Equinevet july2014

The Modern

Equine Vet www.modernequinevet.com

Vol 4 Issue 7 2014

How to manage

Axillary wounds

Equine nasal strip reduces lung damage, may improve performance Technician Update: C. myositis West Nile virus New tissue patch for surgical procedures

Table of Contents

Cover story:

4 How to manage axillary wounds

Cover photo by Shutterstock/Anelina

Infections

WNV: Vaccination and mosquito prevention needed................................................. 8 Respiratory

Equine nasal strip reduces lung damage; may improve performance..............11 Technician Update

Case Study: Clostridial myositis.........................................................................................15 News

Horsing around reduces stress hormones..............................12 CSU appoints first female dean of vet school........................12 New veterinary tissue surgical patch available....................13

advertisers Kensio Equine Tape............................................... 3 Merck Animal Health............................................ 6 Avalon Medical................................................... 10

Horseside Vet Guide............................................ 13 AAEVT.................................................................. 14

The Modern

Equine Vet Sales: Robin Geller • newbucks99@yahoo.com Editor: Marie Rosenthal • mrosenthal@percybo.com Art Director: Jennifer Barlow • jbarlow@percybo.com Published by PO Box 935 • Morrisville, PA 19067 Marie Rosenthal and Jennifer Barlow, Publishers percybo media  publishing

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Issue 7/2014 | ModernEquineVet.com

LEGAL DISCLAIMER: The content in this digital issue is for general informational purposes only. PercyBo Publishing Media LLC makes no representations or warranties of any kind about the completeness, accuracy, timeliness, reliability or suitability of any of the information, including content or advertisements, contained in any of its digital content and expressly disclaims liability of any errors or omissions that may be presented within its content. PercyBo Publishing Media LLC reserves the right to alter or correct any content without any obligations. Furthermore, PercyBo disclaims any and all liability for any direct, indirect, or other damages arising from the use or misuse of the information presented in its digital content. The views expressed in its digital content are those of sources and authors and do not necessarily reflect the opinion or policy of PercyBo. The content is for veterinary professionals. ALL RIGHTS RESERVED. Reproduction in whole or in part without permission is prohibited.

cover story

How to manage

axillary wounds

By Marie Rosenthal, MS

Although somtimes they

might seem minor, axillary wounds can develop severe complications, so these common wounds should be treated and monitored for these complications, according to Amanda-Jo Joswig, DVM, MPH, an associate veterinarian at Thomasville Animal Hospital.

“Axillary wounds are relatively common in horses, and their initial management will significantly affect secondary complications,” Joswig said during a presentation at the 59th Annual Convention of the American Association of Equine Practitioners (AAEP) in Nashville.

Often axillary wounds result after a trauma, such as being kicked by another horse or running into a fence post. They frequently appear to be minor injuries but can develop into more serious issues. One of the most frequent complications is subcutaneous emphysema that may lead to pneumomediastinum if air migrates from the wound and accumulates in the mediastinum.

Pneumothorax, which can be life threatening, can develop when mediastinal air ruptures through the mediastinal tissues.

Assessment

The clinical assessment of the axillary trauma should begin with a general physical examination that includes the horse’s general condition, temperature, heart rate and respiratory rate. Then, the patient should be sedated to enable

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Issue 7/2014 | ModernEquineVet.com

a full evaluation of the wound, according to Joswig.

“When you first evaluate the horse with an axillary wound, you want to consider the general condition of the horse and make sure it is hemodynamically stable. Look for other wounds, and then you can sedate the horse to begin to evaluate the wound,” she said.

She recommended a superficial cleaning with warm water and dilute povidone iodine solution, and then palpating the wound. Note the depth and direction of the wound and any potential involvement of neighboring structures: elbow joint, cranial mediastinum and cranial thorax.

Then, clean, débride and lavage the wound, which should be done with diluted povidone iodine solution. To prevent disseminating contaminants into deep fascial planes, use low-pressure lavage with a catheter-tipped syringe or a 35-mL syringe with an 18-gauge needle, she suggested.

Once the wound is cleaned and prepared, pack it with sterile gauze or laparotomy sponges to help prevent air from migrating into the subcutaneous fascial planes. If possible, partially close the wound using two layers: 1. Muscle and fascia 2. Skin.

Leave an opening to change the packing every 24 to 48 hours until healing by secondary intention occurs. Apply stay sutures and use a

figure-eight bandage around the thorax and axillary region to hold the stent in place.

Auxiliary therapy should include nonsteroidal anti-inflammatory medication (NSAID), broadspectrum antibiotics and a tetanus shot. Put the horse on strict stall rest to eliminate movement to decrease air migrating through the subcutaneous tissues.

You want to promote drainage and healing.

