Equine Veterinary Practitioner_June_2020 by Equine Veterinary Practitioner

The

Equine Veterinary Practitioner

The Official Publication of the New Zealand Equine Veterinary Association

JUNE 2020 Vol. 45 No. 2

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CONTENTS

JUNE 2020 Page No.

Presidents Report

3-4

NZEVA Balance Sheet - 2019

NZEVA Profit and Loss - 2019

NZEVA Treasurer Report

NZEVA Grooms’ Scheme Subcommittee Report - 2020

Equine Health Association NZEVA Representative Report - 2020

8-9

NZEVA Equine Veterinary Practitioner Editorial Group Report - 2020

Equine Research Foundation NZEVA Representative Report - 2020

NZEVA Equine Dentistry Sub-Committee Report - 2020

NZEVA Endoscopy Subcommittee Report - 2020

NZEVA Racing Liaison Sub-Committee Report - 2020

14-15

NZEVA Medication Sub-Committee Report - 2020

Letter to the Editor

16-17

Editorial - June 2020

18-20

Equine Enteric Coronavirus in a Canterbury Pony JoAnna Faircloth

22-24

Let’s look at: Contagious Equine Metritis

Obituary - Charles Roberts

Invited Commentary: SARS-COV-2 and Animals. What do we know so far? Magda Dunowska

26-28

EquiManagement

Update on e-Learning Resources

30-31

New Zealand Thoroughbred Racing Welfare Update

EVP Educational Fund

How to treat complications of Castration in the field Tim G. Eastman

34-37

Medicine Corner - The Might Mast Cell Emma Gordon

39-40

Commissioned Article: Equinne Gastric Ulcer Syndrome [EGUS] in Adult Horses Part 1: Terminology, Diagnosis and Principles of Treatment. Ben Sykes

41-45

Havemeyer Foundation - Workshop on Acute Colitis

46-48

Vetlogic Puzzle

50 / 73

Drug Poser

50 / 56

AAEP 2019 State-of-the-Art Lecture: Fracture Repair Dean Richardson

Invited Comentary: What was learnt from the cluster of deaths at Santa Anita Racecourse - 2019? A threat to World TB racing? C. Wayne McIlwraith

52-55

Grayson-Jockey Club Research Foundation: Research Funding

57-58

US Thoroughbred Racing Economic Indicators: First Third, Jan - April 2020

The Don McLaren Fellowship Fund

Colleague Profile - Wallie Niederer

62-63

Stop Press

Useful Links

AVMA News

Massey Equine Homepage

71-72

BCET Free Webinars & Bulletins

International Forum for the Aftercare of Racehorses (IFAR)

MPI Quarterly Report Equine Cases

75-78

African Horse Sickness Spreads to Thailand

Poetry and Song Offering - Hello in There

Eq Vet Pract 2020 June; 45 (2) iii

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THE EQUINE VETERINARY PRACTITIONER

The Official Publication of the New Zealand Equine Veterinary Association EQUINE VETERINARY PRACTITIONER EDITORIAL GROUP Joe Mayhew (Editor)

2 Owen Road, Gisborne 4010 evp.editor@gmail.com

Mobile: 027 437 3651 Home: 06 927 7263

Erica Gee (Convenor)

e.k.gee@massey.ac.nz

Lucy Holdaway (Advertising Manager)

evp.advertisingmanager@gmail.com

Mobile: 027 541 1294

Lotte Cantley (Chair EVA Edu Comm)

Gareth Fitch

Emma Gordon

Angela Hawker

Barbara Hunter

Rabecca McKenzie

Katie McKinlay

Luca Panizzi

Tim Pearce

Trish Pearce

Andrea Ritmeester (NZEVA Executive Rep)

Lucy Russell (Secretary)

HOW TO SUBMIT PAPERS FOR PUBLICATION Papers for publication in The Equine Veterinary Practitioner (EVP) should be sent to the Editor in electronic form. Authors are requested to follow the usual EVP format for the front page of a paper including name(s) and address and email for contact author. The Editor must be made aware of any copyright matters and any appropriate acknowledgments.

HOW TO SUBMIT ADVERTISEMENTS Application files should be supplied in high resolution with 3mm bleed in pdf format on CD, USB stick or e-mail to the Advertising Manager, Dr. Lucy Holdaway (evp.advertisingmanager@gmail.com). Please ensure no other files are also provided.

DISCLAIMER “The Equine Veterinary Practitioner” is published by the NZ Equine Veterinary Association (NZEVA) a branch of the NZ Veterinary Association Incorporated (NZVA). The views expressed in the articles and letters do not necessarily represent those of the editorial committee of the NZEVA, the NZEVA executive or the NZVA, and neither NZEVA nor the editor endorses any products or services advertised. NZEVA is not the source of the information reproduced in this publication and has not independently verified the veracity of the information. It does not accept legal responsibility for the truth or accuracy of the information contained herein. Neither NZEVA nor the editor accepts any responsibility whatsoever for the contents of this publication or for any consequences that may result from the use of any information contained herein or advice given herein. The provision is intended to exclude the NZEVA, the NZVA, the editor and the staff from all liability whatsoever, including liability for negligence in the publication or reproduction of the materials set out herein.

COVER PICTURE – BISCUIT is browsing the orchard only to find the kunekune piglets have beaten him to the autumn fruit. Kunekune [‘fat and round’ in te reo Maori] pigs were probably brought to New Zealand in the 1800’s by whalers and were traded with Maori. Pigs with similar characteristics occur in Asia, South America and the Polynesian Islands, but the resemblance is slight and suggestive only of a possible common ancestry. The typical Kunekune nature is of a sociable placid pig that likes close human contact and it has found a place in New Zealand as a pet pig.

https://kunekune.co.nz/ Photo Credit: Alexandra Tresta Photography

https://www.facebook.com/alexandratresta/

The EVP Editorial Group would like to invite NZEVA members contribute to the photographic art we display on the front covers, so please feel free to send ny potential photos to evp.editor@gmail.com. These may be of an artistic, clinical, industry, social or humorous theme as long as they relate to Equidae. We may even spring for a prize for best contribution each year! So get your cameras out, scrutinise your hard disks and contribute.

www.wvac2020.com

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of a mare’s reproduction cycle Whether the need is to schedule oestrus and breeding, suppress the mare’s heat cycle or induce ovulation in mares, Dechra’s equine reproduction products are proven and reliable.

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vi Eq Vet Pract 2020, June; 45 (2)

Visit our website

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NZ EQUINE VETERINARY ASSOCIATION EXECUTIVE COMMITTEE Andrea Ritmeester (President)

nzevapresident@gmail.com

027 575 4272

Alex Leander (Secretary)

nzevasecretary@gmail.com

021 179 1126

Roisin McQuillan (Treasurer)

Marcus Allan

Leigh DeClifford

Rob Hitchcock (Vice President)

Alanna Zantingh

Greg Quinn

YOUR NZEVA CONTACT PEOPLE Continuing Education

Charlotte Cantley charlotte.cantley@vets.org.nz

Dentistry

Katie Kindleysides katiekindleysides@gmail.com Glenn Beeman mountainviewequinenz@gmail.com

Endoscopy

Ivan Bridge ivan@vetassociates.co.nz

EVP Journal

Erica Gee e.k.gee@massey.ac.nz

Farriers

Tim Montgomery temonties@xtra.co.nz

Grooms Scheme

Ivan Bridge ivan@vetassociates.co.nz

Insurance

Brendon Bell brendon@southernvets.co.nz

Medication

Andrew Grierson andrew@aucklandvets.co.nz

Radiography

Alec Jorgenson ajorgi@yahoo.co.uk

Website

Tim Montgomery temonties@xtra.co.nz

Young Members

Lauren Kubala lauren@vetassociates.co.nz

LIAISON WITH NZ Equine Health Association

Ivan Bridge ivan@vetassociates.co.nz

NZ Equine Research Foundation

Noel Power noel.a.power@gmail.com

Racing Authorities

Andrew Grierson andrew@aucklandvetcentre.com

Sport Horse

Celia Grant vet@helpmyhorse.co.nz

Eq Vet Pract 2020 June; 45 (2) vii

NEW ZEALAND EQUINE RESEARCH FOUNDATION

VETERINARY SCHOLARSHIPS AND GRANTS http://www.nzerf.co.nz/ TRAVEL AWARDS For any travel relating to research and development in the NZ horse industry. http://www.nzerf.co.nz/travel_awards

APPLICATIONS RECEIVED ANY TIME VETERINARIAN – FARRIER SCHOLARSHIPS $3,000 for a veterinarian and a farrier to attend a suitable course or symposium and/or spend time with colleagues in the USA http://www.nzerf.co.nz/travel_awards

CLOSES 30TH NOVEMBER ANNUALLY YOUNG ACHIEVER AWARD $15,000 available annually to assist an individual under the age of 35 in their career in the equine industry http://www.nzerf.co.nz/young_achiever

CLOSES 31ST OCTOBER ANNUALLY JONATHAN HOPE EQUINE VETERINARIAN SCHOLARSHIP $10,000 available annually to help a “young at heart” New Zealand-based veterinarian to travel and gain practical skills that will be valuable in supporting his or her work within the NZ horse industry. http://www.nzerf.co.nz/hope_scholarship

CLOSES 31ST OCTOBER ANNUALLY EQUINE RESEARCH GRANTS Applications from interested people for funding or projects in the field of equine research. http://www.nzerf.co.nz/research_grants

CLOSES 30TH APRIL ANNUALLY APPLICANTS SHOULD APPLY IN WRITING/EMAIL TO: The Secretary, NZ Equine Research Foundation, P O Box 52, Palmerston North Email allan.fenwick@xtra.co.nz

See the latest NZERF bulletin here

2 Eq Vet Pract 2020, June; 45 (2)

PRESIDENT’S REPORT - JUNE 2020 Andrea Ritmeester, NZEVA President nzevapresident@gmail.com

Well, these are strange times indeed! When I wrote my last president’s report in early February, I never would have guessed that three months later the entire world would have been turned upside down. COVID-19 has swept around the globe and has affected everyone in its path. The NZVA was given 48 hours to prepare a submission to Government that veterinarians should be classified as essential workers during lock-down and draft a proposal as to how we would work in a way that would not risk transmitting the virus. Fortunately, with our training in disease management, the veterinary profession was well equipped to rise to the challenge and the last 6 weeks have proven just how resilient and versatile veterinarians are. As the country hunkered down, veterinarians switched to emergency-only mode, finding ways to continue to deliver their services to clients in a contact-less way. Unfortunately, because of the routine nature of the bulk of our work at this time of year and the complete cessation of all equine sports, equine veterinarians have been among the hardest-hit financially by the level-4 lock down. We can only hope that all the sacrifices pay off and the situation continues to improve so we can move rapidly back through the alert levels towards the new normal, whatever that may look like.

2020 CONFERENCE Unfortunately, New Zealand’s chance to host the 2020 World Veterinary Association Congress was scuppered by the COVID-19 pandemic, with the Government’s rapid move to level-4 lock-down resulting in cancellation of the congress that was due to be held in Auckland in early April. However, out of adversity comes innovation and the NZVA has been able to partner with The Webinar Vet to deliver an international on-line festival of veterinary learning that started on 25 April to coincide with World Veterinary Day. There are over 100 hours of CPD across a mixture of live and recorded lectures that can be enjoyed from the comfort of your own home. As well as lectures by Chris Pearce (European Registered Specialist in Equine Dentistry and founder of the Equine Dental Clinic in the UK) and Cristy Secombe (Associate Professor and Registered Specialist in Equine Medicine at Murdoch University), there will be a number of talks by Debbie Archer (Professor of Equine Surgery at Liverpool University with a special interest in soft tissue surgery and the epidemiology of equine colic). There is also a strong focus on equine welfare, with a

wide variety of talks by several specialists in this field. A reminder that all hours in the online WVAC will earn CPD points as required by the NZ Veterinary Council, so get registered! We are also running the poster session on-line as part of the virtual congress, and participants will be eligible for the Massey University prizes for best NZ Practitioner’s Poster (equivalent to the best practitioner’s paper prize we usually present) and best Overall Poster, which includes international entrants. The NZEVA Gala Dinner has been postponed until later in the year when we will (hopefully!) be able to congregate again. It will very likely be held in the Waikato region in July or August in conjunction with the NZEVA AGM. This is always a great night out, with good food, live music and the presentation of the poster awards, the Jonathan Hope Prize for best publication by an equine practitioner and, of course, the Brian Goulden Prize for an outstanding NZ equine veterinarian. We’ll keep you posted!

AGM With the cancellation of the World Veterinary Congress we were unable to have the NZEVA AGM as scheduled; as I have already alluded to we will endeavour to have it a little later in the year in conjunction with the Gala dinner to celebrate being able to socialise again! Once a date has been finalised the agenda, previous minutes and financial reports will be circulated via e-mail 30 days prior. Please try to attend the AGM if possible, to support the executive and have your say on the future direction of the NZEVA!

RESTRUCTURING THE NZEVA EXECUTIVE We are still looking for nominations for new committee members, with the aim to replace 4 members of current committee at the AGM later in the year. If there are more than 4 nominations, there will be a ballot. Anyone interested in being on the NZEVA executive committee please contact the secretary at nzevasecretary@gmail.com or myself.

2021 CONFERENCE At this stage we are still aiming to hold the 2021 NZEVA conference in Christchurch on 22-24 June, with the VetPD Workshop 25th June 2021. Topics will include anaesthesiology, biomechanics and equine sports

Eq Vet Pract 2020 June; 45 (2) 3

medicine/rehabilitation. We will also be bringing back the Practitioner’s Papers and the “How-to” sessions in a separate stream alongside the main speakers.

UPPER AIRWAY ENDOSCOPY ROADSHOW Unfortunately, the upper airway endoscopy roadshow planned for early May 2020 had to be cancelled due to COVID-19. We are looking into presenting this course online soon, with recorded lectures from Dr Brian Anderson and myself featuring video footage of the main upper airway disorders commonly encountered in equine athletes. Again, we will keep you posted!

CASUALTY MANAGEMENT COURSE The on-line portion of the casualty management course for veterinarians at races or equestrian events is still on target to be run in early August 2020. This course will look at common problems and emergencies encountered at races and equestrian events, and the responsibilities of the duty veterinarian in dealing with these. The 1-day practical workshop portion of the course is on hold at this stage, but we hope to be able to offer this to the participants of the on-line course at some point in the future.

advocate “best practice”. Clients must be educated that pulling teeth (including wolf teeth!) is a painful procedure and the pain relief provided should at a minimum be adequate sedation (including the analgesic butorphanol) and ideally should also include local anaesthesia of the tooth just like a human dentist would provide. As veterinarians we must strive to provide the highest level of care and welfare available; this is what sets us apart from non-veterinary equine dental providers. Remember that it is our role as veterinarians to educate clients regarding the upcoming new regulations, and to be aware of our obligations under the Veterinary Code of Professional Conduct when we are working with, sedating for, or delegating equine dental procedures to non-veterinary persons.

EQUINE VETERINARY PRACTITIONER You are now all receiving the electronic version of the EVP rather than a printed hard copy. Remember there is an option to purchase a printed copy of the EVP for 2020 by going to the NZVA on-line shop. You can order all 4 copies of the EVP for 2020 in print for a fee of $45. Enjoy this edition of EVP, stay safe and be kind.

EQUINE DENTISTRY UPDATE

Regards,

On 12 May 2020 the Ministry for Primary Industries (MPI) announced that due to the COVID-19 pandemic it is delaying the commencement of the proposed changes to the Animal Welfare Act 1999 which were due to come into effect on May 9. The most significant change for veterinarians is the replacement of Section 16 with new criteria to define “significant surgical procedures”. Therefore, the new animal welfare regulations relating to equine dentistry will now come into effect on 9 May 2021. That means that from May 2021 a competent (non-veterinary) person can float teeth and remove loose deciduous teeth (i.e. baby teeth or caps) without a requirement to provide pain relief and without restrictions on the use of tools. A competent (nonveterinary) person is also able to extract wolf teeth (first pre-molars); however, pain relief must be provided to the horse at the time of the procedure. The extraction of all other teeth (i.e. all teeth other than wolf teeth and loose deciduous teeth) may only be performed by a veterinarian and pain relief must be used at the time of the procedure. The owner and/or person in charge of the horse must not allow any tooth extractions to be undertaken except in accordance with the clauses above. Breaching these regulations will be an offence and can result in a criminal conviction incurring a maximum penalty of $3,000 for an individual and $15,000 for a body corporate.

Andrea Ritmeester

As the type of pain relief that needs to be provided to extract wolf teeth is not specified by the Government, the NZEVA feels that this is a great opportunity for veterinarians to

4 Eq Vet Pract 2020, June; 45 (2)

nzevapresident@gmail.com

YOUR CHANCE TO WIN $150.00! All you must do is write a clinical report of about 1500 words that is published in the EVP, and your contribution may be eligible for one of several prizes of $150.00 that the EVP has available each year. The EVP Editorial Group wish to promote the sharing of your interesting cases and practice tips with the wider equine veterinary community, so please contribute. Every case, technique, test and interpretation are different, no matter how experienced we are or how routine the case is, so there is always something for us to learn from each other. Take photos, dig out your diaries, get keyboard tapping and share your views with colleagues. You could be $150.00 richer for it! Please send your clinical reports to the EVP Editor, Joe Mayhew, at evp.editor@gmail.com for consideration. Joe would also be happy chat with you about any articles or ideas you might have. Please phone him on 027 437 3651.

