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A Quarterly Newsletter from Your Equine Health Care Provider | Spring 2014

Dental Exam, More Than Floating Teeth By: R. Brad Tanner, DVM

IN THIS ISSUE EQUINE HEALTH Dental Exam, More Than Floating Teeth Evaluating and Reducing the Incidence of Rhodococcus in Foals NEWS Rood & Riddle Announces New Geratric Horse Care Packages Kentucky Reining Cup Welcomes Rood &Riddle to Their Sponsor Family Rood & Riddle Partners With the USHJA. Rood & Riddle, Partners With the 2014 Alltech National Horse Show Client Education Seminar - A Great Success Rood & Riddle Conference Center in Full Swing Rood & Riddle in Saratoga Holds Inaugural Open House Around the Practice

So often as a horse owner we go through their annual health checklist without pause for what’s being done. Deworming, vaccinations, teeth floating all are important. Equally important is finding the value in what is being provided to your horses. Not all dewormers and vaccines are the same; recommendations can vary widely based on geography, age, sex, use, and travel plans of your horse. The same can be said of floating teeth. Why do we call and ask for the teeth to be floated? Is it because we are feeling resistance in the bit of a riding horse? Is it because we are seeing grain fall out of the mouth at feeding time? Maybe it is incorporated into our annual checklist and the responsible thing to do. Regardless the reason, it is important to have expectations of your dental care provider at the time of floating. As an owner, please keep in mind that your adult horse has between 36-44 teeth dependent on breed-type and sex. We can easily lift the lips and visualize the 12 incisors (Fig 1) and 4 canines (if present) with minimal effort but this accounts for only 1/3 of the teeth and none of these are responsible for the heavy mashing and grinding that must take place before the grass, hay, or grain is processed and swallowed.

Fig 1: Incisors, notife the stained tooth, the enamel is not present.

A full mouth speculum, bright focused light and sedation are all necessary to perform a thorough and complete oral/dental exam. With the aid of these three things your veterinarian can properly visualize not only the teeth but also, ALL of the structures of the mouth (Fig 2). Your veterinarian may additionally choose to use a dental mirror, periodontal probe and explorer just as your own dentist would use. By performing a proper oral/dental exam your veterinarian can identify tumors, cheek ulcers, loose teeth, retained caps (baby teeth), tooth decay (Fig 1), gum disease, packing of hay between teeth and much more. Early detection of abnormalities is key to reversal of many disease processes and crucial in assuring that your horse has a healthy mouth for many years to come.

Fig 2: Open wide, full mouth view.

For an idea of abnormalities that affect different aged horses please reference our client education articles, “Dental Concerns For The Geriatric Horse” or “Dental Concerns For the Young Horse”


“Rhodococcus equi is a freeliving soil bacteria with widespread distribution. Originally known as Corynebacterium equi, R. equi was first proposed as a cause of respiratory disease in foals in 1923.”

“Making control more difficult, healthy foals on farms with high levels of disease have been shown to exhale virulent R. equi suggesting that these foals may harbor the organism in the absence of clinical problems.“

Evaluating and Reducing the Incidence of Rhodococcus in Foals By: Peter Morresey, BVSc. MACVSc, Dipl. ACVIM, Dipl. ACT

Rhodococcus equi is a free-living soil bacteria with widespread distribution. Originally known as Corynebacterium equi, R. equi was first proposed as a cause of respiratory disease in foals in 1923. Although widespread in the environment, R. equi causes a high incidence of disease on some horse farms, is an occasional pathogen on others, and is unrecognized on most. This variation in disease is the result of several factors. These include temperature, soil conditions, and most critically the presence of high dust levels. Management of mares and foals with respect to handling and other stressors also affects how readily the disease spreads. Finally, variations in both the virulence of the particular R. equi strain and the development of protective immunity in the individual foal determines susceptibility to clinical disease . Of importance, airborne R. equi has been shown to be associated with increased respiratory disease in foals. Airborne R. equi levels are increased during warmer, drier and windier weather, but also in stables and paddocks where mares and foals spend the majority of their time. A number of management factors have been found to be associated with infection. These include a large farm size, high numbers of mares and foals, transient horses housed on the farm, and high stocking densities. The factor allowing disease to be caused by R. equi infection is a plasmid (small amount of genetic material) that virulent R. equi have which allows the organism to produce a protective surface protein – virulence associated protein A, abbreviated as vapA. Because of vapA the bacteria can survive inside the phagocytic cells which usually have the ability to kill invading organisms. Environmental R. equi do not contain this plasmid and cannot cause disease, rather they are rapidly cleared by the foal with no signs of infection noticed. Unfortunately, this plasmid can readily be transferred between disease causing and environmental R. equi and therefore formerly harmless bacteria gain the ability to produce disease. Pneumonia resulting from R. equi infection of foals and weanlings usually becomes apparent before four months of age. Chronic bronchopneumonia with abscessation and lymph node enlargement occurs, with initial clinical signs sometimes subtle as the foal has a great ability to compensate for respiratory disease during the early stages. As disease becomes more profound anorexia, lethargy, respiratory distress and high fever become apparent. In one necropsy study, half the affected foals had intestinal lesions (abscessation) although signs of intestinal disease were not present. In another retrospective study, one-third of affected foals displayed immune-mediated polysynovitis (swollen joints without infection), most often affecting the tibiotarsal and femorotibial joints. Septic arthritis or osteomyelitis may also occur. Ulcerative enterocolitis leading to diarrhea and inflammation of the eye (uveitis) is also reported. The particular susceptibility of the foal is not fully understood but can be explained in part by a combination of heavy respiratory challenge by inhalation coinciding with declining maternally derived immunity during a time when the foal’s immune system is not fully competent. Making control more difficult, healthy foals on farms with high levels of disease have been shown to exhale virulent R. equi suggesting that these foals may harbor the organism in the absence of clinical problems. This has a significant effect on transmission and persistence of disease on these farms.