Depending on wound seepage, change the bandage every 24 to 48 hours, lavaging and repacking the wound, she recommended. Topical medications that promote the development of granulated tissue could be applied before repacking the wound. Granulation is the first step in the development of a scaffolding matrix for which new skin tissue cells can adhere.

“Bandage changes should be done every 24 to 48 hours as needed,” Joswig said. “During these bandage changes, you want to lavage the wound and apply topical agents to promote granulation. You should expect dehiscence.”

Complications

Axillary wounds can act as a one-way valve pulling air under the skin causing subcutaneous emphysema. Most is self-limiting and does not require treatment.

However, it should be monitored to make sure it to does not lead to pneumomediastinum.

Since it is frequently asymptomatic, pneumomediastinum is diagnosed based on radiographic evidence. If pneumomediastinum is present, the air within the mediastinal space causes less visible structures to be clearly visible on radiographs. Therefore, one will see more prominent aorta, trachea and esophagus.

There is no specific treatment for pneumomediastinum, but monitoring should continue for pneumothorax.

Pneumothorax is frequently diagnosed based on clinical signs of respiratory distress, tachycardia and absent lung sounds, as well as radiography. Radiographic signs of pneumothorax show collapsed

lung, overexpanded rib cage and a mediastinal shift.

Treat pneumothorax that is causing respiratory distress or is severe on radiographs. Air can be aspirated from a dorsally located chest trocar in the 12th to 15th intercostals space, according to Joswig.

“If you think the pneumothorax will resolve within one aspiration than IV catheters are sufficient. However, if you think you will need more than one aspiration procedure, then trocars are preferred,” she said.

Joswig did a small retrospective case series of seven horses that presented at TAMU with axillary wounds and subcutaneous

Photos courtesy of Dr. Amanda-Jo Joswig

An axillary wound after it has been packed. Be sure to change the packing every 24 to 48 hours.

emphysema. She found a repeatable and predictable association between equine axillary wounds and the development of secondary complications.

These progressions tended to be delayed with subcutaneous emphysema developing about three days post injury.

“Because delays are common, serial evaluations and treatment of the primary cause are necessary, as is restricting movement. However, not all axillary wounds develop secondary complications,” she said.

MeV

Holding a stent in place.

ModernEquineVet.com | Issue 7/2014

5

Easy does it.

Equine Protozoal Myeloencephalitis (EPM) can strike anytime, anywhere. Be prepared with Protazil®.

Only FDA-approved pelleted top dress for the treatment of EPM Safe and accurate dosing with calibrated scoop Easier to use than paste, less stress for you and the horse Effective, less expensive alternative to Marquis™ Contact your Merck Animal Health representative to find out more.

Visit protazil.com We’re for the Horse™

Protazil is contraindicated in horses with known hypersensitivity to diclazuril. Safe use in horses used for breeding purposes, during pregnancy or in lactating mares has not been evaluated. The safety of Protazil with concomitant therapies in horses has not been evaluated. See related page in this issue for details. For use in horses only. Do not use in horses intended for human consumption. Not for human use. Keep out of reach of children.

556 Morris Avenue • Summit, NJ 07901 • merck-animal-health-usa.com • 800-521-5767 Copyright © 2013 Intervet Inc., d/b/a Merck Animal Health, a subsidiary of Merck & Co., Inc. All rights reserved. Photography: Vince Cook. 50035 4/13 EQ-PHARM-VET-1219-AD

ANTIPROTOZOAL PELLETS

Infectious disease

(1.56% diclazuril)

FOR ORAL USE IN HORSES ONLY For the treatment of equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona in horses.

CAUTION Federal (U.S.A.) law restricts this drug to use by or on the order of a licensed veterinarian.

NADA #141-268 Approved by FDA DESCRIPTION Diclazuril, (±)-2,6-dichloro-α-(4-chlorophenyl)-4-(4,5 dihydro-3,5-dioxo-1,2,4-triazin-2(3H)-yl) benzeneacetonitrile, has a molecular formula of C17 H 9 CI 3 N4O2, a molecular weight of 407.64, and a molecular structure as follows:

Diclazuril is an anticoccidial (antiprotozoal) compound with activity against several genera of the phylum Apicomplexa. PROTAZIL® (diclazuril) is supplied as oral pellets containing 1.56% diclazuril to be mixed as a top-dress in feed. Inert ingredients include dehydrated alfalfa meal, wheat middlings, cane molasses and propionic acid (preservative).

INDICATIONS PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets are indicated for the treatment of equine protozoal myeloencephalitis (EPM) caused by Sarcocystis neurona in horses.

