Horse Health Lines - Fall 2019

HORSE

HEALTH LINES Veterinary Medical Centre

Western College of Veterinary Medicine FALL 2019

‘NO BAD HORSE’ Excelling at equine wound healing ‘HOLY GRAIL’ OF REPRODUCTION

Townsend

Equine

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Dr. Carmelle Huberdeau of Saint-Lazare, Man., with four-year-old gelding “Bucklee.” A 2019 WCVM graduate, Huberdeau now practises at a mixed animal practice in Russell, Man. Supplied photo

INSIDE 1 What did you do this summer?

Horse health questions were the focus of four research projects conducted by veterinary students this past spring and summer.

2 Excelling at equine wound healing

WCVM graduate student and resident Dr. Suzanne Mund is part of a collaborative research team exploring stem cells’ potential for helping wound healing in horses.

4 The ‘holy grail’ of equine reproduction

WCVM researcher Dr. Claire Card has received $140,000 in federal funding to address a knowledge gap in equine health: how maternal recognition of pregnancy works in horses.

6 ‘No bad horse’

Sue McDonnell has spent most of her career studying equine behavior traits and helping people understand why horses do what they do.

8 Equine case leads to published article

Alexandra Warren was working as a summer veterinary student at Winnipeg’s Elders Equine in 2018 when a unique case became the basis of her first journal publication.

10 From mentee to mentor

Former TEHRF research fellow and large animal internal medicine resident Dr. Valentina Ragno is now part of the WCVM’s equine clinical team.

12 Galloping Gazette

The latest equine news at the Western College of Veterinary Medicine.

Horse Health Lines is the news publication for the Western College of Veterinary Medicine’s Townsend Equine Health Research Fund (TEHRF). Visit tehrf.ca for more information. Send comments and article reprint requests to: Myrna MacDonald, Editor, Horse Health Lines WCVM, University of Saskatchewan 52 Campus Drive, Saskatoon, SK S7N 5B4 horse.health@usask.ca

Veterinary Medical Centre

SPECIAL THANKS to Rigel Smith of Regina, Sask. Rigel produced stories and photography for Horse Health Lines (Fall 2019) as part of her WCVM summer research communications internship.

On the COVER: WCVM equine surgical resident Dr. Suzanne Mund with “Tommy,” one of the WCVM’s teaching horses.

Rigel Smith

What did you do this summer?

About two dozen veterinary students spent the summer conducting research targeting health issues in various species — including horses.

By Rigel Smith

Mare and fetus: disconnect?

Second-year veterinary student Ashlyn Ketterer of Enderby, B.C., is working with Drs. Claire Card and Maria Lopez to study maternal recognition of pregnancy (MRP) in mares as a means of improving survival rates of unborn foals. About 15 per cent of pregnancies are lost in early stages, likely due to a disconnect in this MRP process.

The team believes that prostaglandin E, a compound involved in body processes, could be an important factor in understanding MRP. By gaining a stronger understanding of the MRP in mares, the team hopes their work will help to prevent early pregnancy loss.

Parasites in Sable Island horses

Brandi Bakken

Their work was part of the veterinary college’s Undergraduate Summer Research and Leadership program – an annual initiative that allows veterinary students and other University of Saskatchewan (USask) students an opportunity to gain hands-on research experience. The WCVM’s Interprovincial Undergraduate Student Research awards, Natural Sciences and Engineering Research Council of Canada (NSERC), Boehringer Ingelheim Veterinary Scholar program, USask and other agencies provide financial support for these positions.

Four students’ equine-focused projects covered potential options for improved breeding in mares, a parasite mystery among horses on Sable Island, and a congenital disease syndrome in foals.

Investigating a foal disease

Second-year veterinary student Brandi Bakken of Craik, Sask., helped Drs. Claire Card and Maria Lopez with their ongoing investigation of congenital hypothyroid dysmaturity syndrome (CHDS) in foals.

Dietary factors may cause some pregnant mares to be deficient in iodine — an essential nutrient in thyroid hormone development. If foals don’t receive enough iodine during fetal development, this can lead to CHDS. This summer, the team continued collecting milk and serum samples to examine iodine and thyroid hormone levels. The team also used ultrasonography to visualize and measure thyroid gland dimensions in mares and foals.

A better understanding of CHDS will lead to more effective intervention methods.

Third-year veterinary student Martha Smith of Jasper, Alta., spent her summer investigating the presence of lungworms in feral horses on Sable Island (300 kilometres from Halifax, N.S.). It’s the first time the lungworm Dictyocaulus arnfeildi has been found in the Sable Island horse population and the first documentation of this lungworm species in 40 years. Another peculiarity is in parasite transmission: it’s thought that the lungworm is transmitted through donkeys, but there are no donkeys on the island. While the lungworm isn’t life threatening, its presence in Sable Island horses provides an opportunity to study the parasite’s epidemiology.

Shooting for better breeding

Second-year veterinary student Angèle Lalonde of Saskatoon, Sask., is examining a new drug and its effects on uterine inflammation with theriogenologist Dr. Steve Manning and equine field service resident Dr. Lea Riddell. Uterine inflammation in horses, similar to endometriosis in women, is a common problem in mares that leads to increased difficulties in successful pregnancies. The new injection contains granulocyte-colony stimulating factor (G-CSF), a glycoprotein that increases the number of neutrophils (white blood cells) defending against infection. If this research eventually yields positive results, G-CSF would be a less invasive and less expensive option for treating susceptible mares.

