Equinevet july2014

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Vol 4 Issue 7 2014 www.modernequinevet.com Equine Vet The Modern Equine nasal strip reduces lung damage, may improve performance Technician Update: C. myositis West Nile virus New tissue patch for surgical procedures How to manage AXILLARY WOUNDS

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Transcript of Equinevet july2014

Page 1: Equinevet july2014

Vol 4 Issue 7 2014www.modernequinevet.comEquine Vet

The Modern

Equine nasal strip reduces lung damage, may improve performance Technician Update: C. myositisWest Nile virusNew tissue patch for surgical procedures

How to manageAxillArywounds

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2 Issue 7/2014 | ModernEquineVet.com

TablE of CoNTENTs

InfecTIonsWnV: Vaccination and mosquito prevention needed ................................................ 8

RespIRaToRyequine nasal strip reduces lung damage; may improve performance..............11

TechnIcIan UpdaTecase 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

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how to manage axillary wounds

coVeR sToRy: 4

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SaleS: Robin Geller • [email protected]

editor: Marie Rosenthal • [email protected]

art director: Jennifer Barlow • [email protected]

Published by

p E r c y b omedia publishing

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advertiSerSKensio equine Tape .............................................. 3Merck animal health ........................................... 6avalon Medical .................................................. 10

horseside Vet Guide ........................................... 13aaeVT ................................................................. 14

PO Box 935 • Morrisville, PA 19067Marie Rosenthal and Jennifer Barlow, Publishers

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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 Aman-da-Jo Joswig, DVM, MpH, an as-sociate veterinarian at Thomasville Animal Hospital.

“Axillary wounds are relatively common in horses, and their ini-tial 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 af-ter a trauma, such as being kicked by another horse or running into a fence post. They frequently appear to be minor injuries but can de-velop 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 me-diastinal air ruptures through the mediastinal tissues.

assessmentThe 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 pa-tient should be sedated to enable

a full evaluation of the wound, ac-cording to Joswig.

“When you first evaluate the horse with an axillary wound, you want to consider the general condi-tion 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 di-lute povidone iodine solution, and then palpating the wound. Note the depth and direction of the wound and any potential involve-ment 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 solu-tion. To prevent disseminating con-taminants into deep fascial planes, use low-pressure lavage with a cath-eter-tipped syringe or a 35-mL sy-ringe with an 18-gauge needle, she suggested.

once the wound is cleaned and prepared, pack it with sterile gauze or laparotomy sponges to help pre-vent air from migrating into the subcutaneous fascial planes. If pos-sible, partially close the wound us-ing two layers:

1. Muscle and fascia2. Skin.Leave an opening to change the

packing every 24 to 48 hours until healing by secondary intention oc-curs. Apply stay sutures and use a

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

Auxiliary therapy should in-clude nonsteroidal anti-inflamma-tory medication (NSAID), broad-spectrum antibiotics and a tetanus shot. put the horse on strict stall rest to eliminate movement to de-crease 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. Topi-cal 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 scaf-folding matrix for which new skin tissue cells can adhere.

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

complicationsAxillary 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.

how to manage

B y M a r i e R o s e n t h a l , M s

axillary wounds

CovEr sTory

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ModernEquineVet.com | Issue 7/2014 5

Since it is frequently asymp-tomatic, pneumomediastinum is diagnosed based on radiographic evidence. If pneumomediastinum is present, the air within the me-diastinal 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 pneumotho-rax will resolve within one aspi-ration than IV catheters are suf-ficient. However, if you think you will need more than one aspira-tion procedure, then trocars are preferred,” she said.

Joswig did a small retrospec-tive case series of seven horses that presented at TAMU with ax-illary wounds and subcutaneous

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

These progressions tended to be delayed with subcutaneous em-physema developing about three days post injury.

“because delays are common, se-rial evaluations and treatment of the primary cause are necessary, as is re-stricting movement. However, not all axillary wounds develop secondary complications,” she said. Mev

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

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Josw

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axillary wounds

Holding a stent in place.

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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 • 800-521-5767Copyright © 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

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 fi nd out more.

Visit protazil.com

We’re for the Horse™

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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 • 800-521-5767Copyright © 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

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 fi nd out more.

Visit protazil.com

We’re for the Horse™

Page 8: Equinevet july2014

8 Issue 7/2014 | ModernEquineVet.com

INfECTIoUs dIsEasEFOR 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 FDADESCRIPTION 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 C17H9CI3N4O2, 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 ADMINISTRATIONDosage: 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)

mLs of Pellets Weight Range of Horse (lb)

mLs of Pellets

275 - 524 20 1275 - 1524 60525 - 774 30 1525 - 1774 70

775 - 1024 40 1775 - 2074 801025 - 1274 50 - -

One 2-lb bucket of PROTAZIL® will treat one 1100-lb horse for 28 days. One 10-lb bucket of PROTAZIL® will treat fi ve 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 fi eld 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. falcatula in bovine turbinate cell cultures was studied by Lindsay and Dubey (2000).1 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 (IC95) 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 fl uid (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 substantially exceed the in vitro IC95 estimates for merozoite production (Dirikolu et al., 1999)2. 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 fi eld study. All horses were confi rmed 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 modifi ed Mayhew neurological scale on Day 48 as follows:

0. Normal, neurological defi cits not detected.1. Neurological defi cits 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 defi cit obvious at normal gaits or posture; signs exacerbated with manipulative procedures.

