Equine Resources

Racing Victoria vet trainers’ seminar on horse injuries with Professor Chris Whitton

Thursday, November 09, 2017

Please click the image above to watch the seminar

Professor Chris Whitton BVSc FANZVSC PhD is Head of the U-Vet Werribee Animal Hospital’s Equine Centre and a Specialist in Equine Surgery. Chris has lectured and published extensively on lameness matters. He developed a multidisciplinary research programme into the understanding and prevention of limb injuries in racehorses and has published 42 peer reviewed papers during his career. His current research interests are in prevention and diagnosis of injury in performance horses.


In this seminar held by Racing Victoria, Professor Chris Whitton presents to vet trainers on reducing the risk of musculoskeletal injuries in horses, covering:
  • types of injuries
  • evidence for bone fatigue as the cause
  • Understanding bone fatigue
  • Loads in the limb
  • How injuries occur.

New research on snake envenomation of horses

Monday, October 30, 2017




A new research project led by University of Melbourne equine medicine researcher Dr Nick Bamford has been published. It’s the first in which scientists looked at the clinical signs of elapid snake envenomation (tiger snakes, taipan) in a large population of horses. The team also evaluated laboratory findings, treatments, and outcomes from 52 elapid snake envenomation cases from several universities and private veterinary practices from 2006 to 2016.

The findings showed that snakebite wounds aren’t always apparent, but affected horses often exhibit clinical signs of envenomation. When vets can make a diagnosis based on these clinical signs, this can aid fast treatment and better outcomes. 


 In 94 per cent of cases developed signs of neurotoxicity, typically characterized by neuromuscular weakness. Owners should look out for these signs:

  • unsteady movement

  • muscle tremors

  • the inability to stand

  • pupil dilation (mydriasis)

  • eyelid drooping (ptosis)

  • partial tongue paralysis. 

Fifty per cent of horses in the study also developed rhabdomyolysis (muscle damage) and 19 per cent developed hemolysis (red blood cell damage).

Observing clinical symptoms was more effective than urinary analysis in predicting snakebite. Out of the 18 urine samples they evaluated, only seventeen percent were positive for snake venom. As such, it is recommended that veterinarians consider elapid snake envenomation as a differential diagnosis for any horse exhibiting the aforementioned clinical signs, especially in areas where these snakes are most common (the tropics and subtropics in Asia, Australia, Africa, North America, and South America).

If a veterinarian makes the right diagnosis based on clinical signs and administers antivenom promptly, survival rates can be quite high for equine snakebite patients - 86 per cent of the 49 horses studied survived.

The study, "Elapid snake envenomation in horses: 52 cases (2006-2016)," was published in the Equine Veterinary Journal

Read the full article featured in The Horse.

For emergencies and to make an appointment, contact us

 


Endocrinopathic Laminitis With Dr Simon Bailey

Thursday, October 19, 2017
Words by Jess Whinfield. As seen in Horse's and People magazine July 2017.

Image: Simon Bailey is a Professor of Pre-clinical Veterinary Sciences at the Melbourne Veterinary School, University of Melbourne.

Dr Simon Bailey is a world-leading researcher who has devoted his professional career to examining endocrinopathic laminitis, a common, but potentially devastating, disease. With over 30 horses on his property, including one pony that ís being managed for laminitis, Simon is well-versed in the challenges the disease presents from the perspective of a horse owner, a researcher and a veterinarian. In this article, he shares his research findings on the topic, as well as the key steps that can be taken to prevent the disease.

Simon's interest in laminitis began in his final year of veterinary studies in 1993 and he went on to publish a PhD on the subject. Now, almost 20 years later, Simon is a Professor at the University of Melbourne Veterinary School, and he and his team continue to answer questions around the relationship between diet, management practices and endocrinopathic laminitis.


Endocrinopathic laminitis

Endocrinopathic laminitis is the form of laminitis that makes Spring time such a stressful season for pony owners. As well as rich pasture, it can also develop in animals on high sugar or high starch dietary supplements.


Image: The devastating effect of the detachment of the lamina from the hoof wall is the rotation of the pedal bone.


Although it can have the same catastrophic outcomes as inflammatory laminitis, which can be triggered by carbohydrate overload (commonly seen when horses get into feed bins) or systemic diseases (such as colic or retained placenta after foaling), endocrinopathic laminitis is distinct in the way it causes disease in the hoof.

Endocrinopathic laminitis is a condition that does exactly what it says on the tin - if you're fluent in Latin. The prefix 'endocrin' refers to the endocrine glands, which are the producers of hormones. In relation to laminitis, insulin is the hormone of interest. The suffix '-pathic' simply means 'disease'.

The term 'laminitis' can be similarly broken down, with the '-itis' component meaning 'inflammation' and 'lamin-' referring to the laminae in the hoof. So, a rather wordy translation of 'endocrinopathic laminitis' is: 'a disease caused by hormones which results in inflammation or breakdown of the hoof laminae'.



The role of insulin in laminitis


Before the relationship between insulin and laminitis can be understood, it's important to understand the normal role of insulin, which is the same in horses and people.

Insulin is a hormone produced by the pancreas and is essential for life. It's released into the blood when the body detects that blood glucose levels (sometimes referred to as blood sugar levels) are increased, such as after a sugar or starch-rich meal or on lush pasture. Insulin triggers the movement of this glucose out of the blood stream and into cells, where it can be used as a source of energy. It also promotes obesity.

In overweight animals, insulin continues to be produced, but the body's cells ignore its presence. This means the glucose stays in the blood, rather than being taken up into cells. The body detects these persistently high blood glucose levels, and so produces yet more insulin to try and lower them.

A cycle, therefore, develops in which there are large amounts of insulin in the blood, but the cells are unresponsive to it, and so, blood glucose remains high, triggering yet more insulin release. This is the same mechanism that results in metabolic syndrome, or 'pre-diabetes' in humans.