Western College of Veterinary Medicine

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Dr. Suzanne Mund works with research team member Dr. Ali Honaramooz.

Christina Weese

Excelling at equine wound healing

By Rigel Smith

Managing wounds in horses is challenging for horse owners and veterinarians alike. In many cases, equine wounds are slow to heal with the potential for unsightly scars and the production of an excess amount of granulation tissue, commonly known as “proud flesh.”

For the past five years, researchers from the University of Saskatchewan (USask) have been working to determine whether stem cells can help enhance healing for equine wounds.

One team member is Dr. Suzanne Mund, a combined Master of Science candidate and large animal surgical resident at the Western College of Veterinary Medicine (WCVM). Her graduate supervisor, research mentor and the research project’s principal investigator is Dr. Spencer Barber — a WCVM specialist in equine surgery. He has conducted research, written book chapters and spoken at international meetings on equine wound healing for decades.

Barber and Mund are collaborating with WCVM researchers Drs. Ali 2

HORSE HEALTH LINES | Fall 2019

Honaramooz, Bruce Wobeser, Daniel MacPhee and John Campbell. These team members bring advanced and sophisticated technological skills and knowledge to the partnership.

Previous research has shown that there is a difference between leg and body wounds in horses, and between those of horses and ponies. This is believed to be attributed to the differences in inflammatory reaction.

Research in laboratory animals shows that stem cells can alter the inflammatory reaction. Based on these past findings, the WCVM team’s research focuses on differences in wound healing on the horse’s thorax (chest area) compared to equine limbs after stem cell administration.

“We know that in horses, if you take a wound that’s the same size on the leg versus on the body, the one on the leg is always going to heal much slower and it’s not going to be as nice a repair,” says Mund. “What we wanted to do was to give stem cells and see if it could enhance the rate and quality of healing.”

Putting stem cells to the test Stem cells have potential for improving wound healing because they can alter the inflammatory response, which may be important since the body’s healing response is linked to inflammation.

Stem cells can also replicate into cells of repair and produce growth factors that could enhance the speed and quality of wound healing.

The researchers used multipotent mesenchymal stromal cells, which can be easily extracted and are found throughout the body of adult horses.

This type of stem cell can differentiate into fat cells, cartilage cells and bone cells. They can also produce various proteins that affect the inflammatory reaction and enhance wound repair and wound closure rates. As well, the team decided to use allogenic stem cells (cells extracted from another horse).

As Mund explains, using stem cells derived from other horses could allow clinicians to treat a wound during acute inflammation when it may be most responsive to stem cell therapy. Waiting to grow stem cells from the patient may take too long, causing veterinarians to miss a “window of opportunity” for ideal treatment.

The team wanted to explore if stem cells would have a favourable effect on the wounds’ inflammation process. If they did, this would help to decrease abnormal inflammation that may be contributing to slow and irregular wound healing.

The researchers surgically made small skin wounds on the thorax and legs of horses involved in the study. Then, they administered stem cells through intravenous (IV) injection and monitored the horses to see if the cells would travel to the wound site and assist in healing.

“Most other studies have always used stem cells topically or injected them locally,” says Mund. “We gave our horses the most cells through IV that have ever been given to horses, by far. The other highest amount was 50 million, and we gave up to 250 million.”

As the wounds began to heal, the researchers continued to monitor the horses and collected biopsies from both the wounded and non-wounded sites to determine if the stem cells were gathering at the wounded area.

There are risks associated with administering foreign cells into a patient, so the researchers closely monitored the

horses after the stem cell treatments for any type of allergic reaction.

“The horses tolerated the cells really well, and we found that the cells did go to the wound site,” says Mund. She adds that no one studying equine wound healing has ever shown this outcome.

In September 2018, the research team published a secondary paper in the Journal of Equine Veterinary Science detailing their work in measuring the gene expression of five inflammation-associated proteins — CXCL8, CXCR2, CXCL10, CXCR3, and β-arrestin-2 — in equine wound tissue.

These proteins have been shown in other research animals to be critical in determining the inflammatory reaction, but they had never been identified in horse wounds before. Barber and Mund’s research team wanted to measure the gene expression of these proteins.

“We’re pretty proud that we were the first ones to do that,” says Mund.

The researchers discovered that gene expression is different for CXCL8, CXCR2, and β-arrestin-2 between limb and thorax wounds, but it remains the same for CXCL10 and CXCR3 proteins.

This finding could point to why wounds heal at different speeds in different locations. As well, their identification and the differences seen could open the door to further research in this area.

Mund says the most exciting part of the study was seeing the cells come alive.

“We tagged [the cells] with red fluorescent protein, and then we also transfected [tagged] them with a green fluorescent protein. So, red fluorescence seen when looking at a wound biopsy under the microscope would tell you that the cell made it to the wound site. But then once you start to see green fluorescence, that would tell you the cells were actually alive,” says Mund.

“We saw some green fluorescence on day two, but when you see it definitely on day seven — wow,” says Mund. “Those cells are actually alive, they’re not just dead cells that are stuck there.”

One Health link Mund says there’s significant interest in this research for human medicine.

Part of the research involves exuberant granulation tissue (an excessive amount of granulation tissue), which grows along the edges of a wound and blocks new, healthy skin from growing across it. This is like keloids (raised scars) that develop

in the skin of humans — the only other species to suffer from the disorder. Both are related to abnormal inflammatory responses.

