterinary medicine. After college at West Virginia University, I worked for the Marion duPont Scott Equine Medical Center in Leesburg, Virginia, where I gained invaluable experience from many excellent veterinarians and technicians and went back to school for my veterinary technology degree. In 2018, I accepted a position as the first equine nurse at the Equine Veterinary Medical Center in Doha, Qatar, where I assisted with the startup of the hospital services and lived for nearly two years. I have a passion for patient care, dentistry and mentoring others in business and work/life balance

What excites you most right now?

I am excited to be part of a company who recognizes and is concerned about sustainability in the equine veterinary industry. If we want to change the industry, we have to be part of the difficult conversations and be open to new ideas or ways of working.

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

I’d have to say a combined driving horse, because they are versatile, unflappable and enjoy their jobs!

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

It’s a simple phrase: Let horses be horses. They need their turnout time for mental and physical health, and they need social interaction for behavioral stability.

Which podcasts are in your heavy rotation?

I listen to a wide variety on my travels throughout my territory, and some on my rotation include, The Huberman Lab, Revisionist History, Serial, and of course, Disease Du Jour (sponsored by Merck Animal Health).

10 PARTNERS IN PRACTICE | Spring 2023 Meet the Team
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