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

4. Neurological defi cit 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 defi ned 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 classifi ed 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 fi rst 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 stiffl y 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 fi ndings associated with the drug were limited to elevations in BUN, creatinine, and SDH and less than anticipated weight gain. Defi nitive 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 fi ndings 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.REFERENCES1. 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 identifi cation and detection and preliminary pharmacokinetics. J. Vet. Pharmacol. Therap. 22:374–379.

May 2010Intervet Inc.56 Livingston Ave, Roseland, New Jersey 07068© 2010 Intervet Inc. All rights reserved. 08-10211.x.3.1.0

ANTIPROTOZOAL PELLETS (1.56% diclazuril)

In many parts of the country, the sum-mer is hot, wet and muggy, perfect weather for breeding mosquitoes and the trans-mission of diseases like West Nile virus (WNV), and as a result more than a dozen states have already reported WNV in senti-nel animals like horses.

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

The USDA Animal and plant Health In-spection Service (ApHIS) Veterinary Ser-vices collaborate with the centers for Dis-ease control and prevention (cDc) and

State veterinary and public health officials to facilitate communication about arbo-virus 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 hu-man cases of WNV also occur.

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

neededvaccination and mosquito prevention

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

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

WNV:

West nile virus activity by State in 2014 (as of July 15, 2014)

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ModernEquineVet.com | Issue 7/2014 9

sort of weather patterns create a high risk for mosquitoes to trans-mit the disease not only to hors-es, 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 Medi-cine’s Veterinary Health center,

There are two primary strate-gies for disease prevention: Vac-cination and eliminating mos-quito breeding grounds.

West Nile virus is a core vac-cine for horses, recommended by the American Association of Equine practitioners. Four equine vaccines are available. Ini-tial vaccination requires a series of two to three vaccines, depend-ing on the age of the horse, and is then followed by annual boost-ers. 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 mos-quitoes.

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, 2013 - States with Equine CasesTotal cases - 377

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

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

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10 Issue 7/2014 | ModernEquineVet.com

Wound care, redefined.

RediHeal Wound Care products promote rapid, scar-free 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.

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

• Anti-microbial• Easy application

“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 live-stock, 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 replica-tion.”

sudden signsThe onset of clinical signs for

Equine West Nile virus is often sudden, with the progression oc-curring over the following two to four days.

“clinical signs of West Nile vi-rus 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 behav-ior.

“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 abil-ity to chew and swallow properly. We may see dramatic changes in their gait, such as stumbling or being uncoordinated.” Davis ex-plained. Mev

INfECTIoUs dIsEasE

take steps to Protect Horses1. 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

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Although there had been heated debate about whether california chrome could wear a nasal strip in the belmont Stakes, Kansas State University college of Veterinary Medicine research-ers who tested the product said the focus should have been on the nasal strip’s health benefits and not on possible performance en-hancement.

Howard Erickson, DVM, phD, professor emeritus of anatomy and physiology, and david Poole, phD, DSc, professor of kinesiology and anatomy and physiology, re-searched the Flair nasal strip used by the thoroughbred racehorse and found it can help reduce lung dam-age 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 re- duce exercise-induced pulmo-nary hemorrhage by approxi-mately 50%. I think that is benefi-cial,” 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 Erick-son 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 re-duced lung damage.

“The nasal strip reduces bleed-ing, reduces the secondary infec-tions 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 ap-proach to racing enhancements and a better alternative than some drugs currently being used.

“Unfortunately, the horse rac-ing industry is a mine of drugs,” poole said. “you don't know un-der any given circumstances what a horse may or may not be on.”

The Flair nasal strips are be-ing used worldwide at other horse events like barrel racing. Mev

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Dr. E

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equine nasal strip reduces lung damage, may improve performance

rEspIraTory

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.

For more information:

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

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12 Issue 7/2014 | ModernEquineVet.com

NEWs NoTEs

Horsing around reduces stress hormones in young peopleNew research from Washington State University reveals how youth who work with horses experience a substantial re-duction in stress, and the evidence lies in the saliva of children.

While human-animal interaction pro-grams with horses and other companion animals have been credited with improv-ing social competence, self-esteem and behavior in children, there is little sci-entific evidence to support it. Patricia Pendry, phD, a developmental psycholo-gist at WSU, led a research project to en-gage students in grades 5-8 in a 12-week equine facilitated learning program in pullman.