“Human medicine has a lot of interest in using stem cells [for wound healing] too,” says Mund. “So, they’re really interested in seeing if this treatment can ‘reset’ the rampant granulation tissue.”

So far, the team has analyzed the data collected from the limbs of horses in the treatment and control groups. They found that stem cell therapy neither improved the speed nor the quality of the wounds’ healing.

Mund points out that negative results are significant, and the team plans to publish their findings once they complete their analysis.

“Publishing negative findings is incredibly important …. It’s putting a reality check on something that may not be the silver bullet that we always thought it was,” says Mund. “No one has done in horses what we have just done, so we have provided substantial information about the use of stem cells administered intravenously to horses as a foundation for further research by us or other researchers.

“Advances in medicine are usually small steps rather than gigantic steps — and our work definitively advances the field of equine wound healing.”

The study’s other highlights included the following: • Stem cells decreased inflammation during the early stages in healing.

While this finding didn’t make a long-term difference in this project, the study did show that stem cells can modify the inflammatory response at certain time periods. For optimal healing the inflammation needs to be high, while at other times during healing, it needs to be lower. Learning when and how to administer stem cells needs to be determined.

• Stem cell-treated horses had a decreased amount of new epithelium at the wound sites compared to horses in the control group, and a tendency to have increased wound contraction — suggesting that the stem cell-treated horses may potentially have smaller, less noticeable scars. This area needs further research.

Working on this project has helped Mund discover a love of immunology.

She’s also gained a respect for inflammation and its role in healing.

“I’ve learned that inflammation isn’t necessarily a bad thing. So, I don’t think we should always be so quick to stop inflammation — it’s there for a reason.

But we also have to balance the horse’s welfare at the same time.”

The Mark and Pat DuMont Equine Orthopedics Research Fund supported this research project, while the preliminary gene expression study and Mund’s salary are backed by the Townsend Equine Health Research Fund (TEHRF).

Rigel Smith

PROFILE Dr. Suzanne Mund Originally from MacNutt, Sask., Dr. Suzanne Mund was accepted in the WCVM’s Doctor of Veterinary Medicine program in 2009.

“When I talk to young vet hopefuls, I ask them if they’ve explored their other options because veterinary medicine is a long, hard road you must be passionate about,” says Mund, who graduated in 2013. “But when I look back at little old me, I was going to be a vet — there was no way you could have told me otherwise.”

Mund left Canada for an internship at Brandon Equine Medical Center, a busy equine practice in Tampa, Fla., then returned to the WCVM and began her graduate program in 2014.

Mund plans to defend her her MSc thesis in December 2019, and thanks to her research experiences, she’s considering PhD studies in immunology.

Western College of Veterinary Medicine

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equine reproduction

The ‘holy grail’ of

By Rigel Smith

Student researcher Ashlyn Ketterer and Dr. Claire Card work with mares involved in their reproduction study.

Rigel Smith

Imagine spending thousands of dollars and months of your time trying to breed your mare, only to find that she lost the pregnancy after just a few weeks. Now imagine if there was a way to prevent that disappointing outcome. How significant would that be?

For Dr. Claire Card, finding a way to avoid early embryonic death in horses would be remarkable — the highlight of her three-decade career in theriogenology (reproduction). It would also have a huge impact on the lives of her clients and other horse breeders around the world.

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HORSE HEALTH LINES | Fall 2019

“In horses, about 15 per cent of pregnancies are lost in the very early days and that causes a lot of economic loss for the industry — it has a big impact on people,” says Card, a professor and researcher in the WCVM Department of Large Animal Clinical Sciences.

Card is investigating the maternal recognition of pregnancy in horses, and her work focuses on understanding the pathway in which the equine embryo and its mother communicate during pregnancy.

The hope is that by understanding the process better, this knowledge will lead

to the development of new therapies to prevent equine pregnancy loss.

A grant from the WCVM’s Townsend Equine Health Research Fund (TEHRF) helped to support the early stages of the research work, which gave Card some initial data and findings to help attract additional funding. Now, through a new Natural Sciences and Engineering Research Council of Canada (NSERC) grant of $140,000 over five years, Card and her team can delve much deeper into the issue. “[With] food animal species, there’s been a huge amount of money poured into understanding pregnancy. Since horses aren’t considered food animals, they don’t have the same level of support,” says Card, who received the federal funding this spring.

“Our ability to get funding through a national organization like NSERC is really critical because it allows us to have not just a project, but to have a program.”

How do equine embryos ‘talk’?

During pregnancy, the embryo communicates with the mare and signals its presence in her uterus. In response, the mare releases progesterone, an essential hormone for pregnancy. Card and her team want to understand what the steps are between the embryo’s formation, its journey to the mare’s uterus, and its triggering of a signal to maintain the mother’s progesterone secretion.

“If we can really figure out the details of that and how that works, it would be an amazing contribution,” says Card. “We

Fund vital for attracting research dollars

believe it will be the pathway to understanding why mares lose pregnancies.”

A veterinarian can confirm whether a mare is pregnant as early as 11 to 16 days after insemination. A second pregnancy check is usually conducted around 25 to 35 days, and in some cases, that’s when veterinarians find that the embryo is no longer there, Card says.

