February 1, 2013

It seems like just a few short months ago that I was writing an introduction to our annual newsletter reflecting on the past and expressing how grateful I was to have such a gifted staff and for all of you who make Bend Equine Medical Center possible. The content of last year’s newsletter has never been more heartfelt and true. As we move into 2013, the doctors and staff at BEMC are looking forward to an exciting future. The future is where I would like to

take you today.

In September 2012, BEMC launched the Small Animal Division with the completion of the 1,500 sq. foot small animal wing. Over 3 years of discussions, planning, and prognosticating preceded the project launch. Why did we do it? There are several good reasons. First, we have exceptional high tech equipment available and a motivated and talented staff who love small animals. Second, the demanding lifestyles of our equine clients today are moving all of us to-ward more efficient day-to-day living patterns. Convenience helps all of us...why not provide a way for Fido or Hair Ball to have their health care work performed when Ranger is getting his teeth floated or Ginger is being bred? Third, every winter since BEMC was opened, we have been burdened with a winter caseload insufficient to cover the cost of hospital opera-tions. And fourth, the recent recession has significantly reduced the inventory of horses across the U.S., including Central Oregon. To all of our equine clients, I want to assure you that our small animal division will not interfere with our general practice, specialty or emergency equine

services. In fact, I expect that we will become a stronger equine hospital as a result.

The future is shaped by its people. Dr. Evans completed Acupuncture Certification Training at Colorado State University. Jessie is now certified in both small animal and equine acupunc-ture. Dr. Findley has just returned from California after attending the West Coast Equine Reproduction Symposium. Drs. Daws, Krebs, Schmotzer, Technician Ashley Clark, and Hospi-tal Manager Sarah Cook have all just returned from Anaheim after attending the Annual Sym-posium of the American Association of Equine Practioners. Dr. Evans and technician Jessica Arnold recently attended an advanced small animal dentistry training in Portland. Dr. Evans has now completed advanced training courses in equine and small animal dentistry. Please

read on because you will find much more about all of your favorite people at BEMC!

We have so much to be thankful for, so much to be proud of, and so much to look forward to. Please join Dr. Krebs and I and all the staff at Bend Equine Medical Center in a spirit of op-

timism for the future of our country and our quality of life here in Central Oregon.

Wayne

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Contact us at:

(541) 388 - 4006

bendequine@gmail.com

www.bendequine.com

New Faces at BEMC

Dr. Jenee Daws is

our 2012/2013

intern. She gradu-

ated from Michigan

State University

College of Veteri-

nary Medicine this

past May. Dr.

Daws’ strongest

veterinary interest is

equine surgery,

however she enjoys all aspects of veterinary

practice, including small animal medicine.

During her time off, she enjoys the outdoors

with her husband EJ and their dog, Gus.

Jessica Arnold is a

licensed veterinary

technician that joined

the BEMC family in

April. She worked in

small animal medi-

cine for 9 years and

was excited to join

the equine field and

be an active part of

the Small Animal

Division. Jessica spent her youth at a local cut-

ting and reining ranch gaining valuable equine

experience. She spends her spare time enjoying

the company of her husband and two dogs.

Page 2 B E ND E QUI NE ME DI CAL CE NTE R

Current News in Equine Medicine

Be sure to ask us about our

Bend Equine First Aid Kits.

We will provide everything you

and your horse will need in the

event of an emergency. These

also make great gifts for

horse owners!

Abstracts from the 58th Annual American Association of

Equine Practitioners Convention (December 2012)

Equine Dental Extractions

Though removal of a cheek tooth in a horse is typically per-

formed intraorally (especially in older horses with short

roots and loose teeth), there are patients that need exodon-

tias (removal of a tooth) despite having significant amount

of reserve crown left. Oftentimes, these teeth are extracted

through a flap in the sinus cavity, though recently a new

technique for complicated dental extractions has been de-

scribed. The procedure requires the use of a buccotomy

(removal of the tooth through an incision in the cheek) and

using dental drills to remove alveolar bone, allowing visuali-

zation of the crown, reserve crown, and root to facilitate

extraction.

Western Performance Horse Industry

Drug testing is on the horizon to be a requirement in the

Western Performance Horse Industry. The reason for the

push in testing has to do with the misuse of joint injections

as a preventative therapy. Repetitive corticosteroid admini-

stration into normal, high motion joints has long term dele-

terious effects on articular cartilage. In the diseased joint,

repetitive corticosteroid injections can become a serious

masking agent that can lead to irreparable joint damage.