Interestingly, horses with high insulin levels very rarely develop diabetes. Rather, they become laminitic.

These elevated insulin levels are one component in a group of related conditions, termed Equine Metabolic Syndrome (EMS). Obesity is another common outcome of EMS. EMS is the horse equivalent of metabolic syndrome seen in humans, although the outcomes are quite different.

Elevated insulin levels are problematic because insulin does more in horses than lower blood glucose levels; it also causes the cells of the hoof laminae to proliferate and weaken. This causes the sensitive laminae to stretch.

In the healthy hoof, the laminae are crucial for attaching the hard, external hoof capsule to the soft tissue and bone of the foot. With the laminae now stretched out of their normal proportions, due to elevated insulin, they no longer lock neatly into the grooves of the hoof capsule. As a result, painful detachment of the hoof wall from the underlying structures occurs. This is reflected in the classic clinical signs of laminitis; foot pain and a reluctance to move.



Image: Obese pony


Why are ponies and some horse breeds so susceptible to laminitis?

Largely, it's a consequence of evolution. Many ponies, as well as horse breeds from Spanish lineages, such as Andalusians, have evolved over millennia to survive on scant grass availability in the harsh environments of the North West of Britain and the deserts of Spain.

But, today, horses and ponies that are exquisitely adapted to subsist on meagre rations are kept on rich pastures developed for sheep and cattle - modern breeds of which have been developed to require more bountiful environmental conditions. the ponies have evolved to maximise every bit of sugar available to them, and so, they readily become obese and develop chronically elevated insulin levels.

This is the same scenario as confronts indigenous human populations world-wide. After thriving on hunter-gatherer diets for hundreds of thousands of years, when communities are confronted with the high-fat, high-sugar foods of the modern Western diet, catastrophic levels of type two diabetes and metabolic syndrome are seen.


Body condition scoring

The Body Conditioning Scoring (BCS) scale was developed in the 1980’s by Don Henneke, PhD, to evaluate the condition of broodmares. The scale goes from 1 to 9 - where 1 is emaciated and 9 is extremely fat or obese. The BCS system is based on visual appraisal and palpable fat cover at six areas of the horse’s body.

In this photo series, we assess the Body Condition Score of Mary, a pony mare approximately 12hh and 12 years old. Photos by Linda Zupanc.



First, assess the whole body from the side to get a general impression.

Assess the whole body from behind. Then, begin assessing and scoring the following six individual regions.


Neck is smooth, score 5.

Withers are rounded, score 5.

Shoulder has some fat, score 6.

Ribs are not visible, but can be felt, score 6.

Loin is level, score 5.

Tail head has soft fat, score 5.


Mary’s overall score is 5 (moderate), which is considered the ideal for a pony of this type and her level of activity.

Compare Mary with the chesnut pony above which is in obese condition with a cresty neck and may be at risk of laminitis. Image courtesy Simon Bailey.


Prevention

From a practical perspective, prevention is the most important part of any discussion on endocrinopathic laminitis. And the good news is, in many cases, this form of laminitis is preventable.

The most crucial part of laminitis prevention is maintaining a healthy body weight and avoiding obesity. Whilst obesity doesn't cause laminitis, it is commonly correlated with high levels of insulin - which does cause laminitis. Thus, the body condition of a horse can be used as a visible and measurable stand-in for insulin levels, which are effectively invisible without laboratory tests.

Simon recommends taking the following steps to reduce the risk of endocrinopathic laminitis:

1. Assess your horse's body condition, and assign a body condition score.

There are two major methods by which this can be achieved.

The first involves assessing the amount of fat covering different areas of your horse, as explained in the images on the left.

The second method has been relatively recently developed by Simon and a team of researchers, and is the equine equivalent of the Body Mass Index calculation commonly performed at human gyms.

This second method is recommended for people new to body scoring because it's easier to perform accurately and, thus, produces more reliable results. Instructions on how to perform both methods and an interactive tool for doing so are available at the following website: https://www.spillers-feeds.com/weight-management-tools/.

Both condition scoring methods produce a score between 1 and 9, based on a system called the modified 9-point Henneke Scale. A score between 4.5 and 5.5 is ideal. A horse that scores between 6 and 6.5 is over-conditioned, and a score between 7 and 9 indicates obesity.

2. If your horse has a body condition score between 6 and 9, you should remove sugar- and starch-rich supplementary feeds from their diet. This includes feed stuffs such as corn, barley and wheat. If it is on lush grass, it may be necessary to restrict access to pasture.

A horse doing mild to moderate exercise (equal to, or less than, 20 minutes of exercise, three times per week) does not normally require high sugar supplementary feeds.

Removing these foods and restricting access to pasture (providing moderate quality hay instead, plus a protein/ vitamin/mineral balancer), is the equivalent of placing the horse on a low- GI diet.

3. If your horse remains in a condition score above 6 following the removal of sugar- and starch-rich rations from their diet, call your veterinarian.

Your veterinarian will be able to advise management strategies and dietary modifications to assist in weight loss and laminitis prevention.

They are also able to assess your horse or ponyís insulin levels, and evaluate their chances of developing endocrinopathic laminitis. Some horses and ponies are more vulnerable than others and, considering the amount of effort managing an at-risk horse can be for the owner, this is useful information to know.

Management of at-risk horses and ponies is incredibly complicated and requires a holistic approach.

It can be challenging to balance the welfare needs of the pony, such as providing adequate enrichment and companionship, with laminitis prevention. Even changing the diet too drastically, or too little, can have damaging consequences as a result.

With so many factors that must be considered in developing a management plan, it is ill-advised to attempt such measures without seeking professional veterinary advice first.

Even if you believe your horse or pony isn't overweight, it's worth performing a body condition score - it's quick and easy, and costs nothing to perform.