Diagnosis is based on clinical signs (high fever, depression, increased respiratory rate and effort, mucopurulent nasal discharge, and signs of extrapulmonary disease), bacterial culture and PCR of a tracheal aspirate where available, and blood work suggestive of an inflammatory process. Ultrasonography may detect pulmonary abscessation, and in some cases abdominal abscessation. The use of ultrasonography regularly during screening programs has been shown useful to allow early detection of pulmonary abscessation before the onset of disease. While this has undoubtedly reduced the number of deaths from pulmonary abscessation, it has also led to a great increase in the number of foals treated, with implications for the development of antimicrobial resistance. Treatment has centered on the use of a macrolide (usually azithromycin or clarithromycin) with most often the addition of rifampin. While very effective in most cases, resistance has begun to develop rapidly in situations where usage has been high. In these cases, alternative antimicrobials include trimethoprim-sulfa and doxycycline. The decision to withhold antimicrobial treatment of smaller abscesses and monitor over time to look for spontaneous clearance by the foal can be difficult but is necessary to preserve the treatments currently available. The prognosis for foals once recovered from R. equi pneumonia is good. Residual pulmonary damage is not present, and racing performance upon review is as good as the general horse population. Prevention comes down to the avoidance wherever possible of susceptible foals inhaling an aerosol with a high concentration of virulent R. equi. This will most likely reduce the occurrence of pneumonia. Minimizing dust in holding pens and transit areas, maintaining good pasture cover, and reducing time in stables are all associated with a decreased incidence of R. equi pneumonia.

“Minimizing dust in holding pens and transit areas, maintaining good pasture cover, and reducing time in stables are all associated with a decreased incidence of R. equi pneumonia.�

Early recognition of cases, followed by removal from the rest of the herd can be rationalized to reduce losses, decrease the potential for contagious spread and minimize buildup of virulent organism in the foals’ environment. It is therefore useful to attempt to limit the time foals congregate in crowded areas and decrease the size of groups enabling closer monitoring for the onset of disease. Separate management of high risk groups such as foals less than 2 months of age allows prevention and control strategies to be focused.

Rood & Riddle Announces New Geriatric Horse Care Packages Like people, horses are living longer. Advances in management, nutrition, veterinary medicine, hoof care and deworming programs have had a great influence on the health and life span of horses. Rood & Riddle Equine Hospital is excited to announce a new service, comprehensive care packages for your geriatric horse. Rood & Riddle Equine Hospital, with its team of specialists, has developed a wellness program for the geriatric horse. Three different levels of exams and procedures are offered to help meet the special needs of the older horse. The most basic tests can be performed on the farm, however, the more advanced packages are performed at the hospital where each horse rotates through each specialty area designed to identify and treat the individual problem with the geriatric horse. Please contact Whitney Mathes at (859)233-0371 with any questions that you may have about this service. www.roodandriddle.com


“In addition to financial support, Rood & Riddle will supply the Kentucky Reining Cup with on-site veterinary, farrier and ambulance services as well as onsite pharmacy delivery – all invaluable assets to an event of this caliber.”