DOSAGE AND ADMINISTRATION Dosage: PROTAZIL® (1.56% diclazuril) is administered as a top dress in the horse’s daily grain ration at a rate of 1 mg diclazuril per kg (0.45 mg diclazuril/lb) of body weight for 28 days. The quantity of PROTAZIL® necessary to deliver this dose is 64 mg pellets per kg (29 mg pellets/ lb) of body weight.

Administration: To achieve this dose, weigh the horse (or use a weigh tape)). Scoop up PROTAZIL® to the level (cup mark) corresponding to the dose for the horse’s body weight using the following chart: Weight Range of Horse (lb) 275 - 524 525 - 774 775 - 1024 1025 - 1274

mLs of Pellets 20 30 40 50

Weight Range of Horse (lb) 1275 - 1524 1525 - 1774 1775 - 2074 -

mLs of Pellets 60 70 80 -

One 2-lb bucket of PROTAZIL will treat one 1100-lb horse for 28 days. One 10-lb bucket of PROTAZIL® will treat five 1100-lb horses for 28 days.

CONTRAINDICATIONS Use of PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets is contraindicated in horses with known hypersensitivity to diclazuril.

WARNINGS For use in horses only. Do not use in horses intended for human consumption. Not for human use.

Keep out of reach of children.

PRECAUTIONS The safe use of PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets in horses used for breeding purposes, during pregnancy, or in lactating mares has not been evaluated. The safety of PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets with concomitant therapies in horses has not been evaluated.

ADVERSE REACTIONS There were no adverse effects noted in the field study which could be ascribed to diclazuril.

To report suspected adverse reactions, to obtain a MSDS, or for technical assistance call 1-800-224-5318.

CLINICAL PHARMACOLOGY The effectiveness of diclazuril in inhibiting merozoite production of Sarcocystis neurona and S. 1 falcatula in bovine turbinate cell cultures was studied by Lindsay and Dubey (2000). Diclazuril inhibited merozoite production by more than 80% in cultures of S. neurona or S. falcatula treated with 0.1 ng/mL diclazuril and greater than 95% inhibition of merozoite production (IC 95 ) was observed when infected cultures were treated with 1.0 ng/mL diclazuril. The clinical relevance of the in vitro cell culture data has not been determined.

PHARMACOKINETICS IN THE HORSE The oral bioavailability of diclazuril from the PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets at a 5 mg/kg dose rate is approximately 5%. Related diclazuril concentrations in the cerebrospinal fluid (CSF) range between 1% and 5% of the concentrations observed in the plasma. Nevertheless, based upon equine pilot study data, CSF concentrations are expected to 2 substantially exceed the in vitro IC 95 estimates for merozoite production (Dirikolu et al., 1999) .

Due to its long terminal elimination half-life in horses (approximately 43-65 hours), diclazuril accumulation occurs with once-daily dosing. Corresponding steady state blood levels are achieved by approximately Day 10 of administration.

EFFECTIVENESS Two hundred and fourteen mares, stallions, and geldings of various breeds, ranging in age from 9.6 months to 30 years, were enrolled in a multi-center field study. All horses were confirmed EPM-positive based on the results of clinical examinations and laboratory testing, including CSF Western Blot analyses. Horses were administered PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets at doses of 1, 5, or 10 mg diclazuril/kg body weight as a top-dress on their daily grain ration for 28 days. The horses were then evaluated for clinical changes via a modified Mayhew neurological scale on Day 48 as follows: 0. Normal, neurological deficits not detected.

1. Neurological deficits may be detectable at normal gaits; signs exacerbated with manipulative procedures (e.g., backing, turning in tight circles, walking with head elevation, truncal swaying, etc.).

2. Neurological deficit obvious at normal gaits or posture; signs exacerbated with manipulative procedures.

3. Neurological deficit very prominent at normal gaits: horses give the impression they may fall (but do not) and buckle or fall with manipulative procedures.

4. Neurological deficit is profound at normal gait: horse frequently stumbles or trips and may fall at normal gaits or when manipulative procedures were utilized.

5. Horse is recumbent, unable to rise.

Each horse’s response to treatment was compared to its pre-treatment values. Successful response to treatment was defined as clinical improvement of at least one grade by Day 48 ± conversion of CSF to Western Blot-negative status for S. neurona or achievement of Western Blot-negative CSF status without improvement of 1 ataxia grade.

Forty-two horses were initially evaluated for effectiveness and 214 horses were evaluated for safety. Clinical condition was evaluated by the clinical investigator’s subjective scoring and then corroborated by evaluation of the neurological examination videotapes by a masked panel of three equine veterinarians. Although 42 horses were evaluated for clinical effectiveness, corroboration of clinical effectiveness via videotape evaluation was not possible for one horse due to missing neurologic examination videotapes. Therefore, this horse was not included in the success rate calculation.