A component of Simon's research has been surveying participants of Pony Clubs across Victoria. Three in 10 ponies were found to be obese, and this probably reflects the situation for many pleasure horses and ponies across the South and East of Australia. It was also notable that 40% of riders surveyed underestimated their horse's body condition score.

Simon emphasises that taking simple steps, such as making yourself aware of your horse's body condition, can go a long way to reducing their risk of laminitis - and this simple skill is underdeveloped in many owners. Obesity has become so prevalent in ponies that overweight has come to be perceived as normal weight.


Early recognition


Another key consideration when it comes to avoiding the severe, long-term consequences of laminitis is early recognition. Simon implores horse owners to get their veterinarian involved as soon as they notice their horse is exhibiting a stiff gait or reluctance to move. Even a horse that isn't lame on pasture may be lame on hard surfaces, such as concrete, and this is the time to get your veterinarian out.

They will be able to confirm a diagnosis of laminitis, dispense pain relief, provide frog support and suggest future management options.

Early laminitis diagnosis can reduce the duration of disease from several, severe months to a handful of mild days. It makes for a happier horse and a happier owner. If you are in doubt, explains Simon, call your veterinarian.


Other contributors to laminitis

It's important to remember stress can exacerbate the risk of laminitis. When an animal is stressed, their body releases a hormone called cortisol which, in turn, increases the levels of insulin in the blood. This is one of the reasons it's essential no dramatic changes to a pony's diet or lifestyle are made without veterinary advice. Rather than benefiting the animal, it often does more harm than good. Simon's firm advice is to 'never starve the pony' by giving less than 1-1.25% of their body weight in dry matter of hay per day.

Whilst stress can play a role in increasing the risk of laminitis, the surface a horse is kept on has little influence. Normal principles apply: horses should be kept on well-draining surfaces and extremely firm surfaces, such as concrete, should be avoided. But, other than that, the surface shouldn't influence a horse's risk of developing laminitis unless it is often exercised on a hard surface. When treating a case of laminitis, however, a sand or deep bedded surface will take some weight off the hoof wall and make the horse more comfortable.

Regular routine hoof care performed by a farrier or trimmer can help in the early detection of changes that indicate a horse or pony is on the cusp of laminitis. This is a good time to get your veterinarian involved.

Whilst exercise is essential for the overall health and wellbeing of all horses and ponies, Simon's research has shown that dietary management has a greater impact than exercise on reducing a horse's risk of laminitis. One of Simon's experiments involved feeding two groups of obese, at-risk horses and ponies the same calorie restricted ration to encourage weight loss, but exercising only one group. Both groups normalised their insulin levels, but the group that exercised daily did not have any further benefits in terms of the metabolic risks of developing laminitis as the group that didn't exercise.

Furthermore, just as in people, diet is more important than exercise when it comes to achieving weight loss results. So, whilst exercise is important as part of a holistic management strategy, exercise alone is not directly associated with reducing their risk of laminitis.


The future of laminitis research

In recent years, huge advances have been made in terms of our understanding of endocrinopathic laminitis. Simon and his team are continuing to unravel the connection between nutrition, dietary management, insulin and pasture-associated laminitis, and it is likely that further advances will be made in the years to come. It is the responsibility of horse owners, nutritionists and veterinarians alike to stay abreast of suggested changes in management as they arise.

After all, managing laminitis requires a team approach that involves the owner, veterinarian, farrier or trimmer and, sometimes, a qualified equine nutritionist to work towards the common goal of endocrinopathic laminitis prevention.

 


The Role of Veterinary Specialists and Referral Equine Hospitals

Monday, October 09, 2017

Words by Dr Brett Tennent-Brown BVSc, MS, Dip ACVIM, Dip ACVECC, U-Vet Werribee Equine Centre.
As seen in Horses and People Magazine May 2017.



Image: Professor Chris Whitton, equine surgeon at U-Vet Werribee Equine Centre (centre). In addition to more powerful x-ray units, the ultrasound machines at referral hospitals typically allow greater resolution and detail when evaluating the tendons and ligaments of the equine limb than is possible in ambulatory practice.

Like specialists in human medicine, veterinary specialists have extensive experience and expertise in a relatively narrow aspect of veterinary medicine. As such, specialists in equine surgery or medicine are often able to provide services that might be beyond what is possible in general ambulatory practice.

Although not all specialists work from referral hospitals, many do and these facilities enable them to provide an exceptional level of care to your horse.

Understanding what a hospital-based specialist can offer you and your horse is important when trying to decide whether your horse should be referred for specialist evaluation.


What is a veterinary specialist?

Veterinary specialists tend to remain more broadly focused than their human medicine counterparts but, as a whole, veterinary practitioners are becoming increasingly specialised.

Part of this drive toward specialisation is the ever-increasing body of veterinary knowledge. Remember that, unlike human doctors, veterinarians must deal with a wide range of animal species that often differ considerably in their normal physiology and which might be affected by vastly different disease processes.

As a consequence, it has become increasingly difficult to have a comprehensive understanding of the diseases that could affect all of the species that a veterinarian might be expected to deal with!

Although there is still a role for the James Herriot-style mixed animal practitioner, most graduating veterinarians plan to practice on either small animals (cats and dogs) or large animals (horses, cows and other farm animals).

Many specialists might just work with a single species and this is particularly true of large animal specialist practitioners, many of whom just work with horses.

Veterinary specialists narrow their focus further than just small or large animals; the most common specialities in large and small animal practice are Surgery, Internal Medicine, and Emergency and Critical Care - and this is not the end of it! For example, some specialist surgeons will concentrate on orthopaedics, while others work primarily on soft tissue injuries or diseases. Equine orthopaedic surgeons primarily treat injuries to the bony elements of the limbs, whereas soft tissue surgeons often have a particular interest in abdominal surgery, such as treating horses with colic that require surgical intervention.