NZEVA BALANCE SHEET - 2019

New Zealand Equine Veterinary Association Balance Sheet As at 31 December 2019 31 Dec 2019

31 Dec 2018

0 0 18,086 27,481 5,009 104,751 111,758 140,516 407,602

5,082 15,806 0 0 69,461 40,413 107,990 133,644 372,396

3,700 1,735 0 38,111 783 583 44,912

0 4,541 20,681 52,131 0 4,052 81,405

452,514

453,801

8,166 293 4,933 13,392

1,950 -3,023 5,833 4,760

13,392

4,760

Net Assets

439,123

449,041

Equity Current Year Earnings Don McLaren Jonathan Hope Retained Earnings Total Equity

-14,178 9,130 4,259 439,911 439,123

1,286 9,130 0 438,625 449,041

Assets Bank BNZ - Newsletter Account BNZ Newsletter on Call account EVP Continuing Education Fund EVP Newsletter Westpac Bank Westpac Online Saver Account Westpac Term Deposit 25 Westpac Term deposit 26 Total Bank Current Assets Accounts Receivable Accrued Interest Newsletter BNZ Term Deposit 03002 Newsletter BNZ Term Deposits Prepayments Sundry Debtors Total Current Assets Total Assets Liabilities Current Liabilities Accounts Payable GST Sundry Creditors Total Current Liabilities Total Liabilities

Eq Vet Pract 2020 June; 45 (2) 5

NZEVA PROFIT & LOSS - 2019

New Zealand Equine Veterinary Association Profit and Loss For the 12 months ended 31 December 2019 Dec-19

Dec-18

Income Newsletter - Advertising Newsletter - Donations Newsletter - interest Sponsorship/Grants Total Income

37,959 0 1,926 12,383 52,268

57,378 5,000 2,544 8,000 72,922

Less Cost of Sales Newsletter - Advertising Commissions Newsletter Editor Salary Newsletter General Expenses Newsletter Production Expenses - Printing, Postage etc Total Cost of Sales

7,019 30,000 5,581 19,370 61,971

8,352 30,000 5,926 32,332 76,610

Gross Profit

-9,703

-3,688

Plus Other Income Conference Income Interest Income NZEVA Subscriptions Total Other Income

29,535 8,255 25,424 63,215

13,750 8,459 28,751 50,961

Less Operating Expenses Accounting Fee - Administration Advertising and promotions Attendance Fees Bank Fees and charges Committee Expenses Computer Expenses Conference Expenses Continuing Education Donation Expense General Expenses Grants/Sponsorship/Projects Newsletter - Honorarium Prizes & Scholarship Special Topics Expenses Travel - Committee Travel Other Total Operating Expenses

540 0 133 53 4,765 69 15,722 0 27,000 0 8,125 0 2,600 2,908 4,306 1,469 67,690

582 9,922 0 0 2,574 0 16,676 5,684 0 2,292 3,196 400 540 0 2,603 1,519 45,987

-14,178

1,286

Net Profit

6 Eq Vet Pract 2020, June; 45 (2)

NZEVA TREASURER REPORT – 2019

Following discussions with EVP and NZVA it was decided that all NZEVA (including EVP) financial processing will be done through NZVA. This significantly reduces the workload on the treasurer and ensures that the finances are managed properly by a professional accountant who can ensure compliance on taxation issues and give financial advice when needed. All EVP and NZEVA invoices are now forwarded to the NZVA accounting department for processing. All payments from the accounts continue to require authorisation by either the NZEVA president or treasurer. There are separate bank accounts for NZEVA and EVP, but they are now all located at Westpac bank except for a couple of Term Deposits which remain at BNZ and will be transferred to Westpac at maturity. Going forward the EVP and NZEVA will receive monthly and annual financial reports from the NZVA.

COMMENTARY ON ANNUAL RESULT The production costs of the Equine newsletter have been reduced significantly (40%) from 2018. However, the reduction in advertising revenue (34%) from 2018 has meant the newsletter is being subsidised more by Other Income than it was in 2018. The donations totalling $27,000 ($25,000 to the New Zealand Horse Ambulance Trust and $2,000 to Catwalk Fundraising) has meant the New Zealand Equine Veterinary Association has run at a lost for the 2019 financial year. The significant level of Retained Earnings has meant the Associations Balance Sheet remains strong although they have reduced from $439,911 in 2018 to $425,733, reflecting the loss of $14,178. Roisin McQuillan NZEVA Treasurer

NZEVA GROOMS’ SCHEME SUBCOMMITTEE REPORT – 2020 Ivan Bridges - Convenor

Little has changed since my last report. I have taken my concerns regarding the Veterinary Operating Instruction (VOI) to the NZVA Chief Veterinary Officer and have been assured that there is no intention to undermine any of the intent of the Groom’s Scheme. This assurance came with recognition that the Scheme is both required and needs to be robust. We hopefully can progress this through to a practical and useful outcome. I have also documented concerns to MPI Exports re the worthy Guidance Document for Travel of Horses by Air, which originally carried some urgency, but never has been ratified although completed and passed through numerous MPI staff members. This guidance document as I have

previously mentioned is the result of many hours of work over a number of years led by MPI, where agreement was successfully reached by all industry participants, certainly a challenge and thus was considered a milestone at the time. This document although not legislative provides an accepted standard to be used as a guide and for MPI Verification Agency to use as a minimum standard. I have been informed that it is intended without a time frame that there will be a guidance document published this year. I have described in much detail in many previous reports the details and history of the scheme and this year will avoid repetition.

Eq Vet Pract 2020 June; 45 (2) 7

EQUINE HEALTH ASSOCIATION NZEVA REPRESENTATIVE REPORT – 2020 Ivan Bridge, Chairman EHA

As always, the EHA have several initiatives in various stages of fruition. My report for a number of years has documented the progress on both required Environmental Protection Authority registration change and ACVM regulatory usage change of the genetically modified Equine Influenza vaccine Proteqflu™. This was necessary to allow its routine use on horses to be exported where EI vaccination is a requirement of the importing country. As a form of reminder this will facilitate a bank of vaccine being held within NZ where it can be readily deployed if required under emergency conditions in the event of an EI incursion. It is very pleasing to be able to report that these various requirements are all but met. The plan is that the EHA will buy and distribute the vaccine and we are very grateful to Dr Andrew Grierson for his offer to store the vaccine in his recognised Takanini storage facility for no charge. A contract has been prepared by the Boehringer Ingelheim legal team which is being discussed by the EHA at present and will hopefully be signed in the very near future. Once signed, all impediments for the import of the vaccine are solved. The distribution and use under ACVM regulation however require education of those veterinarians involved in the requirements of storage, use, disposal, record keeping etc. of the vaccine. It is anticipated that the simplest method of fulfilling this ACVM requirement will be for Andrew Grierson and myself to visit the practices involved and go through the protocols. On satisfaction of this requirement the vaccine will be ready for use. It appears that Zoetis have approximately a six months requirement of the presently used killed vaccine in their NZ stocks, thus the timing allowing for a short overlap is expected to work well. It was reassuring to recently receive endorsement from Professor James Gilkerson that this EHA initiative is very sound. Professor Gilkerson, an internationally respected virologist, is Professor of Veterinary Microbiology & Director of the Centre for Equine Infectious Disease at Melbourne University, a Past President of Australian Equine Veterinarians and was very involved in an advisory capacity during the Australian EI incursion.

8 Eq Vet Pract 2020, June; 45 (2)

During the year the Live Equine Import Health Standard (IHS) and the IHS for Semen and Embryos for equids along with the associated Risk Management proposal and Guidance Document were released for consultation. The EHA felt these were critically important documents for our biosecurity and thus commissioned experts in the field to give independent opinion on the relevance and efficiency of the tests required by the OIE standard. The opinion garnered on both these documents assisted in preparation of our submission back to MPI. I mentioned in last year’s report that the next challenge to be confronted and resolved by the EHA was the concept of an industry levy. At the time of signing the GIA in 2015 the NZ Racing Board (NZRB) agreed to provide a provisional underwrite which satisfied the funding requirement. This of course could always only be a temporary fix, now with the formation of the Racing Industry Transition Authority (RITA) and a restructure of the NZRB by July 2020 an industry levy is more urgently required. Levy funding will provide a buffer and a means to pay the share of readiness activities and repay the share of any Government loans created during a hopefully unlikely but potential exotic disease response. There has been much discussion for some years over a fair means of creating a levy that reaches all industry participants, is easy and efficient to collect, practically is worthwhile and ultimately will be accepted as fair and reasonable by Government. Ideas such as a levy on anthelmintics, vaccines, feed and horseshoes have been discussed but dismissed as being impractical for a number of reasons. The proposal that a levy be placed on the import and export of horses and germplasm (semen & embryos) was prepared and distributed to industry for comment. Justification for this is twofold. Those who export germplasm and horses have gained benefit in terms of less disease, less cost and more movement flexibility for their horses and germplasm arising from New Zealand’s enhanced equine biosecurity. Secondly, those who import horses and germplasm are bringing relatively high-risk items into NZ’s equine biosecurity landscape so a small

levy on risk exacerbators is not unreasonable. It is also anticipated that the cost of levy collection will be simple and efficient. Government must ultimately approve any levy with a requirement to demonstrate there has been industry consultation. An application for a Levy Order was drafted, made available to the representative bodies for comment from 9th April to 31st July and ultimately submitted to the Minister of Primary Industries (MPI) on the 2nd October along with a summary of the consultation process and outcome. We await the outcome of the bureaucratic process.

late November, with the signing being witnessed by our Deputy Prime Minister along with a Chinese counterpart of equivalent status. However, at the last minute the timing did not suit and it was then suggested it be signed at a CHIA organised World Horse Culture Forum in Hohhot the last week of November where I had been asked to present on the NZ Horse Industry and Horse Culture. However, at the last minute the Chinese Government considered the occasion was worthy of Government Official witnessing and so it has been postponed to a later date which with present conditions in China could be well into the future.

The Vetintel equine disease surveillance project based on real time data being collected anonymously from equine practices across the country as discussed in previous reports is progressing slowly. It was pleasing that MPI reached agreement with EHA on a financial contribution to the development of Vetintel as a GIA Readiness Project, this was linked to five deliverables, which were achieved and reported.

I did however continue to Hohot for the forum which was a very positive experience. The theme was “Horse Culture” and they had drawn speakers from all and unusual parts of the Globe to present not only on their country’s horse culture perspective but also speakers on various breeds. Speakers from Ukraine, Turkmenistan, Germany, Hungary, Spain, Uruguay, Turkey, Iceland, Thailand, Argentina, Uzbekistan, Russia, Lithuania, Portugal, Suriname, Bulgaria, England, France, China and of course New Zealand presented. There was a recurrent theme expressed from CHIA over the days of the Forum. Although they are very proud of their wonderful history and culture with horses spanning 5,000 years, they also acknowledge that of more recent times they have dropped the ball and there was often reference to seeking assistance for a ‘rejuvenation’ of their welfare and veterinary knowledge, which can only be considered a positive approach.

Three types of Practice management Software have now been integrated with seven veterinary practices contributing data. The success of this very worthy initiative is obviously dependent on acquiring national collection of equine clinical data and this will require another twenty veterinary practices cooperating. I encourage those equine practices not linked to consider the benefits to equine health and biosecurity to be gained from anonymously linking your practice software. There is no downside but only positives as this data can survey current equine disease patterns noticing sudden changes, will contribute to acquiring knowledge of areas where future industry funded research may be worthwhile and of course assists with our country’s biosecurity. MPI, Ministry of Foreign Affairs & Trade (MFAT), NZ Trade & Enterprise (NZTE) and Auckland Tourism, Events and Economic Development (ATEED) see potential in growing the relationship between NZ and China in the equine sector. They have recognized the EHA as the equine representative body which has proven health and welfare expertise and have approached the EHA to assist them in achieving these goals. This has resulted in a Memorandum of Agreement (MOA) on Equine Health and Wellbeing Cooperation between the EHA and the China Horse Industry Association (CHIA) being prepared. The stated objective of this MOA being to enhance equine health and well-being in China and to build the professional relationships and capabilities of the participants. It was initially anticipated that as Chairman of EHA I would sign this MOA with the Secretary General of CHIA in Beijing in

The establishment of a single database for all horses in New Zealand has been long discussed. This obviously brings biosecurity benefits and is in line with the Biosecurity Act, which has provision for the establishment of a registration and identification system. It has been agreed that the EHA is the appropriate body to progress this initiative. I am very pleased to report that fellow EVA member Trish Pearce agreed at the November AGM of the EHA to continue in her role as Executive Advisor. Trish’s enthusiasm and genuine concern for equine health & welfare coupled with her experience of Government bureaucracy ensure our projects both remain on track and come to fruition. I do annually acknowledge that the Equine Veterinary Association is well represented on the EHA with five of our members involved. In addition to myself, Andrew Grierson attends as Veterinary Adviser to the two Equine Racing Codes, Dennis Scott represents Standardbred Breeder’s Association, Tony Parsons represents Equestrian Sport and of course Trish Pearce is our Executive Adviser.

Eq Vet Pract 2020 June; 45 (2) 9

NZEVA EQUINE VETERINARY PRACTITIONER EDITORIAL GROUP REPORT – 2020 Erica Gee – Convenor

The EVP continues to go from strength to strength as the official publication of the New Zealand Equine Veterinary Association, expertly led by our editor, Joe Mayhew. Each edition brings a broad range of articles and commentaries that should appeal across the breadth of our members. Commissioned articles using Jonathan Hope’s generous funding are well appreciated by readers. The EVP subcommittee has undergone several changes in 2019, and we are now called the EVP Editorial Group to reflect its functionality. Our committee structure has changed from a Central Districts based group, to a nation-wide group using – very successful - online ZOOM meetings. The new Editorial Group will hopefully provide greater editorial support to Joe, through greater contributions to content and editing. Our financials are now managed through the NZEVA Executive Committee, meaning we no longer need a treasurer on committee. Changing the subcommittee structure has meant many of our recent committee members have voluntarily stood down, to enable others to join. We thank all our outgoing committee members for their sterling voluntary efforts, commitment and time given to the EVP. Special commendation must go to Barry Drayton, who has

been on the subcommittee since its inception with David Carthew then Brian Goulden as editors from 1977. Barry has contributed to the EVP development, from a Gestetner-produced* NZEVA Newsletter through to the substantial publication it is today, latterly taking over the role of treasurer. Special thanks also to former convenor Tim Pearce for his sustained commitment to the group. A small gathering was held in December to thank current and previous members of the EVP for their efforts; we were honoured to be joined by former editor Brian Goulden, and former secretary Ian Anderson. The EVP is now delivered electronically to NZEVA members, with options to subscribe for hard copies. Members can also access e-versions through the NZVA website. Moving into a digital format has significant cost savings from printing and postage. We have had positive feedback about the e-format from members so far, including one Australian subscriber! We look forward to delivering more relevant, topical and thought-provoking articles and commentaries in 2020. – See https://www.youtube.com/watch?v=LyOVzyis2UQ

Radtke A et al. Intra-articular anaesthesia of the equine stifle improves foot lameness. Eq Vet J. 2020; 52(2): 314-319 DOI: 10.1111/evj.13135 Nine horses were fitted with a circumferential hoof clamp to induce a moderate unilateral hindlimb lameness and intra-articular stifle anaesthesia was then performed and gait was evaluated every 10 minutes for 90 minutes using an inertial sensor system. The lame horses had a reduction in push-off lameness after intra-articular stifle anaesthesia. The mean change in diffmax at 90 min was -4.3 mm (P = 0.005) for the experimental group vs. -2.3 mm (P = 0.2) for the control group. Lameness decreased over time, with an average improvement of 23% at 30 min, 33% at 60 min and 38% at 90 min. There was high inter-horse variability with 3/9 horses improved by ~50% within 30 min, while 2/9 improved by ~30% and 4/9 had minimal (<10%) or no improvement in lameness. Improvement after IA stifle anaesthesia was not related to the severity of baseline lameness (P = 0.3-0.7). Thus, intra-articular stifle anaesthesia reduced foot lameness in a third of horses by up to 50% within 30 min. Clinically, the results of intra-articular stifle anaesthesia should be considered with caution, as additional diagnostics may be required to rule out pain originating in the distal limb because nerves that convey sensation from the distal limb pass close to the caudal stifle joint capsule.

10 Eq Vet Pract 2020, June; 45 (2)

EQUINE RESEARCH FOUNDATION NZEVA REPRESENTATIVE REPORT - 2020 Noel Power

Another very successful year for the team at NZERF despite the numerous changes to the board and the increasingly difficult financial climate. Tim Pearce has been a wonderfully galvanising Chairman and without Alan Fenwick dealing to the minutiae of secretarial duties we would be lost! Between deposits and cash ERF has approximately $800K of funds - a healthy amount - but attracting nothing near the capital gain of an Auckland house! Research completed in the past year includes: • Identifying Equine Metabolic Syndrome (EMS) In New Zealand (Michelle Logan). • Streptococcus equi subsp. zooepidemicus and other equid respiratory bacteria in NZ (Ray Cursons, Olivia Patty). • Radiographic findings at Thoroughbred Sales: Prevalence, radiographic regression and associations with racing performance (Frances Peat). • An investigation of Wastage in the Standardbred industry (Jasmine Tanner). • Correlation of Performance Related Parameters to Laryngeal Function in Yearling & 2- Year- Old Ready to Run Thoroughbred Horses sold at auction in NZ (Jonathan Hope). Ongoing research includes: • Evaluation of a novel protein-free extender for the prolonged storage of stallion semen at room temperature (Lee Morris). • In vitro evaluation of the efficacy of antimirobials and their alternatives to treat post breeding endometritis in mares (Lee Morris). This year’s Rodmor Lecture Series was presented by Wayne McIlwraith and Lacy Cam, and it was well received as usual at five venues around the country. However, turnout in recent years has continued to dwindle despite our advertising and the model will be revisited in 2020. Competing for attention in the age of Dr Google is difficult. Our booklets continue to be popular. The Laminitis Booklet by Dr Chris Pollitt - edited by yours truly - has been well received, I am told!