Based on the numbers of horses that seroconverted to negative Western Blot status, and the numbers of horses classified as successes by the clinical investigators, 28 of 42 horses (67%) at 1 mg/kg were considered successes. With regard to independent expert masked videotape assessments, 10 of 24 horses (42%) at 1 mg/kg were considered successes. There was no clinical difference in effectiveness among the 1, 5, and 10 mg/kg treatment group results.

Adverse events were reported for two of the 214 horses evaluated for safety. In the first case, a horse was enrolled showing severe neurologic signs. Within 24 hours of dosing, the horse was recumbent, biting, and exhibiting signs of dementia. The horse died, and no cause of death was determined. In the second case, the horse began walking stiffly approximately 13 days after the start of dosing. The referring veterinarian reported that the horse had been fed grass clippings and possibly had laminitis.

ANIMAL SAFETY PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets were administered to 30 horses (15 males and 15 females, ranging from 5 to 9 months of age) in a target animal safety study. Five groups of 6 horses each (3 males and 3 females) received 0, 5 (5X), 15 (15X), 25 (25X) or 50 (50X) mg diclazuril/kg (2.27mg/lb) body weight/day for 42 consecutive days as a top-dress on the grain ration of the horse. The variables measured during the study included: clinical and physical observations, body weights, food and water consumption, hematology, serum chemistry, urinalysis, fecal analysis, necropsy, organ weights, gross and histopathologic examinations. The safety of diclazuril top-dress administered to horses at 1 mg/kg once daily cannot be determined based solely on this study because of the lack of an adequate control group (control horses tested positive for the test drug in plasma and CSF). However, possible findings associated with the drug were limited to elevations in BUN, creatinine, and SDH and less than anticipated weight gain.

Definitive test article-related effects were decreased grain/top-dress consumption in horses in the 50 mg/kg group.

In a second target animal safety study, PROTAZIL® (1.56% diclazuril) Antiprotozoal Pellets were administered to 24 horses (12 males and 12 females, ranging from 2 to 8 years of age). Three groups of 4 horses/sex/group received 0, 1, or 5 mg diclazuril/kg body weight/day for 42 days as a top-dress on the grain ration of the horse. The variables measured during the study included physical examinations, body weights, food and water consumption, hematology, and serum chemistry. There were no test article-related findings seen during the study.

STORAGE INFORMATION Store between 15°C to 30°C (59°F to 86°F).

HOW SUPPLIED PROTAZIL® (1.56 % diclazuril) Antiprotozoal Pellets are supplied in 2-lb (0.9 kg) and 10-lb (4.5 kg) buckets.

REFERENCES 1. Lindsay, D. S., and Dubey, J. P. 2000. Determination of the activity of diclazuril against Sarcocystis neurona and Sarcocystis falcatula in cell cultures. J. Parasitology, 86(1):164–166.

2. Dirikolu, L., Lehner, F., Nattrass, C., Bentz, B. G., Woods, W. E., Carter, W. E., Karpiesiuk, W. G., Jacobs, J., Boyles, J., Harkins, J. D., Granstrom, D. E. and Tobin, T. 1999. Diclazuril in the horse: Its identification and detection and preliminary pharmacokinetics. J. Vet. Pharmacol.

Therap. 22:374–379.

May 2010 Intervet Inc. 56 Livingston Ave, Roseland, New Jersey 07068 © 2010 Intervet Inc. All rights reserved.

08-10 211.x.3.1.0 ®

WNV:

Vaccination and mosquito prevention

needed In many parts of the country, the sum-

mer is hot, wet and muggy, perfect weather for breeding mosquitoes and the transmission of diseases like West Nile virus (WNV), and as a result more than a dozen states have already reported WNV in sentinel animals like horses.

In 2013, 377 equine cases of WNV were reported from 42 states, which was fewer reported cases than in 2012 and considerably lower than the 2002 WNV outbreak when 15,257 equine cases were reported.

The USDA Animal and Plant Health Inspection Service (APHIS) Veterinary Services collaborate with the Centers for Disease Control and Prevention (CDC) and

More than 12 states already report WNV in sentinel animals like horses.

State veterinary and public health officials to facilitate communication about arbovirus disease cases in horses and confirm equine cases in each state. The CDC uses its ArboNET reporting system, an electronic surveillance and reporting system to track and report arboviral activity in humans and animals.

Warn owners that they must take steps to protect against arboviruses, not only for their horses, but also for themselves as human cases of WNV also occur.