Rather than just focusing on one or two animal species, some veterinary specialities focus on diseases that affect just one part of the animal, such as the specialties of cardiology or ophthalmology, or on a single disease process, like oncologists who treat veterinary cancers.

Veterinary cardiologists, ophthalmologists and oncologists are usually able to diagnose and treat conditions across a wide range of veterinary species, although many spend more time working with small animal patients.

Finally, there are several groups of specialists that animal owners might never meet, including veterinary anaesthetists, radiologists and pathologists. These specialist veterinarians can all provide invaluable insight into animal diseases.

As a point of clarification, in Australia, veterinary specialists are veterinarians with speciality level training who have registered as a specialist with the appropriate veterinary regulatory board. There may be veterinarians with extensive specialist level training, skills and training that are not registered with the regulatory board.

While those veterinarians are not allowed to call themselves specialists in Australia, they are perfectly capable of providing a very high level of care to your horse. This is obviously slightly confusing, so it is important to understand the sort of training that qualifies a veterinarian as a specialist in Australia specifically.


How do specialists become specialists?

Veterinary school graduates receive extensive training and are well equipped to tackle most of the challenges they will encounter in general practice. However, some veterinarians decide they would like to know more about a particular area of veterinary medicine, so they are able to provide more tailored services for their patients.

The first step in becoming a veterinary specialist is usually to undertake an internship (i.e. become an intern) in either small animal or large animal practice. Internships are usually one year long and most are rotating - that is, the intern spends time with surgery specialists, medicine specialists, anaesthetists, and so on. The aim of these internship programs is to expose recent veterinary graduates to high level veterinary practice under the supervision of specialists in a range of fields.

Following successful completion of an internship, veterinarians who want to gain specialist qualifications will apply for a residency training program. Veterinarians undertaking residency training programs are called residents most work very long hours and so reside or are resident at their hospital!

Residency training programs are usually three years in length and have a narrower focus - for example, large animal medicine or large animal surgery - than internships. As a part of their training program, residents are required to study the scientific literature around their chosen speciality and many will complete a research project investigating a particular aspect of veterinary medicine.

There are a number of governing bodies that oversee and regulate veterinary resident training programs. The most well-known are the American College of Veterinary Internal Medicine (ACVIM) and the American College of Veterinary Surgeons (ACVS), and their European counterparts - the European College of Equine Internal Medicine (ECEIM) and the European College of Veterinary Surgeons (ECVS).

Each college has a set of very rigorous requirements that residents must meet, and a certifying examination or examinations that must be passed. Residents that fulfil the college’s requirements become Diplomats in that specialty.

The Australian and New Zealand College of Veterinary Surgeons (ANZCVS) oversees many of the residency programs in the Southern Hemisphere and this college has particularly stringent standards. Veterinarians who complete ANZCVS sanctioned residencies become Fellows of the ANZCVS.

Regardless of the governing body, veterinarians who have gone through a residency program and have fulfilled their college requirements (i.e. Diplomats or Fellows) have extensive knowledge and clinical experience in their chosen area of expertise.

“Many equine internists have extensive imaging skills and are particularly adept at ultrasonography. This is a vital tool.”

Understanding what a surgery specialist does is fairly straightforward, although many of the procedures performed by veterinary specialist surgeons are very complex and require an incredible level of skill. It is a bit harder to understand what it is that a medicine specialist, or internist as they are often called, does.

In the equine field, a large portion of many medicine specialists’ jobs involve treating very sick horses on an emergency basis. Many internists have a deep interest in neonatal medicine and will have extensive experience treating critically-ill foals.

Other emergent cases commonly managed by internists include horses with diarrhoea and pleuropneumonia. In many hospitals, it is the internist who will first evaluate horses with colic and help make the decision about whether that horse requires surgical evaluation of the abdomen. It is also often the job of the internist to manage those horses with colic that don’t immediately require surgery. Although internists usually don’t perform surgery themselves, they are often responsible for the post-operative management of these horses.


Image: The high-speed treadmill at the U-Vet Werribee Equine Centre can be used to simulate high intensity exercise and allows assessment of respiratory and cardiac function.

Liver, kidney and heart disease are, fortunately, fairly uncommon in horses. However, when diseases of those organs do occur, an internist is well equipped with the knowledge and skills to make an accurate diagnosis and devise an appropriate treatment plan.

Many equine internists have extensive imaging skills and are particularly adept at ultrasonography. This is a vital tool when evaluating horses with problems, such as weight loss, persistent colic or diarrhoea, and infections of the respiratory tract. Evaluation of blood work is often is an important aspect of managing medical cases, and equine internists have a deep understanding of the subtleties and intricacies of laboratory results. Internists can also recommend and interpret testing that might not be routinely offered by general practitioners.


When should my horse be referred for specialist evaluation?

This is a difficult question to answer because there are so many factors to consider when deciding whether a horse should be referred for specialist evaluation. In most cases, horses are referred to a specialist by the attending veterinarian, but it is also reasonable for owners to suggest or seek referral.

There are a number of things that are easier to do at a hospital or can only be done at a hospital. These include complex surgeries (particularly those requiring a prolonged general anaesthetic), continuous administration of intravenous fluids and other medications, and continuous and complex monitoring of patients. Many referral hospitals have laboratory equipment on-site or nearby, allowing frequent and rapid laboratory evaluation (blood work) that is absolutely critical in managing very sick horses.

Most hospitals will have veterinarians who have expertise in a range of areas who can be consulted in the management of your horse. In our hospital, for example, both medicine and surgery specialists frequently evaluate the same horse.

Our hospital also has a group of highly trained nurses who work around the clock, and veterinarians who are continuously available to monitor and treat hospitalised horses, and this is a feature of many referral hospitals.