She adds that horses are one of the only livestock species for which their early stages of pregnancy remain a mystery to researchers. Much of the existing research on the issue is based on comparing horses to pigs, cows and other livestock.

“In evolution many things are conserved …. But in maternal recognition of pregnancy, there are differences between the species,” says Card. “Pigs and ruminants are very, very distinct and we think that horses are yet a third category.”

Value-added research

Card says this research is crucial in advancing the horse industry, making horse ownership and breeding more effective and affordable.

“Some people describe figuring out this embryonic symbol as the ‘holy grail of equine reproduction’ because so many groups have attempted to unravel what’s actually happening and [they] have not been able to figure it out,” says Card.

Her research work also provides unique learning opportunities for veterinarians gaining specialized training at the WCVM as well as the college’s veterinary students — Western Canada’s future practitioners.

“We believe the public has fairly high expectations for graduates in terms of what they can do and how fast they can do things,” says Card. “By allowing students to participate in this kind of research, they really become much more proficient than your average [veterinary] graduate.”

Her research is also creating clinical tools that are used throughout North America and have helped many practitioners and horse owners.

But Card and her team aren’t the only ones trying to answer the same questions.

“It’s considered an area of concern to the industry and therefore many different groups have been working on it,” says Card. “We’re actually in competition with quite a number of other very high-profile groups.”

Card is confident her team has insight into the issue and hopes the new funding can allow them to find answers. However, she does note that some conditions — such as chromosomal abnormalities in foals — won’t be preventable.

Ultimately, Card says her research aims to help individual horse owners and breeders.

“Having been in animal reproduction for 27 years, early embryonic death is quite noticeable,” says Card. “We have so many clients that have had this experience. My interest is helping to address this gap in knowledge and to help our clients get more mares in foal.”

The WCVM’s Townsend Equine Health Research Fund (TEHRF) has been providing tremendous support to horse health research since 1977. Through the generosity of Western Canada’s horse industry, the fund annually invests over $100,000 in equine health research and training.

Dr. Claire Card’s research received a TEHRF grant in 2013 that spanned three years. Her research at that time was focused on evaluating the role of fatty acids in regulating reproductive processes, such as luteal function, which are important in the maternal recognition of pregnancy in mares.

Reports have shown that administering plant oils containing fatty acids into the uterus could be helpful in suppressing prostaglandin F2a (PF2a), a hormone that damages the corpus luteum. This structure releases the necessary pregnancy hormone — progesterone.

Card says that the initial grant from the WCVM’s 42-year-old horse health fund helped propel her research. In part, that earlier support also helped her team to be successful in obtaining federal research funding this spring.

“I believe that TEHRF funding is very essential to create the basic research for us to then move forward and to apply for bigger grants.”

Western College of Veterinary Medicine

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‘No bad horse’

By Rigel Smith

New Bolton Center’s semi-feral pony herd roam on 50 acres of pastureland in rural Pennsylvania.

Supplied

Unlike many who spend their careers working with horses, Sue McDonnell wasn’t always so keen on the equine species.

“I was familiar with horses and we always had horses, but it wasn’t really my sport or activity as a kid,” says McDonnell, who grew up on a dairy farm in rural Pennsylvania. “Training and showing cattle was my 4-H focus. I first got involved seriously with horses as a professional when I went to graduate school, and I did my research with them.”

She’s now surrounded by horses, both at work and home. Besides holding a master’s degree in psychology and a PhD degree in reproductive physiology and behavior, McDonnell is a board-certified applied animal behaviorist. She’s also an adjunct professor and founding head of the Equine Behavior Program and Research Laboratory at the University of Pennsylvania School of Veterinary Medicine’s (Penn Vet) New Bolton Center campus.

Much of what she has learned about the natural behavior of horses is based on her observations of a semi-feral pony herd at UPenn’s New Bolton Center. Members of the herd, which she established 25 years ago, are kept on about 50 acres of pasture land. The ponies aren’t handled, and they’re allowed to breed and socialize as they naturally would.

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HORSE HEALTH LINES | Fall 2019

McDonnell says observing semi-feral and feral herds has helped inform practices surrounding domestic horses. The New Bolton Center’s semi-feral herd draws people from around the world to study their behavior.

In the late 1980s, McDonnell learned about the value of simply observing and recording the behavior of horses after spending time watching pasture breeding horses with Western College of Veterinary Medicine (WCVM) researcher Dr. Frank Bristol at the Clements Ranch in Rossburn, Man. “Understanding the rhythm of how things go with horses is very valuable information,” says McDonnell. “A fair amount of compromised welfare can be attributed to people just not understanding [horses’] natural behavior.

“There’s no bad horse, there’s just less than ideal management.”

McDonnell’s role at Penn Vet’s New Bolton Center started as a researcher, but as the only person with formal training in animal behavior at the veterinary school, she soon found herself increasingly involved in behavioral cases.

“Until probably 10 years ago, most of the information put out about horses was not really correct, and there still is a segment of the industry where people will just sit down and write what amounts to fiction about what horses do,” says McDonnell.

She adds that until recently, even veterinarians with equine-focused practices had little training in animal behavior: “I would be asked to videotape a horse and give an opinion on what I thought was happening.

In many cases, [the veterinarians] weren’t sure whether there was a physical issue or just a misbehavior.”

McDonnell says this presented a void in veterinary teaching, which led to her founding Penn Vet’s equine behavior program.

“There, students learn what things could go wrong physically with the animal that would psychologically impair their function and may present itself as a behavior,” says McDonnell.