“We look to species like horses to help give us some insight into how likely humans are to have problems with the virus, but it's important to recognize that these

West Nile Virus Activity by State in 2014 (as of July 15, 2014)

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Issue 7/2014 | ModernEquineVet.com

*WNV human disease + WNV veterinary disease cases or infections in mosquitoes, birds or sentinel animals like horses.

sort of weather patterns create a high risk for mosquitoes to transmit the disease not only to horses, but also to potentially make humans sick,” said Beth Davis, professor and head of the equine medicine and surgery section at the College of Veterinary Medicine’s Veterinary Health Center, There are two primary strategies for disease prevention: Vaccination and eliminating mosquito breeding grounds.

West Nile Virus, 2013 - States with Equine Cases Total cases - 377

WNV Symptoms • Lack of coordination and stumbling • Depression or apprehension • Weakness of the hind limbs • Falling down, inability to rise • Muscle twitching • Grinding teeth • Colicky appearance • Hypersensitivity • Excessive sweating • Disorientation • Convulsions • Paralysis West Nile virus is a core vaccine for horses, recommended by the American Association of Equine Practitioners. Four equine vaccines are available. Initial vaccination requires a series of two to three vaccines, depending on the age of the horse, and is then followed by annual boosters. Vaccine efficacy depends on horse owners working with their veterinarians to establish proper protocols, Davis said.

In addition, look around the barn and farm and eliminate all sources of standing water, which are breeding grounds for mosquitoes.

Distribution of reported equine WNV cases in 2012 (627 total cases).

U.S. distribution of 15,257 reported equine WNV cases in 2002.

ModernEquineVet.com | Issue 7/2014

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Infectious disease

Take steps to Protect Horses 1. REDUCE STANDING WATER. Mosquitoes require standing water to reproduce. By eliminating, reducing or treating standing water, you will help prevent the mosquito population from growing. Sources of standing water and ways to treat or eliminate them.

2. MANAGE TURN-OUT. Mosquitoes feed at dawn and dusk, so turn-out should be arranged to have horses inside at these times, if possible. This scheduling is especially critical from mid-August until the first killing frost (in 2001 this was late November), the period when horses are most likely to be infected.

3. MAINTAIN IMMUNE SYSTEM. Recommend good health maintenance to include vaccines, parasite control and nutrition to optimize immune function. A weakened immune system may leave the horse more susceptible to infection from WNV. Source: NJ Department of Agriculture

“Eliminate things like old tires, boats with tarps on them and rain gutters that may hold water,” Davis said. “Birdbaths are areas where there is going to be standing water, so clean them at least once a week. For other areas that you can't eliminate standing water, like water troughs for livestock, put mosquito-eating fish in the tanks. Minnows and goldfish will eat any of the eggs that have been laid by mosquitoes and will minimize the mosquito replication.”

Sudden signs

The onset of clinical signs for Equine West Nile virus is often sudden, with the progression occurring over the following two to four days.

Wound care, redefined.

• Rapid, scar-free healing • Angiogenic and osteogenic properties

• Anti-microbial • Easy application

RediHeal Wound Care products promote rapid, scarfree healing while providing continuous anti-microbial protection. Trauma injuries, lacerations, and abscesses are just a few of the applications where RediHeal has found success when other wound treatments have failed.

Don’t make treating your next wound harder than it has to be. Get all the exciting details at www.rediheal.com, or click on this ad for an amazing equine case study.

www.AvalonMed.com 888.289.1890

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Issue 7/2014 | ModernEquineVet.com

“Clinical signs of West Nile virus can vary quite a bit in horses,” Davis said. “Mild forms of it may be a fever or a change in attitude for a few days. Most commonly, we do see it progress to where the horse has neurological signs, which could be a quite dramatic change in temperament or behavior.

“They may have a period where they’re not eating properly or they seem like they’re not quite with it. Also, they may experience changes in the nerves and control function in their head, in things like eye movement and their ability to chew and swallow properly.

We may see dramatic changes in their gait, such as stumbling or being uncoordinated.” Davis explained.

MeV

respiratory

Equine nasal strip reduces lung damage, may improve performance heated debate about whether California Chrome could wear a nasal strip in the Belmont Stakes, Kansas State University College of Veterinary Medicine researchers who tested the product said the focus should have been on the nasal strip’s health benefits and not on possible performance enhancement.

Howard Erickson, DVM, PhD, professor emeritus of anatomy and physiology, and David Poole, PhD, DSc, professor of kinesiology and anatomy and physiology, researched the Flair nasal strip used by the thoroughbred racehorse and found it can help reduce lung damage in horses.

“I think the Flair nasal strip was beneficial for this horse, and the Flair nasal strip has been shown by our research to reduce exercise-induced pulmonary hemorrhage by approximately 50%. I think that is beneficial,” Erickson said.