There is also evidence that the indiscriminant use of hock

joint injections may be responsible for an increase in high

suspensory ligament disease in the horse. With the known

incidence of performance enhancing medications contribut-

ing to break down injuries in the horse, it is no surprise that

authorities will be cracking down on the misuse of these

and other drugs.

Abstracts from the West Coast Equine Reproduction

Symposium IV (November 2012)

Equine Placentitis

Placentitis (infection of the fetal-placental unit) is the num-

ber one cause of late term abortions in mares. New re-

search shows that when caught early and treated properly,

there can be up to a 90% chance of saving the pregnancy

resulting in the birth of a healthy foal. It is recommended

that ultrasounds of the pregnant mare, especially in high

risk mares, should continue past the first trimester. We now

know 3rd trimester ultrasounds and exams can identify and

prevent the loss of a pregnancy due to placentitis.

Hormonal Therapy in Mares

There is now a new drug protocol for keeping mares out of

heat that utilizes the hormone Oxytocin. Research has

shown it to be an effective and affordable alternative to tra-

ditional progesterone hormone treatment. 70% of mares

will stay out of heat for up to 90 days after just 7 days of

treatment. This option is available at Bend Equine for

about $20.

Update on Dummy Foal Syndrome

The scientific discussion and research continues on what is

the true cause of "dummy foal syndrome". New preliminary

data coming out of UC Davis shows that there may be a

hormonal imbalance in dummy foals causing them to not

know they have been born and act as though they are still in

utero. The research is still in progress but it is very exciting!

Abstracts from the 26th Annual Veterinary Dental Forum

(November 2012)

Equine Odontoclastic Tooth Resorption and Hypercementosis (EORTH)

EORTH is a newly recognized pathology affecting both the

incisors and canine teeth of horses typically greater than 15

years of age. The condition is very painful and the teeth

can become infected. New research was presented that

looked at the possible correlation of senior feeds and the

incidence of disease. There was concern that over feeding

equine senior complete diets (feeding more than the pack-

age recommendations) could lead to ingestion of up to 2x

the Vitamin A and D, 4x the Vitamin E, 4x the Copper,

and 2.5x the Zinc that is required in a horses diet. High

blood levels of these vitamins and minerals may predispose

horses to EORTH.

Services Offered Examinations Vaccinations Acupuncture Parasite control (internal and

external, heartworm) Routine Surgeries (spay, neuter,

hernia repair) Dental prophylaxis, radiology

and extractions Dermatology Ophthalmology Laceration repair, cheat grass

removal Microchip Insertion Pain Management At home visits, including in

home euthanasia Pregnancy evaluation Radiographs Ultrasound Shockwave Mesotherapy IRAP

We love working with your small animals! Our feedback has been great—the convenience of preventa-tive care on both small and large animals at the same time has saved time and money for our clientele. Our focus has been on preventative care, routine surgeries, and pain management. This division of Bend Equine has been very rewarding. As many of our patients have stated, “It’s all fun and games until some-one ends up in a cone!”

Orthopedic surgical procedures, such as cruciate repairs, total hip replacements, and fracture repairs can all be performed and managed by local veterinary orthopedic sur-geon, Dr. Robert Fuller. Dr. Fuller will use the Bend Equine Small Ani-mal Division surgical suite for his surgical repairs. Dr. Fuller gradu-ated from UC Davis in 1977 and is experienced in all areas of orthope-dic and spinal surgery.

Page 3

Small Animal Division

B E ND E QUI NE ME DI CAL CE NTE R

Canine and Feline Dentistry

Oral exams are an important part of any pet’s an-nual examination. An alert (unsedated) oral exam allows for visualization of the external structures of the head for abnormalities (swellings, dis-charge, assymmetry, malodor) and, depending on the animal’s compliance, an evaluation of plaque and tartar accumulation on the teeth and the pres-ence of worn, broken, or discolored teeth. A com-plete oral exam can only be performed under gen-eral anesthesia and includes physical examination of the oral and dental structures, periodontal probing, dental charting and intraoral radiogra-phy.

Dental radiography is the standard of practice this day and age...we are very excited to be able to pro-vide intraoral radiography as a complimentary

service with every com-prehensive oral health assessment and treat-ment at Bend Equine!