Expect one on Farriery and Foot Problems by Julie Bell, when we can finalise funding. The Valachi Downs Young Achiever Award went this year to Sophie Wallace, a Physiotherapist who is in training to become an Animal Physiotherapist [Equine]. In 2018 Nikita Stowers used her award to attend the European Equine Health and Nutrition Conference in Utrecht as well as to further research and education in the science of treadmill training horses in NZ. The Jonathan Hope Award In 2019 went to Melissa Sim of Franklin Vets to help her attend a course titled Certified Equine Rehabilitation and Performance Medicine (via the Integrative Veterinary Medical Institute). In 2018 Lucy Holdaway of Cambridge Equine Hospital used her scholarship to further her dentistry knowledge and training. Final year students Rachel Elliot and Danielle Guiver have completed their studies following NZERF Massey Scholarships in 2019. The 2020 Scholars are Alyse Hansen and Natascha Vivian. NZERF continues to receive feedback through board member Mr Colin Hall regarding Racetrack Injuries and goings on at Equine Health Association meetings. The 2019 Vet/ Farrier Scholarship was awarded to Felicity Wade (Auckland) and Farrier Richard Evans (Thames) who were to attend Rood and Riddle Veterinary practice in April 2020 .

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NZERF recently made a submission to the Transport and Infrastructure Select Committee as part of the call for submissions for amendments to the Racing Industry Bill. In this submission we highlighted the omissions regarding ongoing future support for research and education, being a significant departure from the present Racing Act 2003 where Clause 9(1)g had a specific Function of the (Racing) Board - “to undertake, or arrange for the undertaking of, research, development and education for the benefit of New Zealand Racing.” Our sincerest condolences go to the families of Dr Dave Hanlon and Dr Harry Pearce well known to the NZERF and respected researchers in their respective fields.

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NZEVA EQUINE DENTISTRY SUB COMMITTEE REPORT – 2020 Katie Kindleyside & Glenn Beeman – Co-convenors

It has been an extremely busy year for the dental sub with much time spent preparing information for the MPI regulation proposals in anticipation of the new definition of ‘significant surgical procedure’ that is coming into the welfare act this May. The process gave rise to much debate among the equine veterinary, lay technician, and owner communities and we feel it was a positive experience overall by bringing public discussion on who is doing what in equine mouths and lack of current regulation. The sub wishes to especially thank all in the veterinary industry who engaged in the public consultation process which was at times a lively debate. Thanks go to Andrea and the EVA Executive alongside Helen Beatie (NZVA) who’s support and input was invaluable. The decision on the final wording of the new regulations was announced in December 2019 and the sub-committee will continue to work alongside the executive, NZVA, and VCNZ on guidance for veterinarians in equine practice working alongside these regulations over the next few months. The second focus of 2019 was on equine dental education as we are very aware of the importance of this within the NZ veterinary industry as equine dentistry appears to be the fastest growing sector of equine veterinary practice globally. A Level-1 introductory course was proposed and with the support of the executive was run under NZVA’s umbrella using an online format with a supporting practical day in the Waikato during winter 2019. The course was fully subscribed indicating there is much eagerness amongst NZ-based vets

to develop their dental skills. The sub-committee provided the lecturing material and we were very impressed at how engaged and keen all delegates were. We hope to use the feedback received to enhance and repeat this course in 2021 and will be looking at how we can provide further education opportunities on NZ soil in the future. We were excited to see Chris Pearce of The Equine Dental Clinic, UK was to get to Auckland in April as a key speaker at the WVAC! Although not to be, this was another indicator of how dentistry is becoming a more valued part of equine veterinary discussion in NZ. We hope as many of you as possible are able to make use of some of the presentations via the Virtual 2020 WVA/NZVA Conference to learn more about the most recent developments in all levels of equine dental practice. Finally, we would like to acknowledge the work over the previous several years of Dr Ray Lenaghan upon him recently stepping down as convenor for the dental sub-committee. Ray has been an instrumental force in driving discussions on how we regulate equine dentistry based on a strong passion to uphold optimal welfare standards in horses, and has dedicated much time to ensuring the sub has provided sufficient sound scientific information to support regulation proposals as well as take lead organising events such as the recent Level-1 training. We are pleased Ray will be continuing to be involved in sub-committee activity whilst he takes a break from the front seat.

Young JM et al. Efficacy of orally administered gabapentin in horses with chronic thoracic limb lameness. Vet Anaesth Analges. 2020; 47(2): 259-266. DOI: 10.1016/j.vaa.2019.11.003 Fourteen adult horses with chronic thoracic limb lameness were administered each of four randomized, crossover treatments orally in grain: treatment G = gabapentin 20 mg/kg BID for 13 doses; treatment F = firocoxib 171 mg once, then 57 mg SID, x6; treatment GF = gabapentin and firocoxib at same doses; or treatment C = grain only. The rank change in subjective lameness score of treatment GF was significantly greater than that of treatments C (p = 0.01) and G (p = 0.01), but not of treatment F (p = 0.08). No differences in vector lameness sum (p = 0.4), peak vertical ground reaction force (p = 0.4) or vertical impulse (p = 0.1) from inertial sensor testing were observed among treatments. Thus, in these horses/doses gabapentin did not improve subjective or objective measures of lameness and although subjective evaluation identified an improvement in lameness using gabapentin plus firocoxib it was not different from firocoxib alone.

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NZEVA ENDOSCOPY SUBCOMMITTEE REPORT - 2020 Ivan Bridge - Convenor

The 2020 National Yearling Sales (NYS) marked the third year that laryngeal video-endoscopes were available in the repository attached to the yearling’s sales series radiographs. It was very pleasing that those vendors who had in the two previous years elected not to have them available in the repository had a change of attitude this year. The darkened quiet repository room is obviously a far better environment to view a video than trying to view on a laptop/iPad in a horse box, the back of the stud’s hospitality marquee or even in the breezeway on an iPhone. Being able to evaluate both radiographs and laryngeal videos whilst the file is open is also obviously hugely more efficient for the veterinarian rather than having to tramp around the sales complex to an inferior viewing area and on occasion having to queue for the privilege. The head injury suffered by an Australian veterinarian whilst carrying out sales video-endoscopy at a Gold Coast Sale last year led to much discussion over the sales period. The endoscopy panel met and agreed on a recommendation to be taken to the sales company, that a series of endoscopy rooms with appropriate restraining crushes be built across the complex, for both pre & post sale endoscopy. I am pleased to report that the sales company accepted this recommendation positively and ideas of numbers and location have been discussed. It is envisaged that these will be available for the 2021 (NYS). It has been further suggested that with available facilities and yearlings brought to those facilities all post sale endoscopic examinations will be recorded rather than at present where only those yearlings referred to the video room are recorded. Having two veterinarians rostered to each endoscopy room will also solve the present nightmare of organising a roster to keep veterinarians away from conflicts of interest with their practice’s clients. There were 686 yearlings at the 20 NYS and 204 twoyear olds at the 19 RTR sale that had post-sale endoscopic examinations. Of these 34 yearlings and 6 Ready-to-Run 2yos were further examined using video-endoscopy by a panel of 3 veterinarians. Fifteen of the 34 yearlings

scoped were due to the wish to record arytenoid ‘kissing lesions’. Four from Book 2 were videoscoped because they couldn’t be done safely in a box and one was not scoped as it couldn’t be handled. Presale endoscopy has reduced the number being referred for video-endoscopy. However, more horses were referred for video-endoscopy this year than at the 2019 NYS with the increased number due to the increase in mucosal lesions. The hot, dry, dusty conditions experienced this summer could well be the triggering factor in this increase. In summary 1 RTR horse and 3 yearlings failed to meet the conditions of sale as per clause 3.6 in the Sale Catalogue [see below]. READY TO RUN SALE 2019 Lots examined using video-endoscopy: 6 Lots failing to meet conditions of sale: 1 • One horse had a bilateral arytenoid chondritis BOOK 1 2020 Lots examined using video-endoscopy: 15 Lots failing to meet conditions of sale: 3 • One had marked swelling of the left ary-epiglottic fold protruding into the airway • One had marked swelling of the right ary-epiglottic fold protruding into the airway • One had a right-sided arytenoid chondritis BOOK 2 2020 Lots examined using video-endoscopy: 17 Lots failing to meet conditions of sale: 0 BOOK 3 2020 Lots examined using video-endoscopy: 2 Lots failing to meet conditions of sale: 0

Eq Vet Pract 2020 June; 45 (2) 13

NZEVA RACING LIAISON SUB-COMMITTEE REPORT – 2020 Ivan Bridge – Convenor

Meetings between representatives of the Racing Integrity Unit, the three racing codes, Racing Board, Thoroughbred Trainer’s Association, Racing Laboratory and the Equine Veterinary Association, were held twice over the year being in May and December. This forum allows free and frank discussion between the various entities involved in the racing industry and provides the opportunity for the sharing of opinions, which can only be considered positive. Having to follow International Federation of Horse Racing Authorities (IFHA) rulings is often very frustrating. Although a stance on such things as altrenogest use in racing fillies/mares, timing of IRAP joint treatment etc. has been vigorously debated, our hands are tied by the obligation to follow the IFHA protocol for NZ Racing to retain its international recognition. I am sure Andrew Grierson can elaborate further but at present the use of altrenogest in racing females requires one clear day withdrawal before competing, with NZ watching how Australia respond to any ban. There has been discussion re the use of ice/clay/ poultices on horses after racing. At present it is not permissible under the rules for this to be done pre-race. However common sense prevailed, and it was agreed that for welfare reasons ice or pre-frozen gel type wraps could be applied after racing. The use of ‘clay’ wraps on a racecourse will not be permitted due to the possible contamination if DMSO has been added to the clay. I have mentioned in previous reports that the Raceday Horse Incident reports we have been filling in for a number of years were to be converted to a digital format by way of a phone app. Harness Racing NZ’s (HRNZ) IT staff have led this process and during the year the app has been introduced. I think all users will commend this initiative although the iPhone app has difficulties updating compared to android with both dropping out readily even on 4G. Accessing the Racing Clubs Wi-Fi eases most problems encountered. The RIU Administrator is certainly delighted as it has saved her many tedious hours laboriously trying to decipher

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veterinarians’ writing and entering all data manually. We look forward to meaningful data being presented with the passage of time. The recent annual report from Marty Burns, Chairman of the NZ Horse Ambulance Trust, noted that there are now five ambulances in commission with another expected to be delivered in March with a seventh expected by June of this year. At $130,000 per towing vehicle and ambulance package this has been no mean feat and full credit must go for the efficient fund raising and management by the Trust. The Trust has also managed to secure operational agreements or volunteer arrangements to have ambulances present at almost all race meetings. EVA member Wally Niederer has recently agreed to become a Trustee representing the Equestrian Association and joins Trustees and fellow EVA members Bill Bishop and Peter Gillespie who of course instigated and drove the project. As reported last year the one clear day’ treatment rule promoted by the Codes Veterinary Adviser and the Medication Sub-Committee, to bring our rules in line with Australia, has been passed and gazetted by Harness Racing NZ. NZ Thoroughbred Racing are expected to gazette this rule in the very near future. The Massey University injury research team have made their kits available, but the logistics of where, when and how limbs are removed and shipped to Massey from raceday euthanased horses are yet to be organised. It has also been pointed out that there is an important public relations communication exercise to be had with racehorse connections, extolling the merits of this initiative for the future welfare of our racing population, before this practice is introduced. It is certainly not the Veterinarians’ role to be dealing with emotional owners/trainers after limbs have been removed off their prized horse. The EVA Race Day Guidelines for Veterinarians are presently being reviewed and updated and will hopefully be made available soon.

Animal rights related groups (as opposed to animal welfare groups) have made various press releases over the year stating they will be staging active protests outside racecourses on several feature days as they feel racing is an infringement of horses’ rights. Fortunately, these have been remarkably poorly attended protests and have overall gone unnoticed. As veterinarians the welfare of our racing/breeding stock is obviously a concern for us all and we work to maintain the highest standards. It

is gratifying that both horse racing codes have invested considerable resources addressing the welfare aspects of racing with post racing welfare high in their priorities. These initiatives are constantly being addressed to continually improve welfare aspects, and it is important that this message is conveyed wherever possible as the only response to challenge - which will never go away is by positive endorsement of industry practices.

NZEVA MEDICATION SUB-COMMITTEE REPORT – 2020 Andrew Grierson – Convenor

With around four months to go in the 2020 racing year there has been seven dope-testing positive results to date; five Standardbred and two Thoroughbred. Last year ending 31st July 2019 there were ten positives; six Standardbred and four Thoroughbred cases. Prior to that there has been an average of eighteen positives each year peaking in 2014-5 with thirty-one. Number of positives is down but on the rise are environmental contaminations which now account for almost a third of positives. These include positives to anti-psychotic and heart medications derived from the unsavoury habit of stable hands urinating on shavings in horse boxes rather than using the toilet. Positive test results have also occurred where horses under treatment have either contaminated the environment of another horse or were the source of their own contamination after treatment ceased. No doubt this is in part due to the sensitivity of modern equipment being able to identify drugs to very low levels, but improving hygiene would eliminate the majority of these cases - staff using toilets for one. Where horse urine is the source the removal of soiled

bedding as a daily routine and then completely replacing bedding after a course of treatment is all common sense. A horse contaminating its own box with urine containing a prohibited substance after treatment can give rise to a positive even if the withholding time [WHT] has been adhered to. Veterinarians need to be aware of the risks especially when using clenbuterol, xylazine, ketamine and NSAID drugs. There have been a lot of Regulations and Rules changes this racing season. In August 2019 Harness Racing completed changes to Regulations and Rules around the use of prohibited substances. HRNZ now has restricted the use of bisphosphonates to only horses 4-year-old or older, revised the wording to ‘one clear day’ prior to racing for all medications, introduced ‘8 clear days’ for all injection of joints, and banned the administration of any blood product back into the circulatory system. A comprehensive list of notifiable surgical procedures was also added. This brings HRNZ in line with International changes. NZTR are working on following suite this year.

Eq Vet Pract 2020 June; 45 (2) 15

LETTER TO THE EDITOR

Dear EVP: Again, the NZEVA Executive was disappointed with Dr Bill Bishop’s comments in his Enlightened Commentary published in the March EVP, once more trivialising the significant financial donation made to the NZ Horse Ambulance Trust (NZHAT) by the Executive on behalf of NZEVA members. It appears that the $30,000 we have already donated means little to the NZHAT, as it was underquoted by $5,000 in the article. The article also implied that the Executive does not value the horse ambulance initiative, based purely on the fact we have not donated as much money as the 3 NZHAT Equine Welfare Partners: NZ Bloodstock, Valachi Racing and Cambridge Stud. To this end NZHAT has proposed that the NZEVA contribute another $45,000 from its reserve funds to bring us into parity with their 3 Equine Welfare Partners, who have each contributed between $75,000 and $150,000. However, one has to remember that NZ Bloodstock, Valachi Racing and Cambridge Stud are all large business entities turning over millions of dollars every year, whereas the NZEVA is a small non-for-profit member organisation running at an annual loss. The Executive feels that to put us in the same funding category as these companies is ludicrous and it stands by its decision that a donation of this magnitude to a single project is inappropriate use of the Association’s funds. The article goes on to quote that as NZEVA members we are not here to save money, but to apply ourselves as an association representing equine veterinary activities and to do the very best we can for horses under our care. Unfortunately, this is not correct. While it may be true for individual members, according to the Constitution the primary objectives of the Association are to support the personal and professional welfare of its members, to provide leadership and direction, to provide continuing professional development through education, and to enhance the professional status of veterinarians in NZ. Obviously, welfare in horses used for sporting events is extremely important to equine veterinarians and has become a major issue in the public eye. Having an equine ambulance present at race meetings and major equestrian events has a very positive impact on the public’s perception of the sport, which the NZEVA wholeheartedly supports. However, the Executive wants to support this animal welfare initiative in ways that are more directly beneficial to its members, e.g. by educating veterinarians in the appropriate management of equine emergencies at events, including the use of the equine ambulance. To this end we are funding an Equine Casualty Management course for veterinarians at races or equestrian events to be run in early August 2020. This course will look at common problems and emergencies encountered at races and equestrian events, and the responsibilities of the duty veterinarian in dealing with these. According to the article, the objective of the NZHAT is to fund, procure and maintain a fleet of 10 equine ambulances complete with tow vehicles (6 in the North Island and 4 in the South Island) to be fully commissioned and in use by the end of 2020. To date, the Trust has raised $870,000, and 7 equine ambulances complete with new tow vehicles are now fully funded, with 5 units already in use and the 6th and 7th due to be actively commissioned by June 2020. Dr Bishop states that a further $500,000 is required to complete the capital project. The Executive has a number of issues with this, which it feels have not been adequately addressed by the NZHAT to date. Firstly, the total number of ambulances required may need to be reviewed given the poor economic outlook in general and significant shrinkage of the racing industry in particular in the face of the COVID-19 pandemic, and if the Masara Report recommendations of reducing the number of racing venues in NZ are followed through. Secondly, NZHAT’s strategic business plan detailing how the use, repair and maintenance of the ambulances will be funded going forward has not been forthcoming. Currently their whole operation relies solely on donations and has no clear business plan for the short or long term. This is not sustainable; you cannot rely on donations indefinitely as there is a well documented process called ’sponsor fatigue’ which has not been taken into account. The Executive feels that now that the majority of the ambulances are up and running they should become self-funding through the NZHAT charging a hire fee to the racing clubs and equestrian

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entities that use them. Currently no one is paying for the use of the ambulances, so the question needs to be asked why donors would continue to pay for something that others get to use for free. Thirdly, there is currently no differentiation between donors and sponsors. The NZHAT advises that donors’ contributions assist in the capital procurement and that annual sponsorship proceeds go towards the cost of repairs, maintenance and development, but this distinction currently does not exist. The Executive feels that the primary cost of acquiring new ambulances should rest with the major equine industry partners. The NZEVA would be better to offer the NZHAT a yearly sponsorship to help pay for ongoing costs. To that end the Executive has previously proposed putting aside a principal fund to generate interest that can be donated to the NZHAT annually to help maintain the ambulances, but to date this offer has not been acknowledged. Instead we continue to be pushed for another large lump sum. Lastly, the NZEVA does not make enough (if any) net profit per annum to give away another $45,000, even if we do have some money in the bank. Last year the Association made a $14,000 loss primarily due to our donation to the NZHAT. Our subscription levels are declining and if we are already losing money why would we give another big chunk of our savings away? And although the project was initially conceived by the NZEVA it is now firmly under the umbrella of the NZHAT, an independent group which is not linked to the NZEVA in any way and certainly not in the public’s eye, so what direct benefit would there be to NZEVA members from this significant financial loss? The NZEVA Executive has never been anything but complementary towards Dr Bishop for his on-going drive and enthusiasm to see this project to fruition, but we are tired of being publically attacked for wise financial stewardship of the Association. We greatly appreciate the amount of time and effort Dr Bishop has put into this venture on our behalf and have already supported it to tune of $30,000, which is significantly more than the NZEVA has spent on any one single project previously. Thank you. The NZEVA Executive

WE'RE GOING DIGITAL Dear Colleagues: The Equine Veterinary Practitioner is going digital in 2020! We're doing this to reduce our environmental footprint and because we feel our members’ money is better spent elsewhere other than on printing and postage!