Unlike people, horses only breathe through their nose. Poole said that equine breathing can generate a negative pressure in the lungs. High-intensity activities like races, combined with a narrow na-

sal passageway, put extra pressure on the horse and often result in pulmonary hemorrhage. The Flair nasal strip is designed to alleviate that pressure..

Poole was skeptical of the product when approached by the manufacturers. Poole and Erickson conducted a randomized, control study on seven geldings trained to run on a treadmill. The nasal strip is designed to tent the airway and hold it open. Results showed that the nasal strip did improve the airway, leading to reduced lung damage.

“The nasal strip reduces bleeding, reduces the secondary infections that can damage the lung af-

terward and also may help facilitate the horse to perform better,” Poole said.

The researchers said the nasal strip may improve performance because it reduces fatigue. They believe this is a more honest approach to racing enhancements and a better alternative than some drugs currently being used.

“Unfortunately, the horse racing industry is a mine of drugs,” Poole said. “You don't know under any given circumstances what a horse may or may not be on.”

The Flair nasal strips are being used worldwide at other horse events like barrel racing.

MeV

Photos courtesy of Dr. Erickson

Although there had been

The nasal strip could provide an alternative to drug therapy during exercise.

For more information: Erickson HH, Hildreth TS, Poole DC, Cox JH. Management of exercise-induced pulmonary hemorrhage in non-racing performance horses.

Comp Cont Ed for the Pract Vet. 2001;23:1090-1093.

McDonough P, Kindig CA, Hildreth TS. Effect of furosemide and the equine nasal strip on exercise-induced pulmonary haemorrhage and time-to-fatigue in maximally exercising horses. Equine and Comparative Exercise Physiology 2004;1(3):177-184.

Erickson HH, Poole DC. Exercise-induced pulmonary hemorrhage: Current Concepts. In: Lekeux P. (Ed), Equine Respiratory Diseases. Ithaca: International Veterinary Information Service (www.ivis.org), 2007; Document No. B0320.0102.

Erickson HH, Epp TS, Poole DC. A review of alternative therapies for EIPH. Proc Am Assoc Eq Pract 2007;53:68-71.

ModernEquineVet.com | Issue 7/2014

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news notes

New research from Washington State University reveals how youth who work with horses experience a substantial reduction in stress, and the evidence lies in the saliva of children.

While human-animal interaction programs with horses and other companion animals have been credited with improving social competence, self-esteem and behavior in children, there is little scientific evidence to support it. Patricia Pendry, PhD, a developmental psychologist at WSU, led a research project to engage students in grades 5-8 in a 12-week equine facilitated learning program in Pullman.

She approached the coordinator of the Palouse Area Therapeutic Horsemanship (PATH) at the WSU College of Veterinary Medicine, which offers a therapeutic riding program.

Stress hormone functioning is a result of how we perceive stress as well as how we cope with it. Stress is not just what you experience, she said, but it’s how you interpret the size of the stressor.

During the study, children were randomly assigned to participate in the program or be waitlisted. Based on natural horsemanship techniques, the program

Photo courtesy of Colorado State University

CSU appoints first woman to head veterinary training program

12

Melinda Frye, DVM, PhD, DACVIM, an associate professor in the department of Biomedical Sciences at the Colorado State University, will become associate dean of professional veterinary medicine in the CSU College of Veterinary Medicine and Biomedical Sciences.

She will replace Dr. Dean Hendrickson, who has served in the post for two years and is returning to full-time teaching and equine surgery.

Frye is the first woman to head the veterinary school, but she reflects her school because 80% of the 550 students are female.

Frye began her career as a registered nurse, a pursuit that brought her from Oregon to Fort Collins, where she worked at Poudre Valley Hospital in critical care, among other units. She considered medical school, but ultimately pursued veterinary medicine because of her love of animals. MeV Issue 7/2014 | ModernEquineVet.com

Photos courtesy of WSU

Horsing around reduces stress hormones in young people

provided 90 minutes weekly to learn about horse behavior, care, grooming, handling, riding and interaction. Participants provided six samples of saliva over a two-day period both before and after the 12-week program. Pendry compared the levels and patterns of stress hormone functioning by measuring cortisol.

The results were exciting, she said.

“We found that children who had participated in the 12-week program had significantly lower stress hormone levels throughout the day and in the afternoon, compared with children in the waitlisted group,” she said. “We get excited about that because we know that higher base levels of cortisol — particularly in the afternoon — are considered a potential risk factor for the development of psychopathology.”

Pendry said the experimental design underlying the study gives more scientific credit to the claims of therapeutic horsemanship professionals, parents and children who have reported a positive impact from these types of programs. In addition, she hopes the results will lead to the development of alternative afterschool programs.