Did you know…

• Anesthesia-free dentals are a BAD idea! If someone sug-gests it is the best option for a dog because it is safer, they are uneducated regarding the topic.

• Ability and willingness to eat is not a good judge of oral comfort. The vast majority of cats and dogs continue to eat relatively normally despite dental pain because the al-ternative (in their mind) is starvation - not a good survival plan.

• Cats and dogs still eat well after teeth are extracted. Our pets do not hunt and kill their own food; instead we pro-vide them with a balanced diet that is easily digested. Our small animal friends are far better off having diseased teeth extracted than living with a painful mouth!

• Teeth brushing should be performed on a daily basis (bare minimum is 4 times/week). Although we all know this is going to be hard to instill in our daily routine, it is the BEST way to prevent dental disease in your pets.

• Dogs should not be allowed to chew on real bones, nylon bones, big raw hides, antlers, or cow hooves. All of these can be responsible for fractured teeth!

• Root canals and crowns can be performed on pets too!

Bone loss from inflammation

and infection at the tooth root.

Non-Steroidal Anti-inflammatory

Drugs (NSAIDs) are a class of

drugs that include phenylbutazone

(Bute), flunixin meglumine

(Banamine), firocoxib (Equioxx),

ketoprophen and diclofenac

(Surpass) and are commonly ad-

ministered to the horse to control

pain and inflammation. Although

with proper use under the direction

of a veterinarian NSAIDS are quite

safe, we unfortunately see many

serious consequences from im-

proper administration.

The most common side effects of

overdose, chronic use, or improper

administration include gastric ul-

cers, colonic ulcers, kidney failure,

injection site inflammation and ab-

scessation, and, in serious cases,

even death.

Tips for the Safe Use of NSAIDS

in the Horse:

Always dial down Banamine

and Bute paste tubes to a single

dose when storing (for a 1000lb

horse: 1g of Bute or 500-1000 lb

dose of Banamine). A common

reason we see horses obtain an

overdose is when someone acci-

dentally gives the horse the

whole tube at once.

Do not administer more than 1g

of Bute or 1000 lb dose of Ba-

namine to an average sized

horse without consulting a vet-

erinarian.

Do not administer Bute or

Banamine more than every 12

hours for 2 days without con-

sulting a veterinarian

Colic always has the potential to

be serious, therefore you should

consult a veterinarian before

administering Banamine for

colic symptoms. If it is deter-

mined your horse needs to be

evaluated, the doctor can accu-

rately assess the horse’s pain

level and will prefer to adminis-

ter the Banamine by an IV route

after examining your horse.

Banamine can mask the level of

pain your horse is experiencing.

The NEVER EVER List for

NSAID Use in the Horse:

NEVER EVER administer 2 types

of NSAIDS together at the same

time-this will result in overdose.

NEVER EVER administer in-

jectable Banamine or Bute in the

muscle. Banamine is labeled for

IV or IM use, however it can have

life-threatening consequences if

administered IM. Bute is labeled

for IV use only and if even a

small amount gets out of the vein

it can cause a massive inflamma-

tory reaction.

NEVER EVER ignore signs of side

effects of NSAIDs: depression,

lethargy, inappetence, colic, loose

stool, swelling over vein, blood in

urine, frequent urinations.

Page 4

NSAID Therapy in the Horse: Proper Use and Cautionary Tales

Gastric ulcerations secondary to

chronic Bute administration Multiple incisions to treat an

anaerobic bacterial infection caused

by an IM injection of Banamine

We are all extremely sad to say good-bye to our long-time veterinary technician, Misha Kirchmeier. Misha has been with Bend Equine since the beginning! She has spent the last 15 years not only delivering exceptional care and demonstrating dedication to her work, but also providing our staff with unconditional kindness and daily laughter - she has a personality that will be impossible to replace and never be forgotten. Misha will remain here in Central Oregon, spending time with her husband, son, and Otterdog. Which career path will she venture down next? Not even she is certain. We are excited for her to find a new passion in the work place, blessing others with her perfect impersonations, self-deprecating humor, and

perpetual kindness. We will miss you, Mish!