There are a few ways to renew your membership for 2020. Choose the one that's easiest for you: 1. Login to the NZEVA website and follow the prompts from your profile.

From March 2020 we'll send you a link to read the journal online.

2. Email membership@vets.org.nz with your details and the NZVA team will renew your membership.

However, if you feel you can’t do without your printed copy, members of the EVA can order a print subscription through the NZVA website.

3. Call the NZVA on 04 471 0484.

Thanks for being a member of the NZVA and of the NZ Equine Veterinary Association - you're support is appreciated.

Andrea Ritmeester NZEVA President

Go well.

Eq Vet Pract 2020 June; 45 (2) 17

EDITORIAL – JUNE 2020

This emergent, rampant wee piece of RNA must seem like WW-III-CoV to much of the world’s population and a lot of its mystery is reflected in the huge press-time it is consuming and is reflected in the disparate ways people and countries are responding to it – or not. I was set to offer a rather naive synopsis of coronaviruses but, thank goodness, our virologist colleague, Magda Dunowska from Massey Vet School came to your rescue and has given us a contemporary update on the Coronaviridae with a veterinary perspective on page 26. As a bonus, we are pleased to publish a topical case of equine enteric coronavirus by JoAnna Faircloth from Canterbury Equine Examples of journal Clinic on page 22. And we do have a few abstracts on ECoV infection for your topical reading pleasure.

Probably more from necessity, we have all become adept at videoconferencing using free and paid APPs* to keep in touch with clients, patients, colleagues, teachers and E-learning opportunities. This may be a beneficial spin-off from lock-down in progressing tele-veterinary-medicine in the long haul but has made self and group-learning so much more convenient. This is particularly so for such forums as e-journal clubs that are so beneficial to our personal CPD programs. Even isolated practitioners can participate in e-journal clubs to benefit from the professional development. There are three main formats for operating JCs [see Table 1] and in practice, elements club of the (JC) classic formats. formats can be incorporated into other formats, resulting in hybrid approaches. It can also be

Figure1:1:Examples Examples of journal club formats. From: McGlacken-Byrne SM et Journal club: old tricks Figure of journal club formats. From: McGlacken-Byrne SM et al. Journal club: oldal. tricks and fresh approaches. Arch Dis and approaches. Arch Dis Child - Edu Pract. 2019; 317374. doi: 10.1136/archdischild-2019-317374 Child fresh - Edu Pract. 2019; 317374. doi: 10.1136/archdischild-2019-317374 18 Eq Vet Pract 2020, June; 45 (2)

useful to all in changing the format from time to time to maintain interest. Of all the advice for making the most of these JCs I would say that we need to remember two points: they are a learning tool and not a lecture, so don’t allow [senior] contributors to spout forth with a sermon of their knowledge of the subject, and get input from all parties – alternate viewpoints always are educational. It is axiomatic that in clinical equine practice, as in life, looking is not the same as seeing; we need to have the knowledge to ask the right questions about what we are looking at. So often I have reviewed a video of a neurologic case for the umpteenth time and only then realised what it is I am actually seeing; all the time examining the patient with eyes-wide-shut! For those of us who try to do some running, the TEDMED talk by Anupam B. Jena “The profound difference between seeing and looking” is enlightening in this respect. Dr Jena is a ‘PhysicianEconomist’ and in his talk uses the Boston Marathon bombing as an example of a natural experiment that can teach us to ask the right questions to understand things better, truly seeing the world around us. I have always been fascinated by the guttural pouch that is present in odd-toed ungulates including horse, zebra, rhinoceros, tapir, some bats and other small mammals. One might think that such structures would be useful to help equilibrate ambient pressure in the ear cavities if the owners climbed to great altitudes or dove to great depths, but the function of the guttural pouch is still. Although it has been some time since I found newer insight into the function of these structures [see Vet J. 1997; 153(3): 311-319; Vet J. 1998;1 55(2): 139-148; Biol Lett. 2006; 2(3): 475–477: SEE FOOTNOTE], I was pleased to see that some anatomist colleagues in UC Dublin are putting their minds to this conundrum again [Kilroy et al., 2020. J Anat. Abstract S180; 236(SI-1): 76-77]. They admit that although several functions have been suggested for the guttural pouch including cooling the arterial blood flowing to the brain during exercise, added buoyancy to the head, pressure regulation during respiration and even the production of vasoactive substances, the puzzle remains. We are all aware that infectious arthritis is difficult to treat, and offending pathogens have a propensity to form biofilms that consist of sticky, syntrophic (cross-feeding) microorganism clusters that allow the bugs to hide away from classical antimicrobial drugs. I was enlightened to find that as part of biofilm biology the clusters of microbes and their associated matrix once formed on a surface can disperse as ‘microbial cities’ through synovial fluid to extend colonisation and the arthritis. Several approaches are being tried to dismantle these synovial biofilms and Gilbertie and colleagues in North Carolina have published

on using platelet‐rich plasma [PRP] to do that [Platelet‐rich plasma lysate displays antibiofilm properties and restores antimicrobial activity against synovial fluid biofilms in vitro. J Orthop Res. 2020; 1– 10]. The group used various PRP-lysate formulations produced from a very high concentration of platelets [~15 times that in clinicallyused PRP], with or without amikacin, to determine if there was evidence for enhanced antimicrobial activity using PRP-lysates. All PRP formulations displayed antimicrobial properties against Gram +ve and Gram -ve bacteria. PRP-lysates exhibited synergism with amikacin against aminoglycoside-tolerant biofilm aggregates with greater activity against Gram +ve bacteria. It is thus evident that the use of PRP-lysates can augment current antimicrobial treatments to decrease morbidity and mortality associated with infectious arthritis. Any approach to reducing our reliance on overused antibiotics should be welcome. The perennial issue of what to say when relaying an unanticipated event or outcome to a client came up with the usual unsettled conclusion. We all make mistakes, but often it is felt that any form of “Oh, I am sorry…… “ to a client will be interpreted as an admission of guilt. Michael Lee [Lee MJ. On patient safety: do you say “I’m sorry” to patients? Clin Orthop Rel Res. 2016; 474(11): 235961] gives sensible advice for optimally communicating adverse events to clients: • Communication of what happened, how did it happen and were there factors that made it more likely for this event to occur? • Acknowledgement and validation of client’s emotional [and financial] response. Sincere expressions of sympathy and regret and possibly apology, if appropriate. • Continued discussions on how the event occurred and how it can be prevented in the future. And I particularly like Michael Lee’s concluding reference to All I Really Need To Know I Learned In Kindergarten by Robert Fulghum: “Say you’re sorry when you hurt somebody”. It is very topical to have an Invited Commentary item on page 52 concerning the aftermath of Santa Anita racetrack deaths over a year ago. Since those happenings an international group of interested scientists looked at and frankly discussed the Social License to Operate for TB racing in the USA [Sustainability. 2020; 12(5): 1706] and found that it was deeply tenuous, concluding that “Horse racing in North America is at a critical crossroads; stakeholders have their work cut out for them to maintain sustainability of this longstanding equine sport”. To add

Eq Vet Pract 2020 June; 45 (2) 19

insult to injury, the announcement was made March 2020 that many prominent owners, trainers and veterinarians were among the 27 people indicted March 9 in the US Federal Court on doping-related charges in racing. Do you get the ominous feeling that at least some jurisdictions of the equine industry are up a particular creek without a means of propulsion? Hopefully WW-III-CoV will soon be an historical event instead of an international disaster.

Ngä mihi nui, Joe evp.editor@gmail.com

The Illustrated Horse Doctor Ninth Edition. 1876 Edward Mayhew

FOOTNOTE: Here I might apologise if all URLs do not take the reader to original full texts. Every effort is made to do so, but some search engines may not allow direct access, mostly because there is a firewall or free or paid registration is required.

Miagkoff L et al. Antimicrobial susceptibility patterns of bacterial isolates cultured from synovial fluid samples from horses with suspected septic synovitis: 108 cases (2008-2017). J Amer Vet Med Assoc. APR 1 2020; DOI: 10.2460/javma.256.7.800 Results of bacterial culture were positive for 34 of 70 (49%) and 18 of 61 (30%) samples from 68 adult horses and 40 foals with suspected septic synovitis, respectively. Gram-positive bacteria were more common in adult horses, whereas gram-negative bacteria were more common in foals. No multidrugresistant microorganisms were identified. For adult horses, 92% (23/25) of gram-positive isolates tested with penicillin and gentamicin were susceptible to the combination. For foals, 94% (15/16) of isolates tested with penicillin, gentamicin, or both had susceptibility to 1 or both antimicrobials. Findings suggested that in Quebec Canada, a combination of penicillin and gentamicin would be an effective empirical antimicrobial treatment for most horses with septic synovitis while results of bacterial culture and susceptibility are pending.

BRIAN GOULDEN AWARD

NZ EQUINE VETERINARY ASSOCIATION

The Brian Goulden Perpetual Trophy will be awarded annually and presented at the Annual Dinner of the NZEVA conference. This annual prestigious prize is awarded to members or past members of the NZEVA who have shown leadership, enterprise, contribution to knowledge or education, and have made significant contributions to the equine veterinary profession in New Zealand. Please send your nominations including name, address and qualifications, together with any supporting information for the nominee, whom the nominator considers merits the award. This can include curriculum vitae, letters of support and documentation of achievements etc. Send all details AT ANY TIME to: nzevasecretary@gmail.com Andrea Ritmeester, NZEVA President Elect, nzevapresident@gmail.com

20 Eq Vet Pract 2020, June; 45 (2)

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EQUINE HEALTH AND MANAGEMENT PRODUCTS

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ORAL CORTICOSTEROID FOR HORSES

Palatable prednisolone granules to aid in the treatment of allergic and non-infectious inflammatory conditions of horses. • Oral prednisolone: A safe and convenient alternative to repeated injectable therapy. • Powerful anti-inflammatory agent: Prednisolone non-specifically inhibits the inflammatory process, suppressing local heat, pain, oedema and swelling, and the immune reaction. • Palatable and convenient: Apple flavour ensures higher acceptability so full dose is taken. • Granule formulation packed in sachets: Ensures stability and convenience of dosing during long term therapy. Designed in a continuous strip for easy dispensing. Preddy Granules® are available in a carton containing 50 x 5g sachets.

Founderguard

FOR THE TREATMENT AND PREVENTION OF LAMINITIS IN HORSES

Founderguard® reduces the risk of laminitis in horses and ponies when fed in conjunction with high grain diets. • Clinically proven preventative supplement for feed induced laminitis and founder. • Formulated to ensure delivery of the active drug to the hind gut to control the build-up of lactic acid. • Allows high grain diets to be fed safely. • Small daily dose and highly palatable lucerne-based pallet. Founderguard® is available in a 1 kg bucket.

Sedazine A.C.P. Paste ®

ORAL TRANQUILISER FOR HORSES AND CATTLE

An aid in quietening excitable, nervous, unruly or hard to handle horses and cattle. • Oral acepromazine: less traumatic option for the horse to avoid the stress of injection in “needle shy” or skittish horses. • Provides safe and effective tranquilisation for situations when direct veterinary supervision is not possible. • Pleasant flavoured paste formulation. • Versatile: For use in horses and cattle. Sedazine A.C.P.® Paste is available in a 30 ml dial-a-dose syringe.

Strategy-T

BROAD-SPECTRUM HORSE WORMER

Contains oxfendazole and pyrantel for the treatment and control of all major worms of horses including macrocyclic lactone (ML) and benzimidazole (BZ) resistant strains. • Unique combination of active ingredients that work synergistically to give Strategy-T® a superior efficacy. • Shown to have comparable activity to mectin wormers (including benzimidazole resistant strains), making it New Zealand’s best non-mectin based wormer. • Backed by NZ Trial Data for best efficacy against Ascarids in foals. • Safe to use on all horses including foals, pregnant mares and breeding stallions. • Palatable vanilla flavoured paste. Each syringe can treat horses up to 700 kg. Strategy-T® is available as a 35 ml single syringe, in a display box of 15 syringes.

Available now from your wholesaler. nz.virbac.com Restricted Veterinary Medicines. Available only under Veterinary Authorisation. Registered pursuant to the ACVM Act 1997, Nos.A7476, A6863, A3854, A8044.

Eq Vet Pract 2020 June; 45 (2) 21

EQUINE ENTERIC CORONAVIRUS IN A CANTERBURY PONY JoAnna Faircloth Canterbury Equine Clinic joanna@canterburyequine.co.nz https://ga.lnwfile.com/_/ga/_raw/53/m8/e7.jpg

INTRODUCTION Cases that present with anorexia and concurrent pyrexia +/- mild signs of abdominal discomfort have been annually documented during the cooler months in Canterbury. These cases have largely been described as mild and self-limiting; and have typically resolved without reaching a definitive diagnosis. In recent years, these cases have been the topic of discussion and are now being routinely tested in the Canterbury region to screen for Equine Coronavirus (ECoV).

CASE HISTORY A 16-year-old mixed-breed pony gelding was attended in the field in July 2019 for sudden onset of inappetence and lethargy. The gelding had participated in a local competition three days prior to presentation and had a routine dental performed by a lay dentist without sedation approximately 48 hours prior to presentation. There was no recent history of antimicrobial or anti-inflammatory administration. The owner had not noted any signs of abdominal discomfort and all manure within the vicinity was well formed.

CLINICAL FINDINGS On presentation, the gelding was dull and standing off on his own, facing away from feed. The pony was in ideal condition (BCS 4/9). A heart rate of 50 bpm, temperature of 39.6 ˚C, and very decreased gastrointestinal sounds were detected on examination. Other examination findings were unremarkable. The pony was subsequently isolated from other horses on the property, administered a 0.5 mg/kg dose of flunixin IV, and blood was collected for screening. Notable bloodwork abnormalities included profound leukopenia of 2.1 x 109/L with a left shift and lymphopenia indicating severe, acute inflammatory demand. A very mild hypomagnesaemia and hypochloraemia were also noted. All other results of the initial blood sample were unremarkable. While relaying bloodwork findings to the owner, she revealed that the pony had since stretched out as if to urinate three times, flank watched twice, and had been standing closer to the water trough. Haematological findings and emerging signs of abdominal discomfort placed impending colitis within the top differential diagnoses. The owner was left to administer flunixin oral paste (0.5 mg/kg, q 12h) and an electrolyte paste (Quicklyte™, 15 ml PO, q 12h) while monitoring the pony overnight.

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Approximately 48 hours after original presentation, the pony developed profound ataxia despite improvement in other clinical signs (HR 46 bpm, Temp 36.9˚C). Although no diarrhoea had yet been noted, a faecal culture swab was taken and sent to SVS laboratories in Hamilton for processing. An intravenous bolus of 8L Hartmann’s fluids was commenced while new bloodwork was processed. A nasogastric tube was passed but no net reflux was obtained, and 250 ml of lactulose was administered along with 6 L of water with electrolytes. Dimethyl sulphoxide (DMSO) was administered intravenously (1.0 g/kg, q24h). The second blood sample indicated persistent leukopenia, moderately increased alkaline phosphatase (ALP), and electrolyte derangements (all mildly to moderately decreased) despite adequate hydration parameters and no outward fluid losses through diarrhoea or reflux. Ataxia was suspected to be caused by hyperammonaemia secondary to disruption of the gastrointestinal mucosal barrier, though severe or sudden electrolyte derangements can also be responsible for encephalopathic signs. Unfortunately, hyperammonaemia could not be confirmed in this case as the test for blood ammonia level was unavailable on the weekend. Ataxia improved slowly and resolved within 30 hours of initiating fluid therapy of twice daily IV boluses of 8L Hartmann’s fluids per 400 kg bodyweight and PO lactulose. The pony’s mucous membranes became injected with a brick red appearance throughout the third and fourth days of treatment. The owner noted two small piles of manure that were cow pat consistency in the pony’s pen; this was the only evidence of non-formed manure for the duration of case management. Supportive care consisting of sucralfate (20 mg/kg PO, TID), lactulose (100 ml PO, BID-TID), oral flunixin paste (0.5 mg/kg, q12h), and oral electrolyte paste (Quicklyte™ 15 ml, q 12h) was continued for three days with decreasing amount of intravenous fluids supplemented with electrolytes as needed and bolused once or twice daily as dictated by daily blood results. The pony also received oral doses of metronidazole (20 mg/kg, q12h) for the first three days of treatment due to the original findings of profound leukopenia and development clinical signs congruent with hyperammonaemia. Due to lack of available isolation facilities, the pony was managed in the field throughout supportive treatment.