While the research focused on prevention, Pendry said she believes it could provide a starting point to look at the impact on children of high levels of stress and physical or mental health issues.

Learn more at http://hd.wsu.edu .

MeV

New veterinary tissue patch product available

Photos courtesy of Avalon Medical

Avalon Medical announces the launch of its unique, new SISplus Tissue Patching material.

SISplus is a sterile, porcine-derived small intestine submucosa product, which can be used as a surgical patch for many types of surgical repair and reinforcement.

It supports and promotes wound healing by providing a biocompatible, resorbable tissue repair scaf-

fold that mimics the surrounding native tissue. In addition, the exclusive ion therapy treatment acts synergistically with the preexisting mitogenic factors inherent to the tissue, allowing for faster, more scarfree healing.

Several other biomaterials have been phased out of the veterinary marketplace. The SISplus patch includes some of the most cutting-edge technology in healing: a tissue patch pre-treated with an ion therapy that promotes healing in even the most challenging wounds.

The patch comes in a variety of configurations including single and multi-laminate products. For more information, go to www.avalonmed.com. MeV

Got News?

Do you have a new product release, company announcement or veterinarian or technician appointment? Let us know.

The new SISplus Tissue Patch (above) is a sterile, porcine-derived small intestine submucosa product, which can be used as a surgical patch for wound repair.

Send it to Marie Rosenthal.

ModernEquineVet.com | Issue 7/2014

13

AAEVT Membership

AAEVT* membership is open to US and international equine veterinary technicians, assistants, practice managers, and support staff employed in the veterinary industry. It is also open to students of AVMA/CVMA accredited programs

AAEVT Membership • • • • • • • •

Bi-Annual Newsletter Weekly “HoofBeats” email NEwsblast Full access to www.aaevt.org, including the Career Center and the Library Up-to-date information on the AAEVT Discounted registration for AAEVT Regional Meetings and the annual AAEP/AAEVT Convention NTRA, Working Advantage and Platinum Performance Benefits The opportunity to participate in the AAEVT Online Certification Program or to become a member of the AEVNT Academy-Specialty in Equine Veterinary Nursing • Scholarship opportunities.

• AAEVT’s Equine Manual for Veterinary Technicians (Blackwell Publishing 20% discount on purchase price) • Subscription to THE HORSE Magazine, compliments of Intervet Schering/Plough Opportunity to attend Purina’s Annual Equine Veterinary Technician Conference All Expenses paid!

AAEVT Objectives • • • •

Provide opportunities for CE, training, communication, and networking Educate the equine veterinary community and the public about our profession Inform Members of issues affecting our profession Assist in providing the best medical care to improve the health and welfare of the horse

AAEVT Online Equine Certification Program

• A three course, 10 module, equine-only online program offered through ACT • Geared toward Credentialed Veterinary Technicians, Assistants, Support staff, & Students • Areas of study include: equine medical terminology, anatomy and physiology, parasitology, laboratory, diagnostics, equine basics (breeds, wellness, husbandry,) diagnostic procedures, emergency medicine, restraint, pharmacology, surgical assistance and anesthesia, equine office procedures • A certificate of completion is awarded to those who: Successfully complete required courses Complete the list of required skills (per a supervising DVM who is an AAEP member) Attend an AAEVT regional CE symposium and participate in the we labs • Those individuals who successfully complete the programs will be recognized as AAEVT Certified Equine Veterinary Technicians / AAEVT Certified Equine Veterinary Assistants depending on their current designation. The certificate is recognized by the AAEVT and the AAEP but does not grant the credentialed status by the AVMA • For more information go to www.aaevt.4act.com or call 800-357-3182

AAEVT Mission Statement: To promote the health and welfare of the horse through the education and professional enrichment of the equine veterinary technician and assistant.

For more information visit www.aaevt.org

*American Association of Equine Veterinary Technicians and Assistants

technician update

Case Study: C. myositis admitted, her temperature had risen to 103.5° F. As soon as Goldie was admitted to the clinic, blood was drawn to run a complete blood count (CBC), chemistry profile and electrolytes. She also had a diagnostic ultrasound performed on her left rear leg to determine the cause of her symptoms.

The results were unbelievable; Goldie had formed numerous pockets of gas that were slowly increasing in size.

After the pockets were opened with vertical incisions (which released a foul smelling gas), daily ultrasonography was performed to locate any newly formed gas pockets.

Diagnosis

A swab was taken in one of Goldie’s gas pockets and it was sent to an outside lab for culture. The results came back as Clostridial myositis. Due to the financial cost, the specific species of the bacteria was not identified; however, the results of such a test would not have changed the course of treatment.