In addition to knowledge, skills and equipment, one of the most important commodities that specialists working in a hospital have is time. In our hospital, we will invariably spend hours systematically evaluating a case. This is simply often not possible in ambulatory general practice.

It is not always possible to get your horse to a referral hospital, but that doesn’t necessarily mean it can’t benefit from the expertise of a specialist. There are often specialist veterinarians who are able to travel to examine your horse with your regular veterinarian. Furthermore, most specialists are more than happy to discuss difficult cases with the attending veterinarian or horse owner.
Is referral medicine expensive?

The short answer to this question is, unfortunately, yes - referral medicine and surgery can be very expensive. There are a number of important reasons why this is so, but it is important to recognise that referral hospitals can also provide tremendous value for money.

At our hospital, we have state-of-the art equipment that is tremendously expensive to purchase and maintain. We also have a large facility that allows us to provide exceptional care for your horse and this too is very expensive to maintain. However, our greatest expense is the cost of providing, 24-hour, 7-days a week high-quality nursing and veterinary staff. This level of staffing is essential for the critically-ill cases that we see at our hospital, but can also be important in more routine cases.

Having said this, we recognise that referral might not be an option for some horse owners and most specialists are happy to discuss options to fit within a particular budget.


Conclusions

Specialist veterinarians have undergone years of rigorous training to develop expertise in their particular area of interest. They are often able to provide guidance in the diagnosis and management of cases that is beyond the capabilities of general practitioners.

Many veterinary specialists are based at referral hospitals that are able to offer horse owners a wide range of high quality services. Referral medicine can be expensive and this is important to consider when thinking about taking your animal to a specialist.

However, most specialists are more than happy to work with owners and their veterinarians to provide the best possible care for your horse.


Resident vet Poppy volunteers in Mongol Derby

Thursday, October 05, 2017
Poppy McGeown is an Equine Sports Medicine and Rehabilitation Resident at the U-Vet Werribee Equine Centre studying a specialisation course to deal with finely tuned athletes and try to assist them in optimising performance on a daily basis. She recently returned from Mongolia where she was one in nine veterinarians at the Mongol Derby, the longest horse race in the world, spanning 1000km across the steppe, 10 days and 28 horse stations. In Poppy’s story, she shares her experience of a new culture, meeting some of the most beautiful horses and purest people, learning to do more with less tools and stepping out of her comfort zone.


Rider training at start camp, standing next to me is Harry, a scottish vet who taught me pretty much everything for the race.
 
I am Poppy, a European veterinarian. I started working at the U-Vet Equine Centre in January 2017 as an Equine Sports Medicine and Rehabilitation resident. A specialisation path that is all about finely tuned equine athletes and performance. In August 2017, I set off to Asia for the first time to be a vet at the Mongol Derby. The Mongol Derby is a subtle concoction of adventure, open spaces and a zest of insanity. It is the longest horse race in the world. 1000km of open spaces, over 10 days, 28 horse stations and 42 of the craziest riders I have ever met.

I had applied for this job over Skype on a cold Christmas day from my family home in Belgium over two years ago. “It felt like a lifetime away”, I remember thinking to myself whilst staring at the Gobi Desert from my bunk bed on the Transmongol Express. Since then I had graduated from vet school, completed an internship, travelled the world for 6 months and started a clinical residency at the University of Melbourne which is long way from home.

Why would a vet want to go on the Mongol Derby? It is the ultimate experience for an equine veterinarian and there is simply nothing else like it. For the entirety of my short veterinary career I have been very lucky to work in university environments, where expertise, care and equipment are second to none. I have worked on big scale events before, like the Olympic Games and World Equestrian Games. Mongolia is a long way away from any of that and I knew it. That is what drew me, as the French poet Baudelaire would say “to the end of the unknown, to find the New”.

What do vets do on the Mongol Derby? The Mongol Derby is designed to mimic the postal system of Genghis Khan. Each rider has to ride through every single one of the 28 horse stations set 40km apart from each other. At each station they get off the horse and jump onto a fresh one and every time that happens there has to be a vet. Being a vet is only 30% of our job, yes we treat horses that require treatment and the vet checks them in and out and we are the watchers on the wall of their welfare, but we are also horse station managers, first aid providers, emergency responders, penalty givers, ground control and much more. Out on the steppe the crew and the logistics are put to the test. We are vets yet we are small actors of a much bigger picture.

The only thing that is predictable is that it will be unpredictable. In the land of ‘The Eternal Blue Sky’, anything can happen. Each vet is teamed up with an interpreter, a driver and a vehicle. When we first met, little did I know that these three elements were going to be the only constants for the following 10 days as everything else would change. As the head vet Emma Alsop told me, “less is more”, and this was true in every sense. We were well equipped; our truck full of generous supplies of basic veterinary equipment, food and water (and toilet paper!) – but we only took what we needed and worked with what we had.

There are nine vets on the team. We each head out to a different horse station, living and working with the local family there for the few days while we set the station up and see the riders through: finding, identifying and vetting the selected horses for the race, getting the horse station set up and ready for when the riders come in and then vet the riders in and out as they come. HQ instructed us to which horse station we need to head out next, sometimes leapfrogging more than 300km on dirt roads (if any roads at all).


© Julian Herbert. Traditional Mongolian dress.

Living alongside Mongolians and witnessing, being part of their everyday was an honour. They are a nomadic people that live off their livestock (horses, cattle, sheep and goats), they have little but give without counting and they smile all the time. We lived in ghers, drank lots of milk tea and ate lots of noodles (when I say lots, I mean lots). It is a formidable culture with many traditions and customs you have to learn quickly. They have a deep-rooted respect and understanding of their animals - we should all be taking a page from that book.