DIAGNOSIS The faecal PCR result was positive for equine coronavirus (ECoV). Other enteric pathogens such as Salmonella spp., C.

difficile, and C. perfringens were not detected in the faecal sample. Clinical signs in this case can be closely compared to moderate-severe cases of ECoV reported overseas.

CONTINUED TREATMENT & FOLLOW-UP On receipt of the faecal PCR result supporting ECoV diagnosis and confirmation of an improved leukogram on the fourth day of treatment, antimicrobial therapy was discontinued. The pony’s vital signs and appetite had returned to normal and bloodwork findings were unremarkable by the sixth day of treatment. All medications were discontinued aside from sucralfate, continued PO, q12 h, for another 7 days after resolution of clinical signs. The pony was given two months of reduced exercise before returning to ridden work but has since competed successfully [see figure].

DISCUSSION The most common clinical signs documented in cases of ECoV include pyrexia, inappetence, and lethargy, as seen in the early stages of this case (Nemoto, et al., 2014, Pusterla et al., 2018, Berryhill et al., 2019). Haematological findings often, but not always, include lymphopenia and neutropenia (Berryhill et al., 2019). Primary clinical signs may be quickly followed by enteric signs such as colic, transient diarrhoea or loose manure, and rarely, more severe clinical presentations associated with loss of barrier function within the intestinal mucosa (Pusterla et al., 2018, Mattei, et al., 2020). While clinical morbidity of ECoV has been documented to reach up to 83%, mortality is low (Pusterla et al., 2018). The route of transmission for ECoV is faecal-oral (Mattei, et al. 2020, Pusterla et al. 2018, Fielding et al., 2015). Most cases are mild and self-limiting, but a proportion require intensive care with supportive treatments to recover (Goodrich, et al., 2020). ECoV is more frequently diagnosed during winter months and is thought to survive for longer in cooler temperatures (Pusterla et al., 2018), however, some cases have been documented in warmer seasons (Mattei, et al., 2020). Faecal samples from two horses with anorexia, pyrexia, and mildly loose manure tested positive for ECoV in Canterbury this March (2020) while ambient temperatures were still reaching 20-22˚C daily, possibly demonstrating the adaptability of this virus in New Zealand.

Pony fully recovered.

Antibiotics are rarely necessary or effective for treatment of viral enteric disease. In the case described here, the suspected breakdown in gastrointestinal mucosal barrier and concurrent, profound leukopenia led to the decision to treat with metronidazole while awaiting culture results. Metronidazole is shown to be effective in decreasing enteric production of ammonia and has anti-inflammatory properties (Orsini & Divers, 2008). Intravenous administration of dimethyl sulfoxide (DMSO) was administered due its reported anti-inflammatory and reactive oxygen radical scavenging properties that may reduce cellular damage (Sprayberry & Robinson, 2009). The administration of lactulose (nonabsorbable disaccharide) was used to try and achieve ionization and reduced absorption of ammonia into the bloodstream (Sprayberry & Robinson, 2009). Progression of ECoV infection to necrotizing enteritis, septicaemia, endotoxemia, and hyperammonaemia-associated encephalopathy as suspected in this case is reported but uncommon (Pusterla et al., 2018, Berryhill et al., 2019). Commercial availability of ECoV PCR testing is currently available in several laboratories in NZ. Timing of faecal swabbing for PCR is important, as faecal shedding is often delayed until 24 hours after pyrexia is evident (Nemoto, et al., 2014). ECoV has been historically detected in faeces for a variable duration of 3-11 days after onset of clinical signs and this has been previously used to guide duration of isolation and biosecurity measures (Fielding, et al., 2015). For the case discussed here, the owner was advised to maintain the pony’s isolation from other equids and continue biosecurity measures for 21 days after resolution of clinical signs. However, in recent studies, beta coronavirus has been detected by PCR in faeces of asymptomatic carriers up to 25 days after initial detection during outbreak surveillance testing (Goodrich et al., 2020). The role of asymptomatic carriers in perpetuating outbreaks of ECoV and ability of humans to act as fomites in transfer of the virus may have been previously underestimated and deserves consideration when approaching cases of suspected ECoV. As with all infectious and contagious disease, biosecurity recommendations should be aimed at reducing spread of the agent throughout the affected premise and onto other properties. Current recommendations pertinent to control of ECoV transmission emphasize use of footbaths, personal protective equipment, cleaning of shared facilities and transportation with disinfectants, allocated equipment for collection and disposal of manure and bedding from cases and, ideally, testing of other equids on the property to identify those asymptomatic shedders (Pusterla et al., 2018, Goodrich et al., 2020). Equine coronavirus should be included as a differential for cases of anorexia, lethargy and pyrexia in adult horses in NZ, as isolated cases or as clusters of cases. Most cases resolve quickly with minimal supportive care, but infected individuals can continue to shed the virus in faeces for several weeks after clinical resolution. Testing via faecal swabs in suspected cases could provide more insight to

Eq Vet Pract 2020 June; 45 (2) 23

the prevalence of this disease in NZ and help reduce the occurrence of outbreaks.

Mattei DN, Kopper JJ & Macarena GS. Equine CoronavirusAssociated Colitis in Horses: A Retrospective Study. J Equine Vet Sci. April 2020; 102906.

ACKNOWLEDGEMENTS Grateful thanks to the lovely Harriet Bell BVSc and Shaan Mocke BVSc who assisted with treating the pony.

Nemoto M et al. Experimental inoculation of equine coronavirus into Japanese draft horses. Arch Virol. 2014; 159 (12): 3329-3334.

REFERENCES

Orsini JA & Divers TJ. Equine Emergencies: Treatment and Procedures, 3rd ed. Saunders, St. Louis, MO. 2008: 246.

Berryhill EH et al. Clinical presentation, diagnostic findings, and outcome of adult horses with equine coronavirus infection at a veterinary teaching hospital: 33 cases (20122018). Vet J. 2019; 248: 95-100. Goodrich EL et al. Novel findings from a beta coronavirus outbreak on an American Miniature Horse breeding farm in upstate New York. Equine Vet Educ. 2020; 32 (3): 150-154

Pusterla N et al. Enteric coronavirus infection in adult horses. Vet J. 2018; 231: 13-18. Sprayberry K & Robinson NE. Current Therapy in Equine Medicine, 6th ed. Saunders, St Louis, MO. 2008: 675.

Fielding CL et al. Disease associated with equine coronavirus infection and high case fatality rate. J Vet Int Med. 2015: 29 (1): 307-310.

Letâ&#x20AC;&#x2122;s look at:

CONTAGIOUS EQUINE METRITIS Edited from: DEFRA / AHT / BEVA Equine Quarterly Disease Surveillance Report. March 2020; 16 (1): 4. On 3rd April this year, CVO Scotland confirmed a case of contagious equine metritis in a non-thoroughbred stallion. The horse had been imported from Europe in Nov 2019 and showed no clinical signs of infection. The diagnosis was made during routine breeding testing. Cause: A gram-negative, venereally-transmitted bacterium Taylorella equigenitalis. Species affected: horses, donkeys, mules, zebras and other members of the equid family Transmission: Directly, during natural mating, teasing and artificial insemination. Indirect transmission via hands and equipment. Clinical signs: Stallions do not normally show clinical signs of disease. Mares may have mild to profuse vaginal discharge, especially 1-6 days after mating. Infected mares may also be temporarily infertile. Mares may sustain a carrier state with no signs of infection but remain capable of transmitting infection because the bacteria are established on the surface of the clitoris, the clitoral fossa and the clitoral sinuses. Laboratory diagnosis: Swabs are taken from three sites of stallions; the urethra, urethral fossa and penile sheath, plus pre-ejaculatory fluid when possible. In Mares clitoral swabs are taken from two sites; the clitoral fossa and the clitoral sinus. Endometrial swabs taken during oestrus from the lining of the uterus. Separate swabs should be used for each site and tested by aerobic and microaerophilic culture and/or PCR. Control and treatment: As a notifiable disease in NZ, treatment and control arrangements are under instructions from MPI at 0800 80 99 66. Prevention: Abide by strict biosecurity prior to, during and after breeding. Notifiable in NZ: Yes, required under the Biosecurity Act 1993. Zoonotic Risk: None. Final Note from New Zealand Equine Health Association: Be suspicious of CEM with any mare having a vulval discharge! Although New Zealand has import protocols that demand pre-import testing, getting good samples can be problematic and the organism can be difficult to grow in the laboratory. Thus, it is conceivable that this organism could arrive in New Zealand undetected. All veterinarians should exercise vigilance! If you suspect youâ&#x20AC;&#x2122;ve seen an exotic, or emerging, or re-emerging disease [such as CEM], please phone Biosecurity New Zealand on 0800 80 99 66 or Pest & Disease Reporting as soon as reasonably practical.

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OBITUARY

Charles Roberts One of the legends of the veterinary profession died peacefully on the 27th April at a rest home in Auckland at the ripe old age of 96 years after a successful and colourful career. Charles was born in the heart of Pakuranga on the family dairy farm. His ambition was always to become a vet and work with cattle and horses. In those days that required a trip to Sydney as Massey University Veterinary School had not opened. After graduating, Charles worked in Matamata before starting Veterinary Associates in Takanini, and then in 1990 started the Auckland Veterinary Centre. Also, as a successful dairy farmer in South Auckland Charles bred one of New Zealand’s best pedigree Friesian dairy herds and several of his bulls stood at Livestock Improvement in the late seventies. But his real passion was racehorses and horse breeding. In 1948 he was one of eight founding members of what became The NZ Thoroughbred Breeders Association. He was involved in securing the importation of Thoroughbred stallions Mellay, Noble Bijou and Taipan II to name a few and bred several Group I Thoroughbred winners including Royal Sheen, Fothers, Penny Edition and Beechcraft. His biggest success in racing and breeding came later in life when in 1992 Charles co-foundered the Standardbred Stud Woodlands Stud with his long-time vet colleague and business partner Andrew Grierson. Over the years Woodlands Stud has become a dominant force in Australasia with flagship stallion Bettor’s Delight the number one NZ stallion for the last eight years. Charles bred many Standardbred Group I winners both individually and through Woodlands. The highlight being breeding and racing the fastest mare in the Southern Hemisphere Adore Me. She was a champion on and off the track with her first foal becoming the leading 2-year-old of her year. Charles also bred and sold Adore Me’s full brother as a yearling who later became the fastest horse in Australasia Have Faith In Me. Charles was a smart man and incredibly hard working, being happy to work many weeks on end during the Spring. Charles was always thinking and questioning why we do things and would say to young graduates: ‘get the right diagnosis and only then can you be of help’. His work in the late seventies on epiphysitis in young growing horses confirmed that calcium to phosphorous ratio imbalances in the diet were almost always from a deficiency in phosphorus not calcium. He formulated a product he marketed as Chasmix using bovine bone flour and disodium phosphate with traces of copper and fluoride. This was a breakthrough in its day and was used by all major stud farms in the 1990’s, and only got phased out when feed companies started producing balanced, complete feeds for young horses. Notably, Charles was the first to use propantheline bromide as a smooth muscle relaxant for rectal examinations of

Photo: Jason Oxenham, NZ Herald

maiden mares. On the recommendation of a Proctologist friend he purchased what was available - 10mg tablets in the day. Mixing a syringe of sterile water with a couple of blue propantheline tablets was such a success the idea was later commercialised by NatureVet of Australia and sold around the world. Charles was fearless in investing in new technology. The best example was in 1981 when together with Dr Stan Cosgrove, founder of Troytown Hospital in Co. Kildare, Ireland, they bought one of the first three ultrasound scanners available for use in mares. The hefty purchase price of $20,000 could buy a house in Papakura in the day. The scanner shuttled to and from Ireland for several years and was an undoubted commercial success. Charles was the first person to describe the crushing of one twin embryo that he presented in a paper to the Third International Symposium on Equine Reproduction in 1982. What was extraordinary was this paper pre-dated the advent of the ultrasound scan. He described how they are best done around twenty, rather than out at thirty plus days. This was later to be proven correct with the advent of ultrasound scanning. In the late 1970’s, before bottles of prostaglandin were available, he pioneered the uterine irrigation of kerosene to bring mares into season. He soon realised that some mares with chronic uterine infections regarded as difficult breeders often became pregnant after such treatment. On Charles’s insistence Professor Twink Allen agreed to do a controlled study at the Equine Fertility Centre, Newmarket, UK, where it was confirmed some mares with a Grade III uterine biopsy improved with the procedure. At that time some people said this was a barbaric practice and a welfare issue. Charles, to prove the point that kerosene is not dangerous, would douse his own eye in front of astonished doubters. No harm done. He had found out from the leading eye specialist at the time, Dr Calvin Ring, that kerosene was the “go to” flush for human eyes to counter some industrial solvents. The flushing of mares with Kerosene is still used today. Charles Roberts’ passion for the horse and his devotion as a veterinarian was always clear for all to see. He leaves us as making a difference to both the horse industry and to veterinary science. AG. 13/05/20

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Invited Commentary

SARS-COV-2 AND ANIMALS. WHAT DO WE KNOW SO FAR? Magda Dunowska Massey University m.dunowska@massey.ac.nz

Amid coronavirus disease 2019 (COVID-19) pandemic many people wonder how easy it is for coronaviruses to cross species barriers. Is it possible for household pets or livestock animals, including horses, to become infected with severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), the causative agent for COVID-19? Should we be worried about catching the virus from our cat, our dog or a horse? Some may even wonder if animal coronaviruses such as equine coronavirus can cross-over to humans and cause disease. There are over 2,500 coronaviruses that are currently classified into 39 species, 27 subgenera, five genera and two subfamilies within the family Coronaviridae [1} Coronaviruses did not attract much scientific attention until 2003, when the first worldwide outbreak of SARS occurred [2]. This was followed by emergence of Middle East respiratory syndrome (MERS)-CoV in 2012 [3] and finally the current COVID-19 pandemic. In a recent study, a total of 73 coronaviruses were identified among 1067 bats from 21 species in three provinces of China, with an overall prevalence of 6.8% [4]. The 41 betacoronaviruses were all closely related to the current members of the species Severe acute respiratory syndrome related viruses, including SARS-CoV-1 and SARS-CoV-2, highlighting the likely role of bats as direct or indirect source not only for SARS-CoV-1 [3], MERS-CoV [5] and most likely SARSCoV-2 [6], but also for other coronaviruses with a potential to pose a threat to human health. Despite its presumed zoonotic origin, there is no indication that domesticated animals (pets or livestock) have played any role in the current pandemic spread of SARS-CoV-2 among people. As of today (31 May 2020) there have been over 6M human infections worldwide compared with only a handful of reported animal cases (Table 1). The fact that the lock-down measures implemented in New Zealand and other countries appear to have been effective in controlling spread of SARS-CoV-2 further argues against domesticated animals comprising an important source of infection for humans. A successful cross-species transmission of a virus from an animal to a person, with subsequent person-to-person spread, as we’ve seen with SARS-CoV-2, is fortunately a rare event. Several well-timed coincidences need to happen for this to occur [7, 8]. To start with, the infected

26 Eq Vet Pract 2020, June; 45 (2)

animal host needs to find itself in a close vicinity to the new human host. A major source of new emerging infections for humans are viruses that circulate in wildlife among animals that rarely, if ever, find themselves near people [9]. However, human expansion coupled with activities such as deforestation, urbanization, illegal wildlife or bushmeat trade all tip this balance in favour for potential ‘spill-over’ events to occur [7, 8]. Domesticated animals can serve as intermediate hosts due to their higher frequency of contact with both wildlife and humans, as exemplified by the role of camels in transmission of MERS-CoV to people [5].