A Special Acknowledgement

Bend Equine Medical Center

8th Annual Central Oregon Equine Symposium

19121 Couch Market Rd. Bend, OR 97701

BEND EQUINE MEDICAL CENTER

Phone: 541-388-4006 Fax: 541-389-7508 E-mail: bendequine@gmail.com

Every year, we see numerous dermatologic cases

ranging from superficial skin infections to skin tumors such as sarcoids, melanomas, and the more serious

squamous cell carcinomas. We will discuss commonly seen skin lesions and precautions you as owners can

take to help decrease the incidence of dermatologic

conditions.

Many things have changed in the world of equine

parasitology. The idea of arbitrarily deworming every 2 months, rotating between classes of dewormers is quickly becoming outdated. Would it surprise you to know

that you might be able to safely skip 4 of those 6

dewormings per year? This presentation will focus on appropriate parasite control and how to custom-

ize your individual horses deworming program to

maximize protection and minimize cost.

Over the last few years, alternative medicine has made a rise in the equine industry. Owners are

choosing more holistic treatment plans over the tra-

ditional western medicine that the veterinary profession can tend to feature. Our session will focus on what we know to be true regarding alternative therapy, as well

as debunking myths regarding certain herbal remedies and holistic treatments.

Whether you are a horse breeder or not, our reproduction session will definitely

hold your interest. You will not only learn about what goes into the modern breeding process, but also the latest and

greatest research into artificial insemination, freezing se-men, and embryo transfer. If you are interested, there will

also be a lab option that will allow you to witness a stallion

collection and semen processing, as well as an ultrasonic examination of a mare’s reproductive tract.

TOPICS: Dermatology ◊ Parasitology

Alternative Medicine ◊ Reproduction Lab participants will rotate between

3 wet lab topics

Breakfast served at Lecture

Lunch served to Wet Lab Attendees

at Bend Equine at 1 pm

Sponsored by Bend Equine Medical Center

Wet Lab: 2 pm-3:30 pm

at

BEND EQUINE MEDICAL CENTER

Saturday, March 2, 2013

Lecture: 9:30 am-12 pm

at

FIVE PINE CONFERENCE CENTER

Please join the Doctors and staff of Bend Equine Medical Center for our

annual Equine Symposium. This year’s symposium topics were chosen by you -

our valued clients and previous symposium attendees. At Bend Equine, we

firmly believe that the more educated the horse owner, the healthier and

happier the horse. We hope you are able to attend our continuing education

course to help improve the well-being of your horses!

BEND EQUINE MEDICAL CENTER

19121 Couch Market Road

Bend, Oregon 97701

Phone: 541-388-4006

Fax: 541-389-7508 Email: bendequine@gmail.com

To register, please complete this form and mail or fax with check or credit card number to:

Susie Fisher, BEMC 19121 Couch Market Road

Bend, OR 97701 Telephone: 541-388-4006 Fax: 541-389-7508 Email: bendequine@gmail.com

DEADLINE: February 22, 2013

FEE: $50 (Lecture only: $25)

Name:

Phone:

Address:

Circle one: Lecture only

Lecture and Lab

Number Attending (include names):

Credit Card Number:_____ _____ _____ _____ Expiration:___ /___ Security code:__ ___

Registration Form

Directions to Five Pine Conference Center: From Bend, go west on High-

way 20 toward Sisters. The Five Pine campus is on the left, just before enter-

ing Sisters. The conference center is directly behind the Five Pine Lodge. cut here

Most back pain observed in the horse was traditionally

thought to be associated with lower limb pain or lame-

ness. The powerful back muscles of the horse are capa-

ble of making postural spinal adjustments in response to

leg or foot pain to allow a horse to successfully continue

to carry a rider. Overtime, these overworked muscles

can become exceptionally painful. While this scenario

certainly occurs, there is increasing support for back

pain as a primary problem. Conformation, rider balance,

performance level, saddle type and saddle fit are often

related factors. As some of you know, chronic back pain

is just that – chronic. Currently, back pain is considered

more of a management problem in the horse rather than

a “fixable” one. The goal of therapy is to break the pain

cycle by initially using a combination of back injections,

shockwave, and mesotherapy. In very painful backs, this

combination therapy can be used a second time. A fol-

low-up protocol is then established that employs either

acupuncture, mesotherapy, or shockwave therapy as part

of an individual maintenance strategy. It is extremely

important for veterinarians to follow up on back cases.

Without a maintenance strategy, primary back pain often

returns. Ask about our back pain package, which in-

cludes injections, shockwave, and mesotherapy. This

treatment package is now more affordable with a 30%

cost reduction for the 3 individual treatments!