The Mongolian horses are something completely different from any other equid I have ever come across. Small and weighing probably around 300kg, they are semi-wild and hard as nails. They have nothing to envy of our (Australia’s) finest thoroughbreds or best bred showjumpers. Quintessentially primitive, they are capable of carrying heavy loads for hundreds of kilometres with minimal food and water. Paradoxically both beautifully trustworthy and unpredictable, physiologically fascinating, they are catalysts of emotions and thought for anybody who has the privilege of riding them or being around them.

The landscapes are soul wrenching, endless plains and rolling hills, persistent sun and unpredictable storms, we had it all. It echoes remoteness and reminds you that you are out there alone. The veterinary work was fascinating. We not only treated the racehorses but also, when possible, any animal presented to us by the locals.
When I told herders I was going to give their horse medication, the immediate question was always “injection?”. If so is the case, the entire population of the horse station gathered to watch me administer a simple intravenous injection. As soon as I finished, they bursted into laughter. I asked my interpreter why they were laughing and she said “oh they are just saying that you western vets are like magicians, they are very impressed you got into the vein so easily”. When doing a basic thing was perceived as semi-miracle, it was quite refreshing! I felt I was making a real difference here, more palpable in the steppe than in the comfort of our expensive stables.

We reached a point of the race where we were following a group of three riders in the mid pack that were too isolated from the leaders ahead of them and the followers behind them to warrant a vet waiting at each station. Our mission was to vet them out of a station, give them a 30 min head start and then head off on the road to reach the next station before them. This sounds easy, but in Mongolian terrain, horses are usually more efficient than motor vehicles. We spent days going through up to four stations a day. Opops my interpreter, Sambu my driver, the three riders we were following and the families that briefly welcomed us into their homes were the only people we saw for days. Constantly on the move we were lucky to go through nearly all the stations, witness the diversity of landscapes and live the race at the rhythm of the riders.


One of the last riders on the final leg of the race, sunset and all.

At horse station 24, nearing the end of the race we were lucky enough to stay for a few days, near a river. It gave us time to wash some clothes, wash ourselves, organise our kit, relax a little bit and catch up with some other members of the crew. It was also nice to get the chance to spend more time with the family that lived there. An old man made me the greatest gift a Mongolian can give: he gifted me a horse. It is regarded as the highest honour as their horses are their pride and joy and they only gift them to people that are “pure of heart” my interpreter explained. I am not sure about being pure of heart but I felt very honoured and promised I would return to visit my horse. Mongolians believe that the more good you give to people around you, the more good things will happen to you.

We departed for the final haul towards the finish line when we got a satellite call from HQ: one of the riders had hit their “SOS” button on their tracker. We were the closest crew to her and had to get there ASAP. The people who ride the Mongol Derby are pretty much insane and this rider we knew was a tough cookie. They all carry trackers and can either hit “help” – which is a non-emergency request for assistance or “SOS” meaning what it means and is dreaded by any crew member on the Derby. Luckily we were only 3km away from the GPS coordinates we were given by HQ and quickly found the rider laying on the ground and no horse in sight. She had sustained a fall, injuring her head and neck. Fortunately the stellar team of medics were on their way and the evacuation happened swiftly. We later learnt that no serious injuries were sustained by the rider and made our dash for the finish line.

Although we were not taking part of the race, crossing that finish line, there was a definite sense of exhilaration and achievement. What a journey it had been, after a good shower, a warm night in our gher and numerous vodka toasts the great Steppe Hustle was over. The motto that came back was “Courage is grace under pressure”. I am not sure about being graceful at any stage but it was definitely the adventure of a lifetime.


The on field crew for the Mongol Derby 2017, medics, field operators, referees, veterinarians, interpreters, HQ


































Colitis in Horses

Monday, July 24, 2017

What is Colitis?
The rapid onset of diarrhoea, with horses often being normal one day then becoming ill and passing watery diarrhoea the next. It is called Colitis as it is the large colon and/or caecum that is involved.

The large colon of horses is full of microorganisms that help the horse digest and absorb food. One type of bacteria has a toxin (endotoxin) attached to its cell wall. In the normal horse, this is not a problem but if there is compromise to the gut wall these bacteria and endotoxins are absorbed into the blood stream and can cause a massive inflammatory response (endotoxaemia) in other organs and tissues. The large colon of the horse is responsible for absorbing a large volume of fluid back into the circulation, so losses can quickly lead to severe dehydration.

Acute diarrhoea in horses can be life-threatening and requires immediate veterinary attention.

How do horses get Colitis?
Factors that are thought to predispose horses to acute diarrhea include stressful situations such as transportation, new environments, rapidly changed management, excessive grain engorgement and antibiotics. It is the overgrowth of bacteria and damage to the gut wall that leads to the diarrhoea and these horses quickly deteriorate.

What are the Signs and Symptoms of Colitis?

Horses that have developed acute diarrhea will often appear dull, have a high heart rate, injected gums, increased temperature and have signs of dehydration. These horses can also show signs of colic, often preceding the diarrhoea, but they might also remain uncomfortable throughout the disease. On a blood profile, these horses often have extremely low white cell counts and can also have signs of kidney damage due to the poor circulation to the kidneys.

How is Colitis Treated?
Treatment needs to be rapid these horses will often need large volumes of intravenous fluids to replace deficits and keep up with the losses in diarrhoea. Careful use of non-steroidal anti-inflammatory drugs such as flunixin is often used to provide pain relief and to reduce the effects of the endotoxin. Complications of Colitis include laminitis and therefore constant icing of the distal limbs and sole support is required until the endotoxaemia has resolved.

As the cause of the diarrhoea is often infectious, horses are required to be isolated and proper biosecurity protocols observed to avoid infection of other horses, as well as their handlers.

On a positive note, recovery and return to athletic function of these horses is usually very good, provided there has been no secondary effects such as laminitis or renal failure.