To infect a new host, the virus must be able to enter appropriate tissues and establish productive infection in those tissues. Enough infectious virus needs to be generated to allow infection to be propagated to another individual form the new host’s species. Neither of those steps are easy for the virus to accomplish, as there are several host- and virus-related restrictions that prevent effective establishment of infection in a non-natural host [7, 8]. These include availability of suitable cellular receptors for the virus entry, restrictions at various steps of intracellular virus replication, or innate immune responses. Even if successful, the virus typically needs to adjust to its new host [7, 8]. As a result, infection may be initially established only briefly, without further transmission of the virus, as it was observed in dogs experimentally infected with SARS-CoV-2 [10]. In the same study, cats were successfully infected with SARSCoV-2 and transmitted the virus to one out of three uninfected cats housed in adjacent cages [10]. The experimental conditions (high load of the inoculated virus

and prolonged indirect exposure of naïve cats to infected cats) would be unlikely to be replicated in real life and hence, the ability of SARS-CoV-2 to be transmitted from naturally infected cats to other cats, or to humans, needs to be further investigated. Pigs, chickens, and ducks were fully refractory to experimental SARS-CoV-2 infection in that study. The susceptibility of cats to experimental infection with SARS-CoV-2 was further confirmed by German-based researchers (at https://promedmail.org/ promed-posts/ archive number 20200407.7196506,) and US-based [11] researchers. Wild felids also appear to be susceptible to SARS-CoV-2 infection, with nine reported cases, eight of which from the Bronx zoo in New York ( at https://promedmail.org/ promed-posts/ archive number 20200430.7284183). Although the source of infection for the big cats in the Bronx zoo was presumed to be a COVID-19 affected caretaker, the possibility that cat-to-cat transmission may have occurred cannot be excluded. There are currently no data available on susceptibility of horses to SARS-CoV-2. Horses were refractory to experimental infection with MERS-CoV [12] and there are no reports of SARS-CoV-1 infection in the horse. By extrapolation, it is likely that horses are not susceptible to SARS-CoV-2 infection, but this needs to be further confirmed.

the USA and Korea between February 14 to March 12 were tested. This testing has been subsequently expanded to Canada and Europe, with over 5,000 specimens tested by mid-April all returning negative results. In conclusion, the occasional reports of SARS-CoV-2 infections in animals, most commonly cats, most likely represent exceptions rather than the rule. The animals most at risks would be those in close contact with COVID-19 affected people. However, more research is needed to fully evaluate the extent to which such animals may occasionally become infected with the virus and whether or not they can transmit the virus further. It is worth considering that the on-going exposure to SARSCoV-2 may result in adaptations of the virus to yet another host. In order to prevent that from happening, appropriate precautions should be applied to minimize contact between COVID-19 affected people and pet or livestock animals in their care. Suspected or confirmed cases of SARS-CoV-2 infection in animals should be notified to OIE through the World Animal Health Information System (WAHIS). For more information on case definition and guidelines for sampling see: WWW.OIE.SARS-2-CoV

The successful propagation of the virus in the new host population is also dependent on factors such as density of the new hosts in each area and frequency of direct or indirect contact between them. If some ongoing transmission between the new hosts does occur, the virus can accumulate mutations that are necessary for adaptation to specific restriction factors, with the possibility of subsequent epidemic or pandemic spread within an immunologically naïve population. Those concepts can be illustrated well by the history of human immunodeficiency virus [13] or canine parvovirus [14] pandemics. Occasional unrecognised infections with these viruses among people and dogs, respectively, had probably occurred for many years before either virus was first recognised at the time of its pandemic spread.

SOME USEFUL RESOURCES:

Antibodies to SARS-CoV-2 were found in 14.7% of 102 cats from Wuhan that were sampled during the COVID-19 epidemic [15]. This suggests that cats can be naturally infected with the virus, most likely following contact with COVID-19 affected people. Others reported no SARSCoV-2 seropositivity among samples from 87 cats and 487 dogs collected during COVID-19 outbreak, presumably in China, although the exact geographical region for sampling was not specified [16]. Finally, one of veterinary diagnostic laboratories (IDEXX) has tested samples from cats and dogs as part of validation of their diagnostic test for SARS-CoV-2 RNA among pets. Initially, the samples submitted for one of the IDEXX PCR respiratory panels in

REFERENCES

General advice about COVID-19 to pet owners from the New Zealand Veterinary Association: https://www.nzva. org.nz/news/493076/COVID-19-and-animals.htm Questions and Answers about COVID-19 in animals from OIE: https://www.oie.int/scientific-expertise/specificinformation-and-recommendations/questions-andanswers-on-2019novel-coronavirus/ COVID-19 and animals from Systemic Reviews for Animals and Food at the Michigan State University, USA. This is not peer-reviewed and is designed to provide updated sources of relevant information (peer-reviewed and non-peer-reviewed) of interest to veterinarians: http://www.syreaf.org

1. Coronaviridae Study Group of the International Committee on Taxonomy of, V., The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol, 2020. 5(4): p. 536-544. 2. Song, Z., et al., From SARS to MERS, Thrusting Coronaviruses into the Spotlight. Viruses, 2019. 11(1). 3. Guan, Y., et al., Isolation and characterization of viruses related to the SARS coronavirus from animals in southern China. Science, 2003. 302(5643): p. 276-8.

Eq Vet Pract 2020 June; 45 (2) 27

4. Lin, X.D., et al., Extensive diversity of coronaviruses in bats from China. Virology, 2017. 507: p. 1-10.

11. Halfmann, P.J., et al., Transmission of SARS-CoV-2 in Domestic Cats. N Engl J Med, 2020.

5. Drosten, C., P. Kellam, and Z.A. Memish, Evidence for camel-to-human transmission of MERS coronavirus. N Engl J Med, 2014. 371(14): p. 1359-60.

12. Vergara-Alert, J., et al., Livestock Susceptibility to Infection with Middle East Respiratory Syndrome Coronavirus. Emerg Infect Dis, 2017. 23(2): p. 232-240.

6. Zhou, P., et al., A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature, 2020. 579(7798): p. 270-273.

13. Sharp, P.M. and B.H. Hahn, Origins of HIV and the AIDS pandemic. Cold Spring Harb Perspect Med, 2011. 1(1): p. a006841.

7. Plowright, R.K., et al., Pathways to zoonotic spillover. Nat Rev Microbiol, 2017. 15(8): p. 502-510.

14. Carmichael, L.E., An annotated historical account of canine parvovirus. J Vet Med B Infect Dis Vet Public Health, 2005. 52(7-8): p. 303-11.

8. Parrish, C.R., et al., Cross-species virus transmission and the emergence of new epidemic diseases. Microbiol Mol Biol Rev, 2008. 72(3): p. 457-70. 9. Epstein, J.H. and S.J. Anthony, Viral discovery as a tool for pandemic preparedness. Rev Sci Tech, 2017. 36(2): p. 499-512. 10. Shi, J., et al., Susceptibility of ferrets, cats, dogs, and other domesticated animals to SARS-coronavirus 2. Science, 2020.

15. Zhang, Q., et al., SARS-CoV-2 neutralizing serum antibodies in cats: a serological investigation. bioRxiv, 2020: p. 2020.04.01.021196. 16. Deng, J., et al., Serological survey of SARS-CoV-2 for experimental, domestic, companion and wild animals excludes intermediate hosts of 35 different species of animals. Transbound Emerg Dis, 2020.

Table 1: Reported cases of SARS-CoV-2 in animals (as of 7th May 2020). For references to the sources of information about each case see http://www.syreaf.org Animal

Location

Contact with COVID-19 affected person

Disease yes/no

Domestic cat

Hong Kong

Yes, owner

Domestic cat

Belgium

Yes, owner

Yes

Domestic cat

New York, USA

Yes, owner

Yes

Domestic cat

New York, USA

Possible, outdoor cat

Yes

Domestic cat (x 3, Ab +ve, virus -ve)

Netherlands

Resident on infected mink farms

Domestic cat1

Germany

Yes, owner died of COVID-19

Domestic cat

France

Yes, retirement home

Yes

Domestic cat

France

Yes, owner

Yes

Dog (17-year-old Pomeranian)

Hong Kong

Yes, owner

Yes, death3

Dog (2-year-old German Shepherd)

Hong Kong

Yes, owner

Dog (Ab +ve, virus ?)

Netherlands

Yes, owner

Yes, euthanised

Dog

North Carolina, USA

Yes, owner

Yes

Bengal tiger

Pench Tiger Reserve, India

Malayan tiger (x3)

Bronx zoo, New York city, USA

Yes, caretaker

Yes

Amur tiger (x2)

Bronx zoo, New York city, USA

Yes, caretaker

Yes

African Lion (x3)

Bronx zoo, New York city, USA

Yes, caretaker

Yes

Mink (2 farms)

Netherlands

Yes, caretaker

Yes

Yes, death

1 One out of 3 cats in the retirement home, the remaining 2 were negative for the virus. 2 This unpublished study included unspecified number of cats that had been in contact with people with confirmed or suspected Covid-19. Each cat was tested for SARS-CoV-2 infection using nasopharyngeal and rectal swabs. The cat in question tested positive only on a rectal swab: https://promedmail.org/promed-post/?id=7289409 3 The dog did not display any clinical signs while at the quarantine facility in Hong Kong and died at home following its release. The cause of death has not been established.

28 Eq Vet Pract 2020, June; 45 (2)

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AVMA Veterinarian Wellness Survey Results

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Controlling Estrus in Performance Mares

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Routine and emergency surgical procedures, including: • Orthopaedics, colic, and dystocias • IRAP, stem cell and PRP treatments • Video endoscopy and dynamic airway endoscopy • Critical care and internal medicine services • Lameness and prepurchase examinations A dedicated team, including both a boardcertified surgeon and a board-certified medicine internist, offering 24/7 treatment and services. We aim to provide you and your clients with the best possible care and advice for their horses.

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UPDATE ON E-LEARNING RESOURCES The effects of the SARS-CoV-2 virus and its disease COVID-19 will be with us for some time yet. One result of ‘lockdown’ has been for many groups to share E-education material. We have here collated several of these resources that may be of interest to our EVP readers; ENJOY.

Image by Tumisu from Pixabay

NOTE: some resources may require free or paid registration.

1. AAEP Education Community - Free Online Presentations.

AAEP has opened the Student Educational Resources for free online viewing. Links to the presentations all should still be live at https://aaep.org/student-education-community by the time you read this June EVP.

Tentative presentation schedule: April 14: Equine Neurologic Examination by Sarah Reuss. April 16: How to Determine if a Wound Involves a Synovial Structure in the Field April 21: DIY Equine Rehab: Tools that You Can Use at Home by Sherry Johnson April 23: What is an Equine Sarcoid and How Can It Be Managed? by Derek Knottenbelt April 28: A Case-Based Approach to Equine Podiatry by Craig Lesser April 30: Strategies for Retained Fetal Membranes by Chelsie Burden May 5: Referral Center Colic: How to work up as an Intern by Holly Stewart May 7: How to Maximize Standing Chemical Restraint in the Field by John Hubbell May 12: How to Diagnose and Manage Corneal Ulcer by Kathyrn Wotman Part 1: Equine Cornea: It’s Where the Fun Begins! Part 2: Equine Corneal Disease May 14: Essential Components of the Pre-purchase Exam Reese Hand May 19: Clinical tricks to equine castrations in the field by Luke Bass May 21: Navicular Syndrome by Vern Dryden May 26: Workup of the “Poor Performance” Case by Erin Contino May 28: How to Use the Foal Squeeze Technique by John Madigan June 2: Field Emergencies Case and Lessons Learned from a Current Intern by Jamie Clark June 4: How to Radiograph Cheek Teeth by Leah Limone June 9: TBA June 11: Sharpening Dental Radiograph Interpretation Skills by Robert Baratt June 2: Field Emergencies Case and Lessons Learned from a Current Intern by Jamie Clark June 4: How to Radiograph Cheek Teeth by Leah Limone June 9: Veterinarian Biosecurity Training (CEF presentation) by Jean-Yin Tan June 11: Sharpening Dental Radiograph Interpretation Skills by Robert Baratt

30 Eq Vet Pract 2020, June; 45 (2)

June 16: How to Manage Reproductive Cycle when Using Cooled Semen by Patrick McCue June 18: The Pruritic/Hivey Horse: Allergies and Urticaria by Stephen White June 23: Placentitis: The Basics and Case Examples by Margo Macpherson June 25: Examination and Treatment of Lameness - Stifle to Foot by Cooper Williams June 30: CBD: What the Equine Practitioner Needs to Know by Chelsea Luedke July 2:

How to Perform and Document an Oral Examination by Claudia True

July 7:

Equine Joint Therapies by Colton McInturff

July 9:

Examination of the Equine Foot by Tracy A. Turner

July 14: Neurology Cases by Sarah Reuss July 16: Postpartum Complications in the Mare by Karen Wolfsdorf July 21: Clinical Parasitology for the Equine Practitioner by Martin Nielsen July 23: Making Extractions Possible: Regional Anesthesia by Jennifer Rawlinson 2. AAEP CONVENTION RECORDINGS. American Association of Equine Practitioners. Membership required. 3. International Veterinary Information Service [IVIS] IVIS: Home Page. Free registration required 4. Merck Manual https://www.merckvetmanual.com/. Encyclopaedic resource. 5. Boeringher Academy https://www.boehringer-academy.co.uk/webinars/animal-specie/40. Many webinars. Free registration required. 6. Veterinary Information Network – membership required. VIN has many equine procedure videos. 7. International Society of Equine Locomotor Pathology [ISELP] – Free Webinar: Biologics in Equine Medicine, Sponsord by OWL MANOR 8. International Society of Equine Locomotor Pathology [ISELP] – On Demand For a limited time ISELP are offering a selection of Free Lectures that are excerpts from the 2019 ISELP Sports Medicine & Rehabilitation Module. Since EVP press time, more videos may be added. Improving Radiology of the Hock - Kurt Selberg Radiology of the Stifle - Sarah Puchalski “Shoeing” - Stephen O’Grady Equine Rehabilitation: Can We Make A Difference? - Melissa King Tendon and Ligament Injury with an Eye on Rehabilitation - Duncan Peters 9. AVMA and AAHA have compiled several resources on TeleMedicine that are worth a view. Veterinary Telehealth: The Basics

Virtual Care and Telehealth

Eq Vet Pract 2020 June; 45 (2) 31

NEW ZEALAND THOROUGHBRED RACING WELFARE UPDATE NZTR General Manager for Racing & Equine Welfare, Martin Burns, recently released their Thoroughbred Welfare Guidelines with the aim of supporting NZTR’s vision for Thoroughbred welfare: “A Thoroughbred should be provided a good life, with the care and conditions that allow it to thrive and perform to its natural abilities”. The updated Rules of Racing which reflect these Thoroughbred Welfare Guidelines came into effect in December 2019, and contain welfare responsibilities for persons accountable for thoroughbred racehorses.

EVP Ed ucational Fund Dear Colleagues;

DID YOU KNOW THAT YOU ARE ELIGIBLE TO APPLY FOR EVP FUNDS TO ASSIST YOU IN OBTAINING EQUINE VETERINARY EXPERIENCE, TRAINING, CPD ETC? An annual sum of money is set aside each year by the NZEVA EVP Subcommittee to establish a Continuing Education (CE) fund. The two main purposes of this fund are: • facilitating continuing education and/or specialist training for EVP Editorial Group members AND for all paid up NZEVA members at large • dissemination of such newly acquired information of benefit to New Zealand equine practitioners through publication in the Equine Veterinary Practitioner Applicants seeking assistance from the CE fund must adhere to the following guidelines: 1. Present a complete budget for the proposed CE project and identify all sources of funds being sought and the planned use of any funds awarded from this fund. 2. Demonstrate that funds awarded under this scheme were used for the stated purpose. 3. Normally present a verbal report to the NZEVA EVP Editorial Committee at the first EVP meeting held after completion of the CE project, or at the next NZEVA Annual Conference. 4. Within 60 days of the applicant completing, and/or returning to NZ from, the CE project, submit to the Editor of the EVP a concise report of the project, identifying key new practical items of information of interest and value to NZ equine practitioners. This report should adhere to EVP publication guidelines. 5. Applications can be made in writing to, and will be assessed by, a senior member of the EVP Editorial Committee and the Treasurer – who are ineligible for funding. 6. The application must include a signed statement that, “I have read and understand my obligations to the EVP Editorial Committee.” 7. Approved applications can access up to 75% of awarded funds prior to undertaking the proposed travel. The remaining 25% will be paid upon receipt of an acceptable written report. 8. Except in exceptional cases, the amount awarded to any individual applicant will not exceed 50% of the available funds.

32 Eq Vet Pract 2020, June; 45 (2)

Kennedy RA et al. long-term study of equine cheek teeth post-extraction complications: 428 cheek teeth (2004-2018). Eq Vet J. APR 2020; DOI: 10.1111/evj.13255

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Details of complications, taken from clinical records and from written questionnaires sent to owners, of 428 cheek teeth extractions performed Feb 2004Sept 2018 were analysed. Complications were recorded following 58 of the 428 extractions giving a complication rate of 14%. Longer term clinical problems occurred in 34/428 (8%) cases, with asymptomatic or quickly self-resolving complications in the other 24 cases (6%). The most frequent complication was alveolar bone sequestration, including alveolar infection. Risk of developing a post-extraction alveolar disorder (n = 53) increased following extraction of the mandibular 06s, 07s or 08s compared with all other cheek teeth combined (P = 0.001). The risk was greater when apical infection was present compared with no apical infectionÂ (P = 0.002), and following repulsion or minimally invasive transbuccal extraction (MTE) compared with oral extraction (P = 0.02).

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Various surgical treatments for distal femoral condylar fractures are reported. A 10-day-old Standardbred filly sustained a complex Salter-Harris type-III fracture of the right, lateral, distal femoral condyle along transverse, sagittal and frontal planes. There was only modest lameness and minimal swellimg apparent around the stifle.The filly was treated by restricting it and its dam to a small, level paddock until lameness was no longer apparent. The filly, when weaned at 7 months of age, was turned out to pasture with three other weanlings. The filly entered race training as a 2-year-old, qualified to race as a trotter, was placed second in its first start and won its third race. The authors suggest that conservative treatment should be considered as an option for a young horse with a minimally displaced, Salter-Harris type-III fracture of the distal lateral femoral condyle. In this case the filly was able to ambulate veery well such that stall confinement was not considered nece3ssary. Obviously under other situations that may be advised for conservative management of such a fracture.

Eq Vet Pract 2020 June; 45 (2) 33

HOW TO TREAT COMPLICATIONS OF CASTRATION IN THE FIELD. Tim G. Eastman DVM, MPVM, DACVS http://steinbeckequine.com/

INTRODUCTION Castration remains one of the most commonly performed field surgeries by equine veterinarians. Complication rates vary among studies but remain relatively high with 10-28% of horses experiencing some form of complication and continues to be a major source of malpractice suits against equine veterinarians.1-4 Even with strict adherence to aseptic principles and prophylactic antibiotics complications such as edema, seroma, hemorrhage, infection and eventration are possible. A thorough understanding of how to recognize and manage these complications will oftentimes improve the ultimate outcome. While the preferred surgical approach will vary among individuals and the equipment that they choose, no method is without inherent risks. Castration can be performed in either standing sedated patients using local anesthesia or under intravenous general anesthesia. The various techniques have been well described elsewhere and include closed, semi-closed, and open.5 While it is possible to safely close castration incisions in recumbent patients, most prefer to leave the incisions open to heal by second intention especially in field settings. As with any field surgery, proper anesthetic and surgical planning should be reviewed and care should be taken to make sure any necessary equipment to manage complications is present in addition to what may be needed for the procedure.