Kentucky Reining Cup Welcomes Rood & Riddle to Sponsorship Family February 11, 2014, Lexington, Kentucky – The Kentucky Reining Cup is very proud to announce the addition of Rood & Riddle Equine Hospital and Veterinary Pharmacy as a corporate sponsor of the 2014 event. In addition to financial support, Rood & Riddle will supply the Kentucky Reining Cup with on-site veterinary, farrier and ambulance services as well as on-site pharmacy delivery – all invaluable assets to an event of this caliber. Held concurrently with the Rolex Kentucky Three-Day Event at the Kentucky Horse Park, the Kentucky Reining Cup is the most high-profile FEI Reining event in North America. The event offers a three-star FEI Concours de Reining International (CRI3*), the Kentucky Reining Cup Team Challenge, the World Championship Freestyle Reining and the Adequan/USEF National Open Reining Championship & Official Selection Trial for the US Reining Team at the FEI World Equestrian Games (WEG). The United States has won the team gold medal at every WEG since the inclusion of the sport of Reining in the FEI family in 2000 and they return to the international stage with their sights set on defending that title. As a result, the Reining industry, and indeed the entire equestrian community turns its eyes to the Kentucky Reining Cup to watch the US team take shape. The producers of the Kentucky Reining Cup are relieved to have the horses of such an elite level under the careful watch of the veterinarians and podiatrists of Rood & Riddle.

“The two entities partnered in 2013 as the USHJA named Rood & Riddle as the Official Equine Hospital and Veterinary Pharmacy.”

Rood & Riddle Partners With the USHJA to be the Official Equine Hospital and Veterinary Pharmacy USHJA is pleased to announce that Rood & Riddle will remain as the Official Equine Hospital and Veterinary Pharmacy of the USHJA. The two entities partnered in 2013 as the USHJA named Rood & Riddle as the Official Equine Hospital and Veterinary Pharmacy. The fit was natural; Rood & Riddle has been a longtime proponent of the USHJA and the sport horse industry. They have provided sponsorship to several programs including the International Hunter Derby Championship, the Rood & Riddle Thoroughbred Sport Horse Awards, which provide recognition for Thoroughbreds pursuing second careers, and the Alltech National Horse Show.


Rood & Riddle Continues Their Partnership With the Alltech National Horse Show The Alltech National Horse Show, announced that Rood & Riddle Equine Hospital has, once again, been named the Official Veterinarians, Farriers and the Official Veterinary Pharmacy for this year’s event, scheduled for the Alltech Arena at the Kentucky Horse Park in Lexington, Kentucky on October 28 – November 2, 2014. “Rood & Riddle is extremely pleased to once again serve as the Official Veterinarian, Veterinary Pharmacy, and Farrier for the upcoming Alltech National Horse Show,” Dr. Riddle said. “Rood & Riddle’s support of the National Horse Show underscores our practice’s commitment to the sport horse and our community.” In addition to services provided in Kentucky, the Rood & Riddle sport horse veterinarians and podiatrists provide services in Wellington each winter and travel regularly to competitions throughout the eastern United States. Founded in 1883 at the original Madison Square Garden, the National Horse Show is America’s oldest indoor horse show, firmly established as a major fixture on the national and international sports and social event calendars. The National Horse Show Association’s primary activity is the annual production of the National Horse Show and all ancillary events. Over the years, the National Horse Show has provided financial aid to many worthwhile charities. Rood & Riddle partnered with the Alltech National Horse show in 2011 and the two organizations have worked together on several initiatives to, not only increase the exposure of the Alltech National Horse Show across the nation, but also to open the gates of area horse farms to attendees via the “Kentucky Experience”. The inaugural Kentucky Experience took place during the 2013 Alltech National Horse Show and took nearly 400 attendees on a dream vacation including personal tours of local horse farms, Rood & Riddle Equine Hospital, and free admission to the Alltech National Horse Show. For one lucky attendee, Rood & Riddle Veterinary Pharmacy provided, airfare and lodging in conjunction with the Kentucky Experience!

Client Education Seminar A Great Success The 29th Rood & Riddle Client Education Seminar was a huge success. With over 280 attendees, the 2014 event was our best attended spring seminar yet. The WRNR Newsroom format was maintained this year and allowed for informative and entertaining presentations from our four hosts: Drs. Steve Reed, Raul Bras, Larry Bramlage and Maria Schnobrich. This year was the first year of WRNR to feature special guest presentations as Drs Bonnie Barr, Brad Tanner and Katie Garrett educated the crowd on exciting new developments in their fields of expertise. Thank you to all of you who attended and made this event so special.