Page 7

Back Pain

Parasitology Quiz - How well do you know your horse’s parasites?

1. In a herd of horses, what percentage of the animals harbor the highest parasite load?

A. 0-10% C. 75-85%

B. 20-30% D. All horses generally have equal numbers of parasites

2. True or false? Foals are born with immunity to roundworms which they receive through the colostrum of the mare.

3. What is the most common parasite species found in the feces of adult horses?

A. Ascarids C. Tapeworms

B. Strongyles D. Pinworms

4. True or false? Horses should be dewormed at least every 2 months to prevent infection with intestinal parasites.

5. What is the most common parasite species found in the feces of foals?

A. Ascarids C. Tapeworms

B. Strongyles D. Pinworms

6. True or false? Gastrophilus species (stomach bots) cause gastric ulcers in horses.

7. True or false? Most small strongyle populations are resistant to 1 class of dewormers, and half are resistant to two

classes.

8. What is the best way to decrease pasture contamination?

A. Drag pastures weekly C. Remove manure

B. Rotate pastures D. Keep the grass short Answers on page 8

INTRA-ARTICULAR TILDREN THERAPY

Tildren (tiludronate) is a long acting bisphosphonate drug

that, when administered systemically, prevents bone

breakdown (an anti-osteoporosis drug). In experimental

studies, low to moderate doses of Tildren have shown

promise as an intra-articular drug to help treat inflamma-

tion. Today, Tildren is being directly injected into joints

to treat osteoarthritis – but at much higher doses – with the

hope that there would be a positive clinical effect. In

2011, the Knapp Friesian Foundation (Judy and Jim

Knapp, Sisters, Or.) funded a project on intra-articular

dosing of Tildren. As Director of the Foundation at that

time, Dr. Schmotzer was able to ensure that the clinical

dosing question was addressed. Early results of this pro-

ject have identified the following: low to moderate doses

of Tildren cause no adverse damage to articular cartilage

and do not change synovial (joint) fluid values. High

doses, used today in some practices, cause a significant

elevation of synovial fluid proteins which can be detri-

mental to the cartilage. Could there be a short term nega-

tive effect and a longer term beneficial effect to a high

dose Tildren injected into an osteoarthritic joint? It is pos-

sible. For now, be aware that Tildren injected into a joint

remains an unproven treatment in joint disease with docu-

mented short term negative side effects. Visit with your

veterinarian to ensure you have an understanding of the

goals and risks of intra-articular Tildren therapy.

Bend Equine Medical Center

19121 Couch Market Rd.

Bend, Oregon 97701

2013

NEWSLETTE R

Answers to Parasitology quiz, page 3

1. B. 20-30% of the herd harbors 70-80% of the parasite load. Targeting those horses for deworming will protect

the rest of your herd.

2. False. Foals are usually infected with roundworms soon after birth and develop immunity to the worms by the

time they are about 1 year old.

3. B. Strongyles. Small strongyle eggs are the most common finding on a fecal exam in an adult horse.

4. False. Protecting horses against internal parasites has become an important part of preventive care that should

be individualized for each horse. Attend the 8th BEMC Central Oregon Equine Symposium to learn more!

5. A. Ascarids, more commonly called roundworms, are the most common parasite affecting foals and can cause

damage to the lungs, liver, and intestines.

6. False. Stomach bots do not contribute to gastric ulcers and usually are benign. However when we see them in

the stomach, it gives us a clue that the horse has not been dewormed recently and probably has other types of

internal parasites which may be causing harm.

7. True. Parasite resistance will be discussed at the 8th BEMC Central Oregon Equine Symposium.

8. C. Removing manure is the most effective way to decrease parasite contamination, however it is not that real-

istic for many farms. Another great way is to rotate, or rest pastures, or allow grazing by another species.

Dragging pastures can actually disperse eggs to areas where horses are eating, making it counterproductive.

For more information on internal parasites and your horse,

attend the BEMC 8th Annual Central Oregon Equine Symposium!

Phone: 541-388-4006

Fax: 541-389-7508

E-mail: bendequine@gmail.com

UNPARALLELED COMMITMENT, CARE, COMPASSION & SERVICE

PRSRTD STD.

US POSTAGE PAID

BEND, OR

PERMIT NO. 3

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