She approached the coordinator of the palouse Area Therapeutic Horseman-ship (pATH) at the WSU college of Vet-erinary Medicine, which offers a thera-peutic 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

provided 90 minutes weekly to learn about horse be-havior, care, grooming, handling, riding and interac-tion. 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 after-noon, 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 re-sults will lead to the development of alternative after-school 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

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cSU appoints first woman to head veterinary training program

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

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ModernEquineVet.com | Issue 7/2014 13

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 surgi-cal patch for many types of surgical repair and re-inforcement.

It supports and promotes wound healing by pro-viding 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 scar-free healing.

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

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

new veterinary tissue patch product available

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.

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

Send it to Marie rosenthal.

GoT NEWs?

Page 14: Equinevet july2014

AAEVT MembershipAAEVT* 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 MembershipBi-Annual NewsletterWeekly “HoofBeats” email NEwsblastFull access to www.aaevt.org, including the Career Center and the LibraryUp-to-date information on the AAEVTDiscounted registration for AAEVT Regional Meetings and the annual AAEP/AAEVT ConventionNTRA, Working Advantage and Platinum Performance BenefitsThe 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 ObjectivesProvide opportunities for CE, training, communication, and networkingEducate the equine veterinary community and the public about our professionInform Members of issues affecting our professionAssist in providing the best medical care to improve the health and welfare of the horse

••••

AAEVT Online Equine Certification Program

For more information visit www.aaevt.org*American Association of Equine Veterinary Technicians and Assistants

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.

A three course, 10 module, equine-only online program offered through ACTGeared toward Credentialed Veterinary Technicians, Assistants, Support staff, & StudentsAreas 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 proceduresA 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 labsThose 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 AVMAFor more information go to www.aaevt.4act.com or call 800-357-3182

•••

AAEVT MembershipAAEVT* 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 MembershipBi-Annual NewsletterWeekly “HoofBeats” email NEwsblastFull access to www.aaevt.org, including the Career Center and the LibraryUp-to-date information on the AAEVTDiscounted registration for AAEVT Regional Meetings and the annual AAEP/AAEVT ConventionNTRA, Working Advantage and Platinum Performance BenefitsThe 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 ObjectivesProvide opportunities for CE, training, communication, and networkingEducate the equine veterinary community and the public about our professionInform Members of issues affecting our professionAssist in providing the best medical care to improve the health and welfare of the horse

••••

AAEVT Online Equine Certification Program

For more information visit www.aaevt.org*American Association of Equine Veterinary Technicians and Assistants

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.

A three course, 10 module, equine-only online program offered through ACTGeared toward Credentialed Veterinary Technicians, Assistants, Support staff, & StudentsAreas 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 proceduresA 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 labsThose 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 AVMAFor more information go to www.aaevt.4act.com or call 800-357-3182

•••

Page 15: Equinevet july2014

ModernEquineVet.com | Issue 7/2014 15

By Brittany Aanerud, CVT

Goldie was referred to the clinic late on the night of May 25th, 2011 by a referring veterinar-ian from southern Min-nesota 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 mem-branes were bright pink with a capillary refill time of 3-4 seconds. Approximately 12 hours after being

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 in-cisions (which released a foul smelling gas), daily ultrasonography was performed to locate any newly formed gas pockets.

diagnosisA swab was taken in one of Goldie’s gas pockets

and it was sent to an outside lab for culture. The re-sults 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

Case study: C. myositis

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 10, June 3rd: Smaller incisions are healing slightly; skin is about to slough

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16 Issue 7/2014 | ModernEquineVet.com

TEChNICIaN UpdaTE

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 gen-erally 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 vac-cines/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 ani-mals.. With Goldie’s injection being in the superfi-cial gluteal muscle where there is a large amount of

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

Treatment RegimeThe initial treatment plan was

to supply IV fluids and antibiot-ics, 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 (organ-isms 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 mov-

ing 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

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.

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ModernEquineVet.com | Issue 7/2014 17

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.

For more information:

31 and showed no new pockets. She was able to go home 17 days after being admitted, with basic exercise and cleaning instruc-tions.

prognosis and outcomeGoldie’s prognosis was ini-

tially guarded due to the fact that it was unknown the extent of the gas pockets. However, her prog-nosis 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, spe-cial case, and it was amazing to see such a great out-come. Mev

about the authorBrittany Aanerud, CVT, is a technician at Anoka Equine Veterinary Services

day 15, June 8th: drainage is starting to diminish and wounds are closing up

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.

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Page 18: Equinevet july2014

reach your veterinarians where ever they are, whenever they want.

foR adVeRTIsInG RaTes and InfoRMaTIon, eMaILrobin Gellar

Equine VetThe Modern