“Rood & Riddle Equine Hospital has, once again, been named the Official Veterinarians, Farriers and the Official Veterinary Pharmacy for this year’s event, scheduled for the Alltech Arena at the Kentucky Horse Park in Lexington, Kentucky on October 28 – November 2, 2014.“

“With over 280 attendees, the 2014 event was our best attended spring seminar yet.”

www.roodandriddle.com


Dr. Larry Bramlage Inducted into American Farriers International Hall of Fame. In January, Dr. Larry Bramlage was inducted into the American Farriers International Equine Veterinarian Hall of Fame. Dr. Bramlage joined the Rood & Riddle team of surgeons in 1989 and is an internationally acclaimed orthopedic surgeon. He is also very active in the American Association of Equine Practitioners, participating in their “On Call” program which provides veterinary expertise for media coverage during major horse racing events. He joins Dr. Scott Morrison (2007 Hall of Fame Inductee) as the Rood & Riddle Equine Hospital Veterinarians represented in the Hall of Fame! Congratulations to both of our International Equine Veterinarian Hall of Fame inductees!

Rood & Riddle Conference Center in Full Swing The Rood & Riddle Conference Center officially opened in December of 2013 and features 3 different meeting rooms with full audio/visual capabilities. The Conference Center was a part of the most recent construction project at Rood & Riddle which brought Rood & Riddle Veterinary Pharmacy onto the Rood & Riddle campus. Many organizations have booked the Conference Center for events ranging in size from 8 people to 120 people. The Rood & Riddle Conference Center is available for rent to organizations that are affiliated with the equine, companion animal or veterinary industries. The Conference Center may be booked by calling LaTonna Wilson at Rood & Riddle’s main line (859)233-0371

Over 100 People Attend Rood & Riddle in Saratoga’s Inaugural Open House Rood & Riddle in Saratoga played host to over 100 horsemen from across the northeast this February at the Taste of Kentucky Open House. The inaugural event featured tastes from the Bluegrass State and welcomed area horsemen and women to see the plans for our facility and meet the new veterinarians at Rood & Riddle in Saratoga. All of the Rood & Riddle in Saratoga veterinarians were present as well as the managing partner of the practice, Dr. Brett Woodie who is based out of Lexington. The open house format was planned around the Stallion Shows at local stud farms and served to get interested attendees familiar with our staff as well as the passion that we have for outstanding equine healthcare.


Around the Practice...

Rood & Riddle’s Internal Veterinary Seminar was held in December 2013. This seminar is a chance for our 53 veterinarians to come together and hear presentations by their colleagues. Several of our veterinarians were asked to speak on exciting new topics in their field of practice. The format took advantage of the new Rood & Riddle Conference Center and was very intimate, allowing with our specialists sharing knowledge across the different fields of medicine. This annual seminar is viewed as very important to the continuing education of our veterinarians as they are able to take ideas from one area of practice and apply them to their own. Some of the topics presented were: Biosecurity Protocols for 2013, Community Outreach through Veterinary Medicine, New Research in Equine Dentistry and Trusting Your Compounding Pharmacy. In our effort to continue educating veterinarians around the state and beyond, our annual Reproduction Medicine seminar was held in February of 2014. Our largest attendance ever boasted 67 veterinarians practicing in 4 different states as well as 7 visiting veterinary students from around the country. The meeting was timely for the breeding season, with specialists from our LeBlanc Reproduction Center and our medicine department speaking on issues affecting foal health and the broodmare. Included in these presentations was a new diagnostic test now available to detect inflammation. Rood & Riddle Veterinarians partnered with StableLab Inc. to help develop the Serum Amyloid A test which is a sensitive indicator of inflammation. In 2014 Rood & Riddle welcomes 2 new shareholders to our partnership. Drs Bonnie Barr and Laurie Metcalfe were both named shareholders at the annual Shareholders’ retreat held in January. Bonnie Barr VMD, DACVIM has been a member of our medicine department and specializes in neonatal care and infectious disease while being the Director of Biosecurity for Rood & Riddle. Dr. Laurie Metcalfe is a general ambulatory practitioner who also has a special interest in neonatal care on the farm. We are excited to have these two outstanding veterinarians as shareholders in Rood & Riddle Congratulations to our surgery resident Dr. Taralyn McCarrel on passing the board examinations to become a Diplomate of the American College of Veterinary Surgeons. Dr. McCarrel graduated from Ontario Veterinary College with her Doctorate of Veterinary Medicine in 2006 and moved immediately into an internship with OVC. She was a member of a post-doctorate research team in Equine Orthopedics at Cornell University from 2007-2007. Dr. McCarrel then joined our team at Rood & Riddle Equine Hospital in Lexington to complete a surgical residency.

www.roodandriddle.com


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News From Your Equine Health Provider-Spring 2014  

This edition of the Rood & Riddle Report features articles on equine dentistry, Rhodococcus Equi, exciting new partnerships for Rood & Riddl...