EDEMA/SEROMA Post-operative swelling is the most frequently encountered complication of castration and is generally responsive to medical management (Figure 1). Edema and swelling of the scrotal and preputial tissues is normal but if it persists or becomes excessive should be addressed. Generally it will resolve within several days of the procedure but may occur 7-10 days later, especially if postoperative exercise recommendations are not adhered to. In more mild cases, increasing exercise and administration of non-steroidal anti-inflammatory drugs (NSAIDs) is enough to reduce inflammation. Utilizing good quality emasculators, stretching of the incisions following removal of the instruments, owner compliance to aftercare recommendations specifically forced exercise 5-10 minutes twice daily for 7-10 days

34 Eq Vet Pract 2020, June; 45 (2)

Proc AAEP 2019; 65: 172-176. This paper is republished in EVP with permission of the American Association of Equine Practitioners and the author.

and assuring adequate size of the incisions will minimize post-operative edema formation. The author prefers to ablate the lower third of the scrotum at the time of the initial incision rather than making two separate incisions and later removing the median raphe to facilitate the procedure and establish adequate drainage.

Figure 1: Seroma formation and edema following castration.

Older horses may develop edema more often when compared to younger horses which may make them more reluctant to exercise and increase the chances of seroma formation4. A recent paper has shown that the closed method of castration is less likely to lead to complications when compared to the semi-closed technique1. The authors of that paper tended to use the semi-closed technique on older horses (mean age 46 months) and the closed technique on younger (mean age 18 months) patients. In that study a statistically significant higher percentage of equids castrated by the semi-closed technique experienced complications (23.5%) than ones in which closed castration was performed (6.1%).1 Seromas may develop several weeks following castration especially if the incisions close prematurely. If a seroma develops the horse should be chemically and physically restrained and following aseptic preparation the incision should be manually reopened and stretched with a sterile gloved finger. Once adequate drainage is established, broad spectrum antibiotics and NSAIDâ&#x20AC;&#x2122;s as well as forced daily exercise should be continued until the incisions heal and all swelling subsides.

Occasionally a strip of subcutaneous or fatty tissue will protrude from the scrotal incision which can cause owners to worry and may contribute to swelling and serve as a nidus of infection. Once the castration is completed and the incisions have been stretched any subcutaneous tissue that may hang down from the site should be carefully trimmed. Occasionally a portion of omentum may protrude down from the incision. Following adequate chemical and physical restraint, the omentum may be ligated as proximal as possible and safely transected or emasculated (Figure 2).

scirrhous cords surgical debridement of the infected stump and associated fibrous tissue is warranted. Sinus formation may take place over a year after the incisions have healed and will present with persistent serous drainage (Figure 3b). There is a direct communication along the spermatic cord with the abdominal cavity so the potential to develop septic peritonitis exists, though occurrence is rare. Non-septic peritonitis occurs with all castrations and peritoneal nucleated cell counts can be surprisingly elevated without leading to clinical signs.5 If a horse presents with fever, depression, inappetence or other sign of septic peritonitis following castration possible referral for aggressive treatment should be discussed.

Figure 2: Inflamed omentum prolapsed through a castration site.

INFECTION If swelling and or a seroma becomes persistent, especially in the presence of fever or supportive CBC findings, infection should be suspected (Figure 3a). Most infections are local and respond to similar treatment as for seromas. Long-term drainage may arise from infection of the spermatic cord (scirrhous cord) even months after surgery. The most common bacterial isolates from post-operative castration infections include Streptococcus zooepidemicus and Staphylococcus sp. Pre-operative antibiotics and aseptic technique as well as owner compliance are all important in the prevention of post-operative infections (POI).5 Although there is conflicting results in the literature regarding the efficacy of prophylactic antibiotics at preventing infections, the author routinely administers procaine penicillin G (22,000 IU/kg) approximately an hour before surgery to allow sufficient time for circulation prior to making an incision. Early treatment of incisional infection or seroma will allow management in the field in most instances. Establishing adequate drainage by opening and enlarging the incisions, lavaging the site with copious amounts of sterile isotonic fluids and instituting broad spectrum antibiotics may all be performed either standing or in fractious animals, under injectable anesthesia. NSAIDâ&#x20AC;&#x2122;s should be administered to reduce pain and inflammation associated with the infection. With established infections of deeper tissues as in

Figure 3: A. Localized incisional infections following opening bilateral seromas. B. Necrotic and infected spermatic cord removed following persistent infection of castration site.

HEMORRHAGE A mild amount of bleeding will occur with all castrations following recovery from anesthesia however if bleeding is prolonged or in a steady stream further measures should be taken. Horse owners are commonly told if hemorrhage is mild enough that they can â&#x20AC;&#x153;count the dropsâ&#x20AC;? there is minimal cause for concern. Proper use of a good quality pair of emasculators is imperative to reduce the risk associated with castration site hemorrhage. The emasculators should be placed perpendicular to the spermatic cord, under minimal tension and free of any surrounding tissue. In older horses or larger breeds, bluntly dissecting free the cremaster muscle from the spermatic cord and emasculating each structure individually may reduce the risk associated with hemorrhage. Regardless of what type of emasculators Eq Vet Pract 2020 June; 45 (2) 35

are used, sufficient time (1-2 minutes) should be provided and the stump proximal to the site of the emasculators should be firmly held with a separate instrument such as a Rochester-Carmalt once the emasculators are released, the stump may be further inspected for evidence of hemorrhage (Figure 4). Any persistent bleeding vessels should be identified and ligated prior to completion of the surgery. If bleeding continues once the horse is standing, the scrotal incision should be explored for the source and direct ligation performed. If the hemorrhage is originating from the stump it may need to be locally anesthetized and emasculated a second time. At this point a transfixation ligature should be placed as far proximal on the stump as possible. Placement of a transfixation ligature proximal to the emasculators is thought to increase the incidence of complications following castrations and should only be performed when necessary to control active hemorrhage. If one is unable to identify the source of the bleeding, the scrotal incision may be packed with a roll of gauze or a sterile surgical huck towel may be sutured or towel clamped in place to the scrotal skin to apply direct pressure. Hemorrhage that occurs from deep within the inguinal ring during surgery may need to be controlled by placing sterile gauze into the inguinal canal through the external inguinal ring in an accordion like fashion to exert local pressure and sutured or clamped to the surrounding skin. The packing may be removed 24-48 hours later and the horse monitored to confirm that the offending blood vessel has clotted.

Figure 4: Clamping spermatic cord proximal to emasculators to retain castration stump for visual inspection and hemorrhage control.

Emasculating the spermatic cord under excessive tension may cause the testicular artery and associated vessels to retract into the abdomen beyond the reach of the surgeon. In this instance, internal hemorrhage may occur. Horses with internal bleeding may be identified by characteristic pale membranes, tachycardia, tachypnea, lethargy, and mild colic. Ultrasound of the ventral abdomen should be performed to detect the presence

36 Eq Vet Pract 2020, June; 45 (2)

of hemabdomen which appears as hyperechoic fluid swirling in the abdomen. First-aid measures in the field for excessive external hemorrhage or suspected internal hemorrhage should involve supportive care in the form of IV fluids and possibly aminocaproic acid (100mg/kg, IV). Referral should be considered if internal bleeding is suspected, hemorrhage is prolonged, its source cannot be identified, or signs of hypovolemic shock develop.

EVENTRATION/EVISCERATION Although a rare complication of castration, eventration of the small intestine through the inguinal rings is oftentimes fatal. A breed predilection for increased risk may occur with Standardbreds, Draft Horses, and possibly Saddlebreds and Tennessee Walking horses. Recently a large online survey was conducted of equine practitioners with regards to eventration following castration which agreed with an earlier study that the overall incidence of this complication is low (.20%).7 The survey also suggested that castrations performed standing and the use of emasculators vs twisting the cord until breakage were less likely to lead to eventration.7 When eventration occurs, initial therapy should be aimed at protecting the bowel from further damage. The bowel should be thoroughly lavaged with sterile isotonic fluids and held in place in the scrotal incision with large sutures or towel clamps. If more intestine has passed through the incision than can be held within the scrotal remnant, a sling may be fashioned with a small towel sutured to either side of the scrotal skin. Alternatively, the horse may be re-anesthetized and the external inguinal ring enlarged to allow the bowel to be replaced within the abdomen. Replacing the bowel into the abdomen once a horse has been re-anesthetized is generally not possible due to edema that forms in the intestinal wall and mesentery once eventration has occurred. The internal inguinal ring is not readily accessible however with one hand acting as a retractor to protect the intestine against further damage, a pair of surgical scissors or a curved bistuory may be guided into the cranial end of the external inguinal ring and the ring may be extended several centimeters. This greatly facilitates replacement of the intestine into the abdomen but also requires primary closure of the external inguinal ring with heavy duty absorbable suture.5 The author prefers to use #2 polyglactin 910 (Vicryl, Ethicon US, Johnson & Johnson, Cornelia GA.) threaded through a hernia/kidney needle with the two ends tied together. Once the blunt point of the needle is guided across the cranial aspect of the external inguinal ring the needle can be pulled through the loop of suture so that no knot is needed and subsequent bites are facilitated by holding the suture in traction. Further bowel prolapsing through the canal during transportation to a referral hospital is unlikely with the eternal inguinal ring sutured closed and further damage to the intestine should be halted.

If one is unfamiliar with suturing the external inguinal ring a thorough knowledge of the anatomy is helpful and an assistant if available will greatly facilitate the procedure. The horse should be sent for an exploratory laparotomy as soon as possible because the intestine cannot be adequately evaluated for viability in the field. Broad spectrum antibiotic therapy and NSAID’s are instituted prior to shipping. It is the author’s opinion the further one is from a surgical facility the more one should consider re-anesthetizing the horse and attempt to replace the bowel into the abdomen with closure of the external inguinal ring if an effort to save the horse is going to be made.

OTHER CONSIDERATIONS Duration of surgery may be related to an increased complication rate so having all instruments open and set out prior to anesthesia can save valuable time. Less additional anesthesia may be needed if Lidocaine is used to directly infuse the testicle and possibly the spermatic cord in order to maintain a deeper plane of anesthesia.6 Injury to the penile shaft has been reported during routine castration. A quick review of the relevant anatomy and double checking that the correct structures are present prior to emasculation should reduce the chances of inadvertently damaging any unrelated tissue.5 There are reports that use of the Henderson equine castration tool results in fewer complications and may decrease surgical time by twisting the cord until breakage rather than emasculation.8 Use of the Henderson castration tool has become relatively common although this author has limited experience with its use. Some thought should be given to anesthetic complications during even short field procedures. Facial nerve paralysis can result from direct pressure to the facial nerve from the buckle on a halter so the halter should be removed until the horse is ready to be stood up. Pulling the down leg forward will decrease the likelihood of radial nerve paralysis. Care should be taken to find the safest place to perform castration in the field with regards to sterility and safety from fixed objects when standing. Covering the patient’s eyes and keeping the environment quiet will help maintain horses in recumbency until they are ready to stand. If a horse is to stumble and fall as they stand they generally fall forward so an assistant applying steady traction to their tail as they stand and then quickly relieving the tension once they are up frequently providing a better recovery. Once the horse is standing the tail should be released, and the assistant can carefully put a hand on the cheek piece of the halter and one on their shoulder until they are steady on their feet.

CONCLUSION While complications associated with castration cannot be eliminated, proper pre-operative planning, good surgical technique, and early recognition and treatment will improve outcome. Having everything needed to address complications as they arise will allow for proper first-aid measures and may decrease exposure to litigation. These complications happen to new as well as seasoned practitioners and some thought should be given to assure that should they arise, they can be properly addressed.

ACKNOWLEDGEMENTS Declaration of Ethics: The author had adhered to the Principles of Veterinary Medical Ethics of the AVMA. Conflict of Interest: The author has no conflicts of interest.

REFERENCES 1. Kilcoyne IK, Watson JL, Kass PH, et al. Incidence, management, and outcome of complications of castration in equids: 324 cases (1998-2008). J Am Vet Assooc. 2013; 242: 820-825. 2. Mason BJ, Newton JR, Payne RJ, et al. Costs and complications of equine castration: A UK practice based study comparing “standing nonsutured” and “recumbent sutured” techniques. Eq Vet J. 2005; 37: 468-472. 3. Moll HD, Pelzer KD, Pleasant RS, et al. A survey of equine castration complications. J Eq Vet Sci. 1995; 15: 522-526. 4. May KK, Moll, HD. Recognition and management of equine castration complications. Compend Contin Educ Pract Vet. 2002; 24: 150-162 5. Schumacher J. Testis. In: Equine Surgery. Auer JA, Stick JA, Eds., 4th ed. Missouri: Elsevier. 2012; 804880. 6. Portier KG, Jaillardon L, Leece EA, et al. Castration of horses under total intravenous anesthesia: analgesic effects of lidocaine. Vet Anaesth Analg. 2009; 36: 173-179. 7. Haffner JC, Vidal G, and Davis EW. Online survey: evisceration post equine castration with evaluation of independent variables of method, position, and breed. Proc Am Assoc Equine Pract. 2018; 64: 408410. 8. Hinton SS, Aceto HW, Berkowitz S et al. Prevalence of complications associated with use of the Henderson equine castrating instrument. Eq Vet J. 2018; 51(2): 163-166.

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MEDICINE CORNER THE MIGHTY MAST CELL Emma Gordon E.Gordon1@massey.ac.nz Massey Equine

The mast cell is an often overlooked and underestimated cell in equine medicine compared to companion animal practice. Mast cells are immune cells of myeloid lineage and are generally found in connective tissue throughout the body, rather than within the blood stream. Mast cells contain large granules within their cellular cytoplasm, containing a variety of inflammatory mediators such as heparin, histamine, and varying cytokines. These granules are released when the mast cells are activated by varying stimuli, which typically activate the mast cell by way of IgE mediated hypersensitivity reactions (Figure 1).

significant number of eosinophils. Increased circulating mast cells in peripheral blood is rare.

Figure 2 Figure 1.

Equine mast cell tumours are not commonly diagnosed, and are frequently referred to as mastocytosis, as in many cases is unclear whether the mast cell proliferation is truly neoplastic in nature. Most cases are solitary cutaneous masses (Figure 2) though additional sites are reported including the upper respiratory tract and the eye (Figure 3). Unlike in companion animals, in horses mast cell tumours tend to be slow growing, non-metastatic, well demarcated and range from 0.5-20 cm. Neoplastic and metastatic forms are rare but can occur and can be quite invasive. Mast cell tumours on limbs often mineralise and can be seen on radiographs. Confirmation of diagnosis is by histopathology on biopsy or resected mass. Biopsy specimens may also contain

Figure 3

Treatment options include surgical excision, ablation by laser, cryotherapy or intralesional corticosteroids. Some cases will respond to systemic administration of corticosteroids. Degranulation during manipulation is rare and pre-medication is rarely performed. Like

sarcoids, recurrence of mast cell tumours at the same site, or at a distant site is possible. The second mast-cell related condition of interest is mastocytic inflammatory airway disease (IAD), part of the spectrum of chronic airway inflammatory conditions described by the term Equine Asthma. IAD affects horses of all ages, with subtle clinical signs including poor performance, and occasional coughing but with normal respiratory character at rest. Tracheal mucus tends to be increased, as does airway hyperresponsiveness, but detection of pulmonary dysfunction can require specialised pulmonary function testing. Horses with IAD have bronchoalveolar fluid characterized by mild increases in neutrophils, +/- eosinophils +/mast cells (Figure 4). The underlying pathogenesis of IAD is still uncertain but genetics and environmental allergens appear to contribute. In eosinophilic and mastocytic IAD, there is likely strong argument for the role of aeroallergens. The role of infectious agents in pathogenesis of IAD remains unclear.

Treatment of IAD involves strict environmental control of dust, allergens, and aerosolized endotoxin, as well as medications such as bronchodilators and corticosteroids (systemic or aerosolized). Additionally, omega 3 polyunsaturated fatty acids, particularly docosahexanoic acid (1.5 g/day by mouth) may be helpful. Mastocytic IAD does not always respond well to corticosteroids and may require treatment with the mast cell stabiliser cromolyn sodium which is best administered by nebulisation. IAD is present in New Zealand and likely underdiagnosed. After returning to New Zealand after working in referral practice in the US, I was told on a number of occasions that we don’t see IAD here, but have subsequently diagnosed a number of mastocytic IAD cases, as well as other IAD forms. In reality, there is likely decreased apparent incidence in New Zealand due to reduced stabling, different environmental allergens as well as potentially not always looking for this condition. Increasing BAL sampling of horses with consistent clinical presentations may change our understanding of the incidence of this syndrome in New Zealand.

CITATIONS Couëtil L, Cardwell J, Gerbe, V, Lavoie J‐P, Léguillette R and Richard E. Inflammatory Airway Disease of Horses— Revised Consensus Statement. J Vet Intern Med. 2016; 30: 503-515. https://onlinelibrary.wiley.com/doi/ full/10.1111/jvim.13824

Figure 4

Diagnosis of IAD is made by airway endoscopy confirming excessive tracheal mucus as well as bronchoalveolar lavage which is easily performed in the standing sedated horse. Cytological constituents of normal horses vary based on sampling method. When 250 ml of sterile fluid is used for BAL infusion (most common technique), then normal cell count of total nucleated cells < 530/uL (0.53 x109/L), with <5% neutrophils, <1% eosinophil and <2% mast cells. Using 500ml infusate requires adjusting the ranges. Regardless of technique, neutrophil percentage should remain below a maximum of 10%, mast cells <5% and eosinophils <5%. Values in between these ranges may be technique dependent. In the authors experience, IAD with severe mast cell percentages (10-15%) will sometimes present with BAL fluid with a slightly serosanguinous appearance, which is occasionally noted at the nostrils after exercise, resolving following treatment.