My Horse has been referred to U-Vet Equine Centre for Colitis, what do should I do next?
You can contact U-Vet Werribee Equine Centre on 03 9731 2268 and speak to one of our friendly receptionists who will make sure we have all the relevant information for your horse including your referring veterinarian details.

When you arrive with your horse it is important to leave your horse on the float and come see Equine Reception first. One of our dedicated Equine Nurses will then assist you to admit your horse into our isolation stables. As Colitis is often infectious it is important the correct biosecurity measures are taken. Once your horse has been admitted to hospital our team of Specialist Equine Medicine Veterinarians will be in regular contact with you and your referring veterinarian to work out the best plan of action for treatment. The U-Vet Werribee Equine Centre is a 24 hour hospital, while your horse is in hospital with us you can be assured they are receiving the best care and treatment available 24 hours of the day.     

Deworming Horses

Wednesday, June 14, 2017
Resistance of intestinal parasites in horses to commonly used dewormers is becoming increasingly recognised. Therefore deworming recommendations for adult horses have changed in recent years to reduce resistance of parasites to dewormers in our horses.

The main intestinal parasites of concern in horses are the small strongyles or cyathostomins. These recommendations are for cyathostomin control in ADULThorses; i.e. they DO NOT APPLY TO FOALS. Small strongyles cause disease because larval stages burrow into the wall of the colon where they form cysts around themselves and can remain dormant for extended periods of time. This can interfere with normal function of the colon, or if mass emergence of larvae from the cysts occurs severe colitis (diarrhoea) can result.

The main goals of a deworming strategy are to prevent parasitic disease by minimising pasture contamination with parasite eggs, and minimise the development of parasite resistance to dewormers.We can do this by reducing the numbers of eggs laid by adult worms, and also where possible removal of faeces from paddocks before eggs develop to infective larvae. The preservation of refugia (population of worms that have not developed resistance to dewormers) can be achieved by NOT deworming all horses. Selective deworming acknowledges that horses don’t need to be parasite-free in order to prevent clinical disease, and in fact, that achieving a parasite-free horse is neither possible nor desirable. It also considers egg reappearance periods (the length of time from deworming until eggs can be found in faeces again) in determining when and how often to use different anthelmintics.

This method relies on the identification of horses that are shedding large numbers of parasite eggs onto the pasture, as these horses are the main culprits contaminating the pasture for everyone. Only these individuals are dewormed, thus minimising pasture contamination. A faecal egg count (FEC) is performed on each horse at intervals according to the egg reappearance period of the dewormer being used, and horses are categorised as high shedders (those with a FEC of greater than 500 eggs per gram [EPG]), moderate shedders (200-500 EPG) and low shedders (FEC of less than 200 EPG). All the high shedders are selected for treatment. In some instances, some moderate shedders may also require treatment, for example if they are showing clinical signs of parasitic disease. Dewormers are selected based on an initial faecal egg count reduction test, which makes sure there isn’t already resistance to the dewormer selected, so we know it is effective.

What do you need to do?
  • Talk to your vet about starting a selective deworming program on your farm.
  • Perform faecal egg counts. Start by doing a faecal egg count reduction test (take a FEC, deworm your horse with the product you wish to use, then repeat the FEC in 14 days’ time). This will tell you if you have resistance to that particular dewormer. Faecal egg counts should then be repeated at regular intervals – talk to your vet about the egg reappearance period of your dewormer, most are around 8 weeks. 
  • When you get your FEC results, select the horses with high FECs (>500 EPG) for deworming. Talk to your vet about any horses that have a moderate (200-500 EPG) FEC about whether they should be dewormed as well.
  • Avoid using dewormers that target the encysted larvae, such as moxidectin, on a regular basis. These dewormers should be reserved for horses that need treatment for parasitic disease.
  • Keep pastures as clean as possible. It takes at least 2 days (longer in cold weather) for eggs to hatch and develop to infective larvae that horses ingest. This is an ideal window to remove faeces from paddocks if possible, which will go a long way to reducing the number of worm eggs and larvae on the pasture.
  • Once a year, preferably in autumn, all horses should be dewormed with a product containing praziquantel for possible tapeworm infections.
  • Tell your friends! This works best if everyone does it, so spread the word!

         

 

Behavioural Clinics

Thursday, October 06, 2016


Dr Andrew McLean is widely considered one of the leading academic experts on horse training. He is a winner of Australia’s highest science award, the Eureka Science Prize and in 2013 won the John H Daniels Fellowship to the USA sporting library and was instrumental in forming the International Society for Equitation Science, for which he is an Honorary Fellow. Andrew has written 5 books on horse training, including one academic text, Equitation Science. He has also made 5 contributions to The Encyclopaedia of Applied Animal Behaviour and Welfare and has authored and co-authored 36 papers for scientific journals.

Andrew has had a strong competitive career in horse sports spanning 25 years. In 1989, Andrew won Australia’s premier Horse Trials, the Gawler Three Day Event, and represented Australia in Horse Trials that year. In 1990 he was short-listed for the World Championships in Stockholm. In dressage he has competed to FEI level and trained horses to Grand Prix and he has trained and ridden to Grand Prix in Show-jumping. He has also held a race trainer’s license and has ridden in bareback races in Australia and New Zealand.

Andrew has been an equestrian coach for over 25 years and owing to his broad knowledge of equine psychology, has coached some of the world’s greatest riders, coaches and trainers and reformed internationally competitive horses up to Olympic Games and World Championship level, as well as some top Australian racehorses. Andrew is most widely known for his work in behaviour modification in sport horses and his development of the Australian Equine Behaviour Centre. In addition to training horses, Andrew has also developed successful foundation training programmes for working elephants implemented in Nepal, India, Thailand and Myanmar through his co-founded charity foundation, Human Elephant Learning Programs (HELP).

More information about Andrew’s training programs and the Australian Equine Behaviour Centre can be found here www.esi-education.com
If you would like further information about booking an appointment with Andrew, please call the Equine Centre on 03 9731 2268 during business hours.