C. myositis causes a gangrene-like condition. The

Photos courtesy of Brittany Aunerud

By Brittany Aanerud, CVT Goldie was referred to the clinic late on the night of May 25th, 2011 by a referring veterinarian from southern Minnesota who immediately realized Goldie’s serious situation.

Goldie had been given a multivalent vaccine in the left superficial gluteal muscle on the evening of May 26th. The following morning, her owner became concerned because Goldie was not acting normally. On exam, Goldie was reluctant to lift her left rear leg during the forward phase of a stride but she was bearing full weight on it. She was swollen from the site of injection down to the hock, and the gluteal muscles were hard on palpation. Her initial heart rate was 60 bpm, respiration was 24 rpm, and temperature was 100.9° F. Goldie’s mucous membranes were bright pink with a capillary refill time of 3-4 seconds. Approximately 12 hours after being

Day 2, May 26: Fresh incisions with Penrose drains inserted and little drainage.

Day 7, May 31:-Incisions are very sore and there is a lot of drainage

Day 10, June 3rd: Smaller incisions are healing slightly; skin is about to slough ModernEquineVet.com | Issue 7/2014

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Photos courtesy of Brittany Aunerud

technician update

Day 2, May 26: Fresh incisions with Penrose drains inserted and little drainage.

Day 7, May 31: Incisions are very sore and there is a lot of drainage

Day 13, June 6: Wounds are being kept open for draining & skin has sloughed

The initial treatment plan was to provide IV fluids and antibiotics, probiotics, topical DMSO and use ultrasonography for regular monitoring.

bacteria thrive in anaerobic environments; they eat away at tissue and produce gas, which accumulates and forms pockets that get larger and larger. If this condition is not caught right away, the bacteria move throughout the body causing large areas of necrotic tissue and gas pockets from head to toe. Horses generally have approximately a 24% chance of surviving such a bacterial attack.

Clostridium only needed a small lesion, but once it penetrated the horse's skin, the anaerobic tissue of large muscle masses became a perfect environment for spores to multiply and become active.

Therefore, it is important to give horses their vaccines/injections in the correct areas and to make sure sterile techniques are used. Clostridium can be in the environment and on the skin of healthy animals.. With Goldie’s injection being in the superficial gluteal muscle where there is a large amount of 16

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tissue, the bacteria thrived and there was nowhere for us to drain her wounds easily, which caused serious tissue irritation.

Treatment Regime

The initial treatment plan was to supply IV fluids and antibiotics, probiotics, topical DMSO, and to use ultrasonography for regular monitoring. Goldie was started on a long list of medications for all of her physical issues. Here is a slightly more detailed list of what treatment was used: • Antibiotics targeted at both anaerobic (organisms that do not require oxygen) and aerobic (require oxygen) bacterial infection.

• Anti-inflammatories • Pain relievers, such as Lidocaine • Feet were iced to help with her fever and she was checked by the ultrasound several times to catch any new pockets forming.

• Vitamin E given as an antioxidant • Walked and lounged, keeping her muscles moving to promote healing and push the pus up out of her wounds.

Goldie was slowly weaned off her medications as healing occurred. Her last ultrasound was on May

Photos courtesy of Brittany Aunerud

Day 15, June 8th: Drainage is starting to diminish and wounds are closing up

31 and showed no new pockets.

She was able to go home 17 days after being admitted, with basic exercise and cleaning instructions.

Prognosis and Outcome

Day 17, June 10th:-Large wound is draining; healing is happening inside to out

3 years later: June 24th, 2014: Goldie is back to her normal routine and competing career.

Goldie's prognosis was initially guarded due to the fact that the extent of the gas pockets was unknown. However, her prognosis improved when pockets were only found in the left rear area.

Goldie’s prognosis was initially guarded due to the fact that it was unknown the extent of the gas pockets. However, her prognosis quickly improved to good as the pockets were only found in the left rear area. In most cases, the gas pockets formed by this type of anaerobic bacteria are not caught soon enough and the pockets are found throughout the body resulting in a terrible death.

However, in her case, they were found very early and were managed quickly.

Although Goldie left before she was completely healed, her owner sent numerous pictures to the treating veterinarian to show the progress of Gold-

ie’s healing. To this day she is still doing well and is back to being ridden regularly. She was a lucky, special case, and it was amazing to see such a great outcome.

MeV

About the Author

Brittany Aanerud, CVT, is a technician at Anoka Equine Veterinary Services

For more information: Binns S, Davis J. "Musculoskeletal: Clostridial myositis." vetstream: definitive veterinary intelligence. Vetstream, Ltd, 2010. Web. 30 June 2011. http://www.vetstream.com/equis/Content/Disease/dis01419 Borkoski, Ingrid. Personal Interview by Brittany Aanerud. 22 June 2011.

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