“Many times, the way we keep horses — and we think [it] is really state-of-the-art care — is actually not the best for them.”

While McDonnell teaches a wide variety of equine behavior traits, her true expertise is in stallion sexual behavior.

“Sometimes very valuable horses have difficulties transitioning from whatever career they had to breeding,” says McDonnell. “Often you can just manipulate their situation … to help them overcome their worries.”

Now, McDonnell works primarily with veterinarians and students to educate them about horse behaviors. She says even

Did you know?

The study of natural animal behavior is known as ethology.

It typically involves the study of animals under natural conditions and views behavior as an evolutionary trait. Ethology can be applied to things like human and animal therapy and wildlife studies that help to improve care for zoo animals.

Two foals in the New Bolton Center’s pony herd play together.

Supplied

simple things like the way a horse eats can have a substantial effect on their health and wellbeing. Unnatural eating behavior — such as chewing with their heads high rather than at ground level and standing still rather than moving while eating — can lead to colic, problematic dental wear and other serious conditions. It can also lead to a wide array of behavioral issues such as anxiety.

“They’re meant to be eating continuously … and they should be moving while they’re eating,” says McDonnell.

“Grazing animals evolved to be moving and to be eating with their head down, and so when they are eating out of a hay rack and their head is up … it disposes them to physical and behavior problems.”

McDonnell says it comes down to education.

“Everywhere you go, you see people doing what they think is right, but it’s not really the way you should actually do it,” says McDonnell. “It’s just a matter now of educating people.”

Rigel Smith is a fourth-year student at the University of Regina’s School of Journalism and was the 2019 summer research communications intern at the WCVM.

McDonnell part of Equine Expo In mid-February, Western Canadian horse owners will have the chance to meet Sue McDonnell and learn more about equine behavior during the 2020 Saskatchewan Equine Expo in Saskatoon, Sask.

The WCVM has invited McDonnell to visit Saskatoon for several educational events — including a public workshop on Friday, Feb. 14, at Prairieland Park.

During the two-hour session, McDonnell will cover the “top 10 things every horse owner should know about equine behavior,” along with other highlights based on three decades of observational research.

The certified applied animal behaviorist will use video clips from her extensive case library to demonstrate what works — and what doesn’t work — when it comes to interacting with horses. Her workshop will also include time for discussion and questions from the audience.

McDonnell’s presentation is a prime example of the Saskatchewan Equine Expo’s focus on public education and awareness — a key aspect of the annual event. Each year, the three partners

Supplied

behind Expo — Prairieland Park, Saskatchewan Horse Federation and WCVM — work with a volunteer committee to provide educational experiences in everything from horse training and riding disciplines to equine health and management.

While planning for the ninth annual Saskatchewan Equine Expo is still ongoing, organizers confirm that Alberta horse trainer Josh Nichol will be the show’s featured clinician. Based in Colinton, Alta., Nichol’s training methods rely on building a connection with horses, striving to understand their needs and empowering them to perform at peak capacity.

Saskatchewan Equine Expo takes place from Feb. 13 to 16, 2020, at Prairieland Park. Visit the show’s website (saskatchewanequineexpo.ca) where more details will be posted over the next few months.

Western College of Veterinary Medicine

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Veterinary student Alexandra Warren.

Equine case leads to published article

Christina Weese

When Alexandra Warren accepted a job at an equine veterinary clinic near Winnipeg, Man., last spring, the veterinary student didn’t expect the experience to include a shot at becoming a published author.

Warren’s research paper, titled “Equine sinonasal anaplastic sarcoma infected with multi-drug resistant Escherichia coli,” was based on a unique case seen at Elders Equine Clinic where she worked for four months.

The Canadian Veterinary Journal accepted her paper last fall and included it in the journal’s February 2019 issue.

The idea of writing a paper came from her supervisor, Dr. Chris Bell (WCVM ’06), a board-certified equine surgeon and the clinic’s owner. The case was a five-year-old Hanoverian mare that presented with a bulging mass on her face, which was causing inflammation and a snotty nose. Another veterinarian had prescribed antibiotics to resolve the issue, but medical treatment wasn’t working.

The Elders Equine veterinary team took radiographs of the horse’s head to find out more, and what they saw was concerning. “[We] found what looked like soft tissue present … a soft tissue growth,” says Warren, adding that the team decided to operate and try to remove the mass in the horse’s sinus-nasal cavity. Warren assisted Bell, who performed the surgery.

“It [the mass] was interesting because it was kind of bony, it was odd. Normally we expect it to be quite soft,” says Warren.

The growth was too extensive for Bell to remove entirely. The surgical team also discovered that completely removing the mass would cause serious damage to the horse’s airway. Because of these complications, the equine patient was humanely euthanized and the mass was sent for testing.

“When the pathologist’s report came back, the tumour that she [the mare] had was a sinonasal anaplastic sarcoma, and that is incredibly rare,” says Warren.

Bell encouraged Warren to write a case study about the unique case, and her work on the paper provided new learning opportuni8

HORSE HEALTH LINES | Fall 2019

By Rigel Smith

ties for the veterinary student. Not only did Warren gain experience in scientific writing, but the paper was a way to promote more thorough diagnostic testing for horses.