Foaling Season Tips- U-Vet Equine Centre

Thursday, September 15, 2016

Foaling Season Tips

Foaling season is now in full swing and many of us are smiling as we watch happy healthy foals bouncing around the paddocks! Sadly not every foaling will go to plan and we have already had a number of sick foals in our hospital. Below are a few tips of what to look out for at this exciting but critical time of the year.  
The normal gestation period for horses is 340 days but mare’s can foal normally 1-2 weeks (or longer!) either side of this. Each mare tends to have the same gestational length each year and knowing this can help estimate the due date much more accurately for an individual mare. The mare’s udder begins to develop (‘bag up’) roughly 3-4 weeks prior to foaling and will ‘wax up’ (with a waxy deposit appearing on the teats) sometime between a couple of days and a few hours before foaling.

The foaling process itself can be broken down into 3 stages with mares often foaling in the early hours of the morning (much to the despair of those on foal watch!).

Stage 1, prior to delivery, the mare can appear restless, sweaty, urinate frequently, and show mild discomfort or colic. This stage can last up to 12 hours.

Stage 2 begins when the mare’s water breaks and the powerful waves of contractions that deliver the foal begin. The white amniotic sac should be seen within 5 minutes of the water breaking, followed by the front hooves and the muzzle. Stage 2 should last no longer than 20-30 minutes.

Stage 3 is the expulsion of the placenta (“afterbirth”). This should occur within 30 minutes to 3 hours of the foetus being delivered. If the placenta has not been expelled within this time-frame, you should contact a veterinarian immediately, as serious complications can occur in mares that retain their placenta. It is always good to assess the placenta for completeness to ensure none has been left behind as this too can lead to devastating problems for the mare.

For each of the three stages, if there are any signs of severe pain or haemorrhage or the stage lasts longer than normal, the mare should be carefully assessed as it may indicate a serious complication.

Following birth, the foal needs to be monitored closely to ensure that it is healthy and making appropriate progress. A normal foal will sit upright within the first few minutes after birth and should stand within 1 hour. The suckle reflex develops within 20 minutes and most normal foals will successfully nurse within 2 hours. Healthy foals should be bright and inquisitive and interact with the mare and surroundings. It can take more than 24 hours to pass meconium (first manure) and more than 12 hours to urinate for the first time. However, if there are any signs of abdominal discomfort (colic) or abdominal distension, a vet should be called to examine the foal as soon as possible.

When should you call a veterinarian?

A veterinarian should be called before the foal is born if:

  • the mare begins running or leaking milk (“premature lactation”) or the udder develops too early as this can indicate infection within the uterus
  • the mare experiences recurrent colic (abdominal pain) or serious disease during pregnancy
  • there is sudden abdominal enlargement
  • gestation is longer than usual
  • the mare is in poor body condition
  • there is inadequate udder development prior to the expected delivery date

A veterinarian should be called during foaling if:

  • the foal gets stuck in the birth canal (“dystocia”)
    - This is a real emergency and a veterinarian must be called immediately if the foal is to survive! 
  • a “red bag delivery” (premature placental separation) occurs.
    - In a Red Bag deliver, a red velvety tissue appears at the vulva instead of the normal white amniotic sac. In these situations, the foal must be delivered as quickly as possible so it can start breathing!
  • the foal or foetal fluids are stained with meconium
  • the placenta (“afterbirth”) appears abnormal or hasn’t been passed within 3 hours
    - You can also weigh the placenta - a placenta weighing more than 11% of the foal’s body weight or less than 8% is abnormal

A veterinarian should be called after foaling if the foal:

  • has not stood within 2 hours
  • has not nursed from the mare within 3 hours
  • shows signs of colic or abdominal discomfort or the abdomen becomes distended
  • has a reduced suckle or seems to have lost interest in nursing from the mare
  • is nursing less frequently or the mare’s udder appears full (squirting milk)
  • is sleeping more than normal
  • appears jaundiced (yellow discolouration of the gums and around the eyes)
  • has swollen joint or becomes lame
  • develops diarrhoea especially if the foal appears depressed or sick
  • has swelling, discharge or pain of the umbilicus (navel)
  • is not gaining weight and, especially, if it is losing weight
    - Thoroughbred sized foals should gain 1-1.5 kg daily
  • has a immunoglobulin G (IgG) concentration of less than 800 mg/dL at 24 hours of age
    - Most vets will be able to test this and this is part of the normal post-foal check performed by many veterinarians

 

Dummy Foal Treatment - U-Vet Equine Centre

Friday, February 26, 2016


Alice is a 2 week old Warmblood foal owned by Coldstream Park Warmblood Stud, she was foaled early in the morning of the 28th of January. Staff at the stud realised she wasn’t right when she was unable to stand, they immediately rushed the mare and foal to U-Vet Equine Centre, Werribee.

Alice went under the care of our specialist medicine team Dr Brett Tennent-Brown, Dr Jenny Bauquier, Dr Cristina Rosales and Dr Nick Bamford who diagnosed her with Neonatal Encephalopathy (Dummy Foal Syndrome).

Twenty four hour intensive care was required over the first 5 days of hospitalisation including turning her every 2 hours whilst in recumbency, assisting to stand, nutritional support via a nasogastric tube, intravenous fluid support, intranasal oxygen and antimicrobial therapy.



Alice improved slowly and by day 10 of hospitalisation she started to show normal behaviour and suckle from her dam.



Alice returned home to Coldstream Park Warmblood stud and was monitored closely by stud staff and her regular veterinarian at Yarra Ranges Animal Hospital.

Prompt recognition of symptoms of Neonatal Encephalopathy such as the inability to stand within an hour and the inability to nurse within 2 hours along with admission to a 24 hour emergency care hospital are essential factors in the survival of dummy foals.