“We’re finding that we’re [veterinarians] missing these tumours, then they get to the point where they can’t be treated anymore because they’re just so extensive,” says Warren. “The research is starting to show that taking X-rays or even going as far as a CT scan (computed tomography scan) is becoming more prudent.”

While the final research article was published as a student paper and didn’t go through the journal’s peer-review process, Warren says it was still written just like any other scientific paper.

A year after working at Elders Equine, Warren is now in her fourth year at the Western College of Veterinary Medicine (WCVM). She spent part of this summer completing an externship at Arizona Equine Center in Gilbert, Ariz. — the same specialty practice where Bell worked as a clinical intern in 2007.

“The [United] States have a lot of really good equine hospitals, particularly with surgery. Canada does as well — they’re just not the same kind of experience,” says Warren, adding that the U.S. specialty practices have an increased number of equine cases.

She has a few more externship stops before returning to the WCVM for her final year.

“I’m really looking forward to the practical experience of fourth year, getting my hands dirty and getting to do a lot in equine,” says Warren, a lifelong horse lover.

“I started riding when I was about eight or nine,” says Warren, who grew up in Calgary, Alta. “I wanted to be a riding instructor … [but] at some point I was introduced to a veterinarian and I realized I could work with horses as a vet.”

Warren plans to follow her passion for horses after graduation, and her long-term career goal is to train and become a board-certified equine surgeon — just like Bell, her mentor.

“If I could purely work with horses every day that would be my happy place.”

In his youth on his family’s farm near Airdrie, Alta., where his parents stabled horses and taught dressage, Bell followed the local veterinarian whenever he made field calls. Those interactions sparked a curiosity that only swelled with the passing years, carrying forward into time volunteering with a Calgary equine practice during high school and on into his current role as owner of Elders Equine Veterinary Services in Winnipeg, Man. But to hear Bell describe the great, gentle beasts aloud, it’s clear his fascination with horses goes well beyond that of your average veterinarian.

“It’s amazing to see such a large body being supported by what look like four pretty spindly legs, and yet they are able to outrun a person and keep up with cars,” he says. “It’s wild. They’re very courageous, but they’re silent about it. They don’t come roaring over to you like a lion, and yet, they’re very powerful.”

Today Bell is a highly respected, board-certified equine surgeon working out of Winnipeg — the first person to fill such a position full time in Manitoba’s history. Bell completed his Doctor of Veterinary Medicine degree at the Western College of Veterinary Medicine (WCVM) in 2006 and then finished a one-year clinical internship at an equine referral clinic in Arizona. After completing a combined master’s degree-large animal surgical residency at the WCVM, Bell became owner of Elders Equine in 2012 after its founder, Dr. Norm Elder, retired.

Equine surgeon Dr. Chris Bell (WCVM ‘06).

The decision to specialize in surgery was made out of the immeSupplied photo diacy of the process, Bell says, explaining that he enjoys watching his decisive, concrete actions directly result in fuller animal and human happiness.

“I always liked the way you could see results to procedures right away, and that you were able to return sore horses back to health — just the expression on people’s faces when they saw their horse walk out of surgery and know that they were going to be able to get their friend back and get their horse back.”

As a veterinary student, Bell met students from other North American veterinary schools while completing externships in Canada and the United States. During his internship at Arizona Equine Medical and Surgical Center, he met his clinical mentor and further developed his clinical judgment. He also performed a magnetic resonance imaging study on equine feet and went on to publish his results in the Journal of the American Veterinary Medical Association (JAVMA).

All these experiences, he says, opened his eyes to just how deep the WCVM’s well of resources ran compared to other veterinary schools.

“To my surprise, they were at times under-prepared for the hands-on experience,” Bell says. “They had never done a rectal palpation of a horse, they had never tubed a horse — a lot of things that WCVM provides to our students just aren’t taught as well to veterinary students around North America, and it’s a major strength that we’re

By HenryTye Glazebrook actually able to give the hands-on training that the school does.”

Experiences like these are why Bell maintains a strong connection to his alma mater.

He’s an adjunct professor in the WCVM’s Department of Large Animal Clinical Sciences as well as a member of the Townsend Equine Health Research Fund’s board of directors. He also sits on the WCVM Advisory Council as a representative of the Manitoba Veterinary Medical Association, collaborates with WCVM colleagues on equine health research projects and welcomes senior veterinary students and residents to his practice for additional training and experience.

“I think the WCVM does a really great job, and I want to participate in helping to keep that really positive experience and the outstanding education going in the right direction for the students,” says Bell.

“WCVM are the ones who trained me, and I’ve always felt the need to give back.

Whether through my time or effort or through our donation dollars, I always want to try to give back to the college and keep it as strong and bright as it’s always been going forward.”

Bell’s

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There’s never been a time in Dr. Chris Bell’s life that he wasn’t surrounded by horses.

HenryTye Glazebrook is a freelance writer based in Vancouver, B.C. Western College of Veterinary Medicine

9

From mentee to mentor

By Rigel Smith

Rigel Smith

Dr. Valentina Ragno Canada wasn’t on the radar for Dr. Valentina Ragno when she started her career in veterinary medicine, but the new assistant professor at the Western College of Veterinary Medicine (WCVM) is happy she ended up in Saskatoon, Sask.

Born in Italy, Ragno completed her Doctor of Veterinary Medicine (DVM) at the University of Turin in 2012 and a sixmonth theriogenology internship at Italy’s largest standardbred breeding farm before travelling to Ireland and Texas for rotating internships at private equine hospitals.

Intrigued by North America’s model for veterinary specialty training, Ragno applied for residency opportunities overseas.

Success came in 2016 when the WCVM accepted Ragno for a combined Master of 10

HORSE HEALTH LINES | Fall 2019

Science-residency program in large animal internal medicine, under the supervision of Dr. Julia Montgomery.

As part of Ragno’s three-year program, she conducted research on equine metabolic syndrome (EMS) — a condition that causes an imbalance in a horse’s glucose and insulin metabolism. Her research was supported by the Townsend Equine Health Research Fund (TEHRF), which Ragno says was imperative to the study’s success. The equine fund’s fellowship program also covered her full tuition for two and half years.

Similar to pre-diabetes in humans, EMS can lead to excess weight gain in equine patients. Horses with EMS are also prone to developing laminitis — a painful foot disease that can lead to irreversible lameness.

“There’s a very complex process that happens in laminitis where these tissues that keep together the foot — the hoof

and the bony structures inside — become inflamed, and it’s very, very painful,” says Ragno. “This is now known to be caused by an imbalance in [the horse’s] glucose and insulin metabolism during EMS.” Ragno’s research focuses on finding biomarkers for EMS. If veterinarians could rely on specific biomarkers for early detection of this imbalance in a horse’s metabolism, immediate action could help prevent laminitis from developing in their patients — and save more horses’ lives.

While some lean horses can be affected

by EMS, the syndrome typically occurs in horses that are considered “easy keepers,” says Ragno.

“Horses that evolved to live in environments with not a lot of food can turn a little bit of dry grass into a lot of energy,” says Ragno. “Then we put them in our human-made environments where there is

very lush grass and we don’t exercise them that much and we feed them grains …. So, because their metabolism is too good, they just turn all of that [food] into excess fat.”

Ragno and the research team, led by Dr. Julia Montgomery, recruited horses from the Saskatoon area and divided them into testing groups. Through blood tests, the team found which horses were already resistant to insulin and which ones weren’t.

Then they conducted a series of blood tests to identify biomarkers that were different between the two groups.

Ragno says the mechanisms at play in the metabolic disease are still not completely understood and more research is needed.

Public perception of healthy body weight for horses and companion animals has changed in recent years, which makes early detection of EMS more challenging, says Ragno.

As she explains, veterinarians use a body condition scoring (BCS) system to evaluate horses’ weight. The system’s scale spans from one to nine, with one being under-

weight, five being ideal body condition, and nine being obese.

“It’s almost rare that we give a body condition score of five to horses that come through the clinic,” says Ragno. “Most of the time they’re over that. So, I think it’s [obesity] more common than people think.”

A previous WCVM study, led by Dr. Kate Robinson, investigated the prevalence of obesity in the Saskatoon area’s equine population. The researchers found that 20 per cent of the horses participating in the study were overweight, and eight per cent were obese.

Since EMS involves risk factors that predispose horses for laminitis, overweight horses are at greater risk for the painful disease.

“Laminitis is a huge welfare issue,” says Ragno. “We now know that in 90 per cent of [laminitis] cases where horses are brought into a referral clinic, the cause is of endocrine origin (EMS in two-thirds of these cases). If we could address and prevent that early on, [it] would save the lives of a lot of horses.”

After Ragno successfully defended her master’s thesis this spring, the WCVM hired her as an assistant professor of large animal internal medicine for a one-year term.

“It’s very exciting. A couple of weeks ago I was on that side of the desk, and now, I’m on this side of the desk,” says Ragno, gesturing across the room.

Her role will include clinical activities in the WCVM’s Veterinary Medical Centre, including senior veterinary student and house officer supervision, as well as classroom and lab teaching for veterinary students in the DVM program.

While she’s accustomed to working on cases in the Large Animal Clinic, Ragno is looking forward to developing her teaching skills during the academic year.

“I hope that I can be a good mentor to the new people that are coming … in the same way that Dr. Montgomery and others were to me.”

Dr. Tiago Afonso Another valuable addition to the WCVM’s equine clinical team is Dr. Tiago Afonso, assistant professor in the college’s Department of Large Animal Clinical Sciences.

Afonso is a member of the WCVM’s large animal internal medicine group, with his time split between clinical, teaching and research duties.

Before joining the WCVM’s faculty this spring, Afonso was a senior lecturer in equine internal medicine at New Zealand’s Massey University and at the University of Adelaide in Australia. He also worked during foaling season at a busy private practice in the state of Victoria, Australia.

After completing an integrated master’s (DVM) program at the University of Lisbon (Portugal), Afonso spent one year at Ghent University in Belgium as a large animal intern. His next move was to the Ontario Veterinary College (University of Guelph) for a one-year rotating internship in large animal medicine and surgery.

In 2016, Afonso completed his PhD degree (equine cardiology) and a threeyear residency at the University of Georgia.

During the same year, he also became a board-certified specialist in large animal medicine.

Supplied photo

Western College of Veterinary Medicine

11

BURWASH AWARD

TRAVELLING ROAD SHOW

Anna Henderson of Winnipeg, Man., has received the 2019 Shannon Burwash Award for Leadership and Excellence in Equine, Agri-Business and/or Agricultural Studies. The Western College of Veterinary Medicine (WCVM) veterinary student was selected to receive the $2,000 award that’s annually Anna Henderson presented to a student entering a more advanced academic year in any field of study with emphasis on horses, agriculture, agribusiness, animal health technology or equine veterinary medicine.

Henderson, who has BSc (Honours) and MSc degrees in chemistry, began her third year of veterinary studies in August.

She spent her summer break working at Elders Equine in Winnipeg, Man. Two cash awards are presented each year to western Canadian students in honour of Shannon Burwash, a dedicated horse enthusiast and member of Alberta’s quarter horse industry.

Burwash, who was married to Dr. Wayne Burwash (WCVM ‘69), died in 2013.

During the past 18 months, WCVM equine clinicians have enjoyed visiting members of the British Columbia horse community through Horse Council B.C.’s (HCBC) Community Talks Travelling Road Show. These popular, one-day events bring horse health and management information right to horse enthusiasts’ communities and provide the ideal chance for speakers and organizers to connect with horse owners of all ages. In 2018, Dr. Stephen Manning visited Prince George and Victoria while Dr. Julia Montgomery represented the college in Kelowna. Presentation topics included breeding and mare/foal care as well as equine obesity. Dr. Kate Robinson gave a presentation on hoof-foot care in the community of Nelson in May 2019, and this fall, WCVM’s Dr. Nora Chavarria visited Smithers in mid-September.

AAEP AWARD Alexandra Warren of Calgary, Alta., was among 36 North American veterinary students who received a 2019 Winner’s Circle Scholarship, co-sponsored by the American Association of Equine Practitioners’ Foundation, Platinum Performance and The Race for Education.

Warren, a fourth-year stuAlexandra Warren dent at the WCVM, has been an active volunteer for equine-focused events and served as president of the WCVM’s Student Chapter of the American Association of Equine Practitioners. During the summer of 2018, Warren worked at Elders Equine Clinic in Winnipeg, Man., and was an extern at Arizona Medical and Surgical Equine Center in Gilbert, Ariz., this summer.

The Winner’s Circle scholarships, worth $1,500 USD, help ease the financial burden of a veterinary education. Students are selected for the award based on their leadership roles and dedication to a future in equine health care.

12

HORSE HEALTH LINES | Fall 2019

Getting a leg up on equine nerve blocks When Angèle Lalonde wasn’t working on her equine reproduction research project this summer, the veterinary student was trying her hand at building a simulated equine limb.

“I have a strong interest in equine medicine, as well as anatomy,” says Lalonde, a second-year student at the WCVM. As well, Lalonde worked as a stable hand at a couple of Saskatoon-area equine farms during her high school and university years.

“I also enjoy crafting in my free time, so this project brought together several of my interests and presented a unique challenge.”

The summer side project came up because of a critical void in the world of veterinary simulation tools. So far, there’s no simulated teaching model on the market that’s capable of giving veterinary students a chance to gain realistic experience and practice in administering “nerve blocks” on a horse’s distal limb (lower leg).

During an equine lameness examination, veterinarians routinely use nerve blocks to determine the source of the lameness problem. By strategically injecting analgesic (pain-killing) medication into certain areas of the horse’s lower limb, a clinician can narrow down which structures are contributing to the animal’s lameness issue.

Dr. Chris Clark, associate dean academic, and Carolyn Cartwright, manager of WCVM’s BJ Hughes Centre for Clinical Learning, described their idea to Lalonde and set her up to work on building the limb with two other key team members. Anatomy technician Elizabeth Doerksen provided Lalonde with guidance on the equine limb, and lab technician Marta Van Camp assisted in developing the simulation model.

The result of their work is an equine limb, coated with several layers of silicone-based skin to help give a “realistic feel” to the limb’s tissue. Like the game of “Operation,” the limb is outfitted with electrical components and wiring so users get immediate feedback. If a student inserts the needle into the correct position, that action sets off a buzzer and light.

RESEARCH IN PRINT A round up of WCVM-related equine research articles that have been recently published in peer-reviewed journals Montgomery JB. “Beyond steroids and bronchodilators — investigating additional therapies for horses with severe equine asthma.” Veterinary Record. Aug. 2019.

185(5):140-142.

Veterinary students will use this teaching model to gain experience and confidence in performing equine nerve blocks before moving onto live animals, says Lalonde.

“Students will be able to palpate anatomical landmarks on the model to determine where to place the needle — similar to what they would do on a live horse,” she says.

Ragno VM, Zello GA, Klein CD, Montgomery JB. “From table to stable: a comparative review of selected aspects of human and equine metabolic syndrome.” Journal of Equine Veterinary Science. 79:131-138.

Fernandez NJ, Roy MF. “Do plasma protein:fibrinogen ratios in horses provide additional information compared with fibrinogen concentration alone?” Canadian Veterinary Journal. June 2019. 60(6):625-629.

Carmalt JL, Scansen BA. “Development of two surgical approaches to the pituitary gland in the horse.” Veterinary Quarterly. Dec. 2018. 38(1):21-27.

Mund SJK, Corbett C, MacPhee DJ, Campbell J, Honaramooz A, Wobeser B, Barber SM. “Identification of mRNA of the inflammation-associated proteins CXCL8, CXCR2, CXCL10, CXCR3, and β-Arrestin-2 in equine wounded cutaneous tissue: a preliminary study.” Journal of Equine Veterinary Science. Sept. 2018. 68:51-54.

Angèle Lalonde tests out the new equine simulated limb.

Rigel Smith

Western College of Veterinary Medicine

13

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