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Krystel-Whittemore M, Dileepan KN, Wood JG. Mast Cell: A Multi-Functional Master Cell. Front Immunol. 2016; 6: 620. https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4701915/ Mair TS and Krudewig C. Mast cell tumours (mastocytosis) in the horse: A review of the literature and report of 11 cases. Eq Vet Edu. 2008; 20: 177-182. https://beva.onlinelibrary. wiley.com/doi/abs/10.2746/095777308X291804 Sanni Hansen S, Otten ND, Birch K, Skovgaard K, HopsterIversen C, Fjeldborg J. Bronchoalveolar lavage fluid cytokine, cytology and IgE allergen in horses with equine asthma. Vet Immunol Immunopathol. Feb 2020; 220: 109976. https://www.sciencedirect.com/science/ article/abs/pii/S0165242719302624?via%3Dihub

COMMISSIONED ARTICLE* EQUINE GASTRIC ULCER SYNDROME [EGUS] IN ADULT HORSES

Part 1: Terminology, Diagnosis and Principles of Treatment. Ben Sykes Associate Professor Massey University. B.Sykes@massey.ac.nz

INTRODUCTION Equine Gastric Ulcer Syndrome (EGUS) has been widely recognised as a significant disease entity in the horse for the past 20 years. Recently interest in the disease has again increased as the distinction between squamous and glandular disease has become evident, and as the efficacy of oral omeprazole under field conditions, especially for the treatment of glandular disease, has been questioned. Part 1 of this review is to clarify the terminology of EGUS, discuss the different methods of diagnosis and overview the principles of treatment. In Part 2 of this review, specific diseases of the squamous mucosa and glandular mucosa will be considered in detail.

TERMINOLOGY The term EGUS has been in use since 1999 (Andrews et al. 1999). However, the term is widely misused which commonly leads to clinical errors in diagnosis, treatment and management recommendations. This has recently been addressed with the introduction of specific nomenclature that clarifies the differences in diseases of the squamous and glandular mucosae (Sykes et al. 2015a). The terms Equine Squamous Gastric Disease (ESGD) and Equine Glandular Gastric Disease (EGGD) are now accepted as the appropriate terminology to describe the specific anatomy, epidemiology, pathogenesis and treatment of the distinct disease conditions of the squamous and glandular mucosae respectively (Sykes et al. 2015a). The term EGUS has been retained as an overarching term to encompass all hyperkeratotic, hyperaemia, erosive and ulcerative diseases of the stomach (Sykes et al. 2015a). It is important to recognise that disease of the stomach is often not truly ulcerative and the hyperkeratotic ESGD and hyperaemic EGGD may be clinically significant. Further, EGGD is rarely truly ulcerative, instead it is typically erosive. Lastly, similar to human medicine in which at least 20 distinct disease * Made possible by a generous grant from Dr Jonathan Hope.

conditions are encompassed by the term Peptic Ulcer Disease (PUD) (Malfertheiner et al. 2009), it is likely that there are a number of distinct disease entities encompassed by the term EGGD. ESGD can be divided into primary disease, in which the function of the stomach is otherwise normal, and secondary disease which results from delayed gastric emptying (Sykes et al. 2015a). The previous lack of a distinction between ESGD and EGGD was primarily a result of the shorter gastroscopes originally used in gastroscopy. This resulted in the disease of the squamous mucosa being the dominant finding in early studies. It was only when the use of 3.0-3.5 m gastroscopes became standard practice, which in turn allowed reliable examination of the pyloric antrum where most EGGD occurs, that the importance of EGGD as a separate and distinct disease condition was recognised. A legacy of this is that the majority of the early (pre-2015) literature reports EGUS without specifically referring to whether the squamous or glandular mucosa was affected. Considering this; when reviewing the literature, the author generally regards that unless the affected region of the stomach is stated that the details refer to ESGD. As such most of the information in the early literature should be considered specific to ESGD and cannot be extrapolated to EGGD as the diseases have been shown to have distinctly different epidemiology, pathophysiology, and treatment and management requirements. As an example; the provision of ad libitum hay, or roughage, is considered a cornerstone longterm management strategy for the prevention of ESGD, but it unlikely to have any effect on EGGD risk as its absence is not considered an important pathophysiological contributor, nor has it been shown to be a risk factor in epidemiological studies. Similarly, avoidance of excessively high grain diets is important for ESGD risk management but plays no clear role in reducing the risk of EGGD. This distinction is important because for long-term strategies to significantly impact on disease they must be appropriately targeted to the specific

disease condition and its specific risk factors. Otherwise, the recommendations may provide a false sense of security against disease (re)occurrence.

DIAGNOSIS Gastroscopy remains the reference standard for the diagnosis of EGUS [see Figure 1 ]. The value in obtaining a definitive diagnosis in horses with clinical signs has been reinforced by recent studies that have: (a) demonstrated that ESGD and EGGD require different treatment regimens; and (b) highlighted that a significant percentage of EGGD horses respond sub-maximally, or may in fact worsen, with previously standardised treatment recommendations that were primarily based on ESGD. Other diagnostics that have been proposed include routine haematology and biochemistry, and faecal occult blood testing. In a study of Standardbred racehorses, there was no relationship between packed cell volume or total serum protein and the presence or absence of ESGD (Cate et al. 2012). Faecal occult blood testing is conceptually appealing

and initial evaluation of the test showed promise (Pellegrini 2005). However, the commercially available test performed poorly in two( independently conducted studies that attempted to validate it’s use (Sykes et al. 2014a; Ramey et al. 2016). This, in the author’s opinion, precludes its use in the clinical setting until it is further validated in the peer reviewed literature. Treatment response can be used as a cost-effective means to establish a provisional diagnosis; however, it is important to recognise that some limitations are present. A positive clinical response to treatment supports the diagnosis of, and is specific for, EGUS but does not differentiate ESGD from EGGD. This is potentially significant as the therapeutic response for omeprazole monotherapy for EGGD is poor (Sykes et al. 2014b, 2014c, 2015e). Considering this; it is recommended that, where a positive clinical response to treatment is observed that the treatment protocol chosen is selected based on the relative likelihood of ESGD versus EGGD. Specifically, where EGGD is considered likely sucralfate should be added alongside omeprazole in the front-line treatment. Gastroscopy should be

Figure 1: Gastroscopic examples to assist in the diagnosis of EGUS. a. Normal squamous mucosa. b. Diffuse grade 1/4 ESGD. In the author’s experience such lesions are commonly associated with clinical signs that are rapidly response to acid suppression therapy. c. Severe grade 4/4 ESGD. Severe lesions such as this are common in racehorses but rare in the sport and riding horse population. d. Diffuse hyperaemia of the glandular mucosa. The clinical relevance of changes such as this are hard to interpret and the response to treatment is an important element of decision making when assigning clinical relevance. e. A raised, linear, erosive EGGD lesion within the pyloric antrum. Ventral lesions such as this are a very common presentation of EGGD in the sport and riding horse population. f. A large, severe, focal EGGD lesion within the pyloric antrum.

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performed prior to the discontinuation of therapy to ensure that complete healing has occurred as EGGD lesions are typically slower to heal than ESGD lesions. Premature discontinuation of therapy before restoration of an intact mucosa and its associated protective muco-bicarbonate layer may result in rapid and marked relapse of EGGD lesions. Conversely, EGUS cannot be ruled out where a negative response to trial treatment has been observed. Multiple reasons exist for this including; a highly variable response to oral omeprazole therapy with approximately 25% of horses demonstrating poor bioavailability, even under ideal conditions (Sykes et al. 2015b), with some horses simply not achieving adequate acid suppression at label doses; and, the apparent presence of a “healing threshold” in some animals wherein complete, or near complete, healing must occur before complete resolution of clinical signs occurs. As such, where the clinical index of suspicion of EGUS is high gastroscopy should be performed even if minimal or no response to a treatment trial is observed. The role of biopsy in the evaluation of EGGD is controversial but they appear to be of limited value and are rarely used by the author. When performed the majority of biopsies yield a non-specific gastritis (Crumpton et al. 2015) and true ulcerative disease is rarely, if ever, observed.

PRINCIPLES OF TREATMENT ‘No acid, no ulcer’: This mantra forms the cornerstone of the author’s approach to the pharmacological management of both ESGD and EGGD. The pathogenesis of ESGD is clearly understood and, although a wide range of individual risk factors have been identified, at its core the disease results from acid exposure to the squamous mucosa which has limited defence mechanisms. In contrast, the pathogenesis of EGGD is poorly understood. However, it is believed to be due to a breakdown of normal defence mechanisms. However, acid still plays a critical role in perpetuation of the disease and the development of clinical signs. As such treatment with acid suppression is logical and although initial responses to acid suppression alone were poor with oral omeprazole (Sykes et al. 2014b, 2014c, 2015e), more recent studies investigating the use of more potent acid suppressive therapy in the form of a long-acting, injectable omeprazole formulation have demonstrated that high (≥75%) healing rates can be observed for EGGD with acid suppression alone (Sykes et al. 2017d; Gough et al. 2020). These recent studies have reinforced the importance of maximising acid suppression when treating either form of EGUS. Oral omeprazole is the corner stone drug for acid suppression in the horse and it has been widely used globally for over 20 years. It appears to be safe with adverse effects rarely reported, although specific toxicity has been poorly investigated

to date. It is, based on early pharmacodynamic studies, widely believed to induce 24 hours of acid suppression with once daily administration; however, this is incorrect with more recent studies demonstrating that the magnitude and duration of acid suppression achieved with administration of once daily oral omeprazole is both noticeably less than previously believed, and highly variable (Merritt et al. 2003; Sykes et al. 2017a). As such it is fallacious to simply administer omeprazole and assume that lesions will heal. Several factors, discussed below, contribute to this and it is important that these factors are considered when using oral omeprazole to ensure optimisation of therapeutic outcome. The two biggest factors that impact on the potential efficacy of omeprazole are the impact of concurrent feeding and the role of interindividual variability in drug absorption. Until recently little attention has been paid to the role of feeding on drug efficacy with a blanket recommendation for ad libitum feeding or pasture turnout given for the management of EGUS. However, it has recently become evident that feeding has a marked impact on the bioavailability of omeprazole (Daurio et al. 1999; Sykes et al. 2015c, 2017c) and on its capacity to induce acid suppression (Sykes et al. 2017b). Specifically, the provision of ad libitum hay has been shown to reduce oral omeprazole bioavailability by between 50% and 66% (Daurio et al. 1999; Sykes et al. 2015c) when compared with administration following a 10 hour fast. Although not specifically studied it is expected that ad libitum access to pasture would have a similar effect. Further, it has been shown that this reduced bioavailability has a significant impact on the pharmacodynamics of omeprazole with 3/6 horses in one study failing to achieve therapeutic levels of acid suppression over a 5-day period, even at 4 mg/kg PO once daily (Sykes et al. 2017b). As such, treatment recommendations should now include an overnight fast prior to the morning administration of omeprazole during the treatment phase of disease management (Sykes 2019). Although counterintuitive, the additional benefit of increased omeprazole absorption and efficacy offsets the deleterious effects of overnight fasting. Post-treatment the provision of ad libitum roughage, or pasture, remains a cornerstone preventative strategy for ESGD, although the true protective effect of pasture under New Zealand conditions has been questioned (Bell et al. 2007). Feeding also plays an important role in activation and efficacy of omeprazole post-administration. Omeprazole is a pro-drug that requires absorption and passage into the parietal cell in its pro-drug form. Once within the parietal cell, omeprazole must be exposed to acid production to be converted into its active form which in turn inhibits the proton pump. Peak plasma drug concentrations occur at 45-90 minutes (Daurio et al. 1999; Sykes et al. 2015b, 2016b, 2017c), and stimulation of the parietal cell during this time is required for maximal drug efficacy. Further, the amount of gastrin released in response to feeding is somewhat determined by the type of feed with a

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larger and more rapid release observed following a roughage based meal, than a grain based meal (Sandin et al. 1998). In practice; the author recommends an overnight fast, morning administration of omeprazole, feeding of 1-2 flakes of highly palatable hay (i.e. lucerne) one hour later, then any additional grain supplementation or pasture turnout. This approach optimises the duration of intra-day acid suppression achieved which is the primary determinant in therapeutic outcome. Inter-individual variability in drug absorption plays an important role in individual treatment response as the intra-day duration of acid suppression is primarily dictated by the drug’s area under the curve. As an example, median bioavailability of an enteric coated formulation has been demonstrated at 22% under fasted conditions, but the range observed within the twelve horses ranged from 7% to 56% (Sykes et al. 2015d). In the author’s studies it has been consistently observed that approximately 25% of horses studied had low drug absorption, regardless of the conditions studied. Interestingly this correlates neatly with the approximately 15-30% of horses with ESGD that have been shown not to completely heal over a 28-day period in range of studies evaluating oral omeprazole. Given that removal of acid production should result in ESGD healing, as demonstrated by the recent use of more potent acid inhibitors (Sykes et al. 2017d; Gough et al. 2020), this failure rate in clinical studies likely correlates with the author’s observations of low absorbers. Formulation plays a role in efficacy but the difference between enteric coated formulations and buffered formulations is commonly overstated. The bioavailability of enteric coated formulations is only 25-33% higher than buffered formulations (Birkmann et al. 2014; Sykes et al. 2016a) and although enteric coated formulations may be slightly more resilient to the impacts of concurrent feeding the 2-4-fold reduction in label dose when compared with buffered formulations is not justified on potency alone. The impact of formulation will be considered further in discussing specific treatment options for ESGD and EGGD in Part 2 of this review. Ranitidine is an alternative acid suppressive drug; however, it has been shown to be inferior to omeprazole at a population level (Lester et al. 2005) which limits its usefulness. Considering this the author reserves the use of ranitidine in adult horses to specific circumstances, most notably the use in hospitalised patients prior to the recommencement of feeding as ranitidine does not require activation in the same manner as omeprazole as it is a competitive H-2 receptor antagonist. Importantly, although previously recommended, ranitidine and omeprazole should not be administered concurrently because the competitive H-2 receptor antagonism of ranitidine interferes with the activation of the proton pump and subsequent, and necessary, conversion of omeprazole from its pro-drug form to its active form.

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Sucralfate is commonly used as an adjunctive treatment to omeprazole. Its utility in the treatment of ESGD is questionable and it is primarily used in treatment of EGGD. It is a sucrosesulphate-aluminium complex that creates a physical barrier by binding to the lesion bed and enhancing the muco-bicarbonate layer. Sucralfate may also have some local growth promoting properties as it may stimulate PGE synthesis. It was previously believed that an acidic environment was necessary for binding to the lesion bed to occur, but this is no longer thought to be true. Importantly, sucralfate may impair the absorption of oral omeprazole and as such should be administered at least 1 hour after oral omeprazole administration (Sykes et al. 2015a). In practice; the author recommends administration of sucralfate at the time of morning and evening feeding. The use of misoprostol as an alternative to omeprazole, with or without sucralfate, for the treatment of EGGD has recently become popular. Misoprostol is a prostaglandin analogue which has also been shown to have acid suppressive properties (Sangiah et al. 1989). A dose of 5 µg/kg orally twice daily is supported by a recent pharmacokinetic study (Martin et al. 2019). Like ranitidine it should not be administered concurrently with omeprazole as it may impair the latter’s activation. As a prostanoid there are significant health and safety implications in its use and additional precautions should be taken. The above provides general guidelines for the management of EGUS with a focus on acid suppression. Specific recommendations for the treatment of ESGD and EGGD will be provided in part 2 of this series.

BIBLIOGRAPHY Andrews F, Bernard W, Byars D, Cohen N, Divers T, MacAllister C, McGladdery A, Merritt A, Murray M, Orsini J, Snyder J, Vatistas N. Recommendations for the diagnosis and treatment of equine gastric ulcer syndrome (EGUS). Equine Vet. Educ. 11, 262–272, 1999 Bell RJW, Kingston JK, Mogg TD, Perkins NR. The prevalence of gastric ulceration in racehorses in New Zealand. N. Z. Vet. J. 55, 13–18, 2007 Birkmann K, Junge HK, Maischberger E, Wehrli Eser M, Schwarzwald CC. Efficacy of Omeprazole Powder Paste or Enteric-Coated Formulation in Healing of Gastric Ulcers in Horses. J. Vet. Int. Med. 28, 925–933, 2014 Cate RE, Nielsen BD, Spooner HS, O’Connor-Robison CI, Schott II HC. Prevalence of gastric ulcers and relationship to other parameters in Standardbred racehorses. Comp. Exerc. Physiol. 8, 47–51, 2012 Crumpton SM, Baiker K, Hallowell GD, Habershon-Butcher JL, Bowen IM. Diagnostic Value of Gastric Mucosal Biopsies in Horses with Glandular Disease. Equine Vet. J. 47, 9–9, 2015

Daurio CP, Holste JE, Andrews FM, Merritt AM, Blackford JT, Dolz F, Thompson DR. Effect of omeprazole paste on gastric acid secretion in horses. Equine Vet. J. 31, 59–62, 1999 Gough S, Hallowell G, Rendle D. A pilot study investigating the treatment of equine squamous gastric disease with long‐ acting injectable or oral omeprazole. Vet. Med. Sci. ( January 16, 2020). doi: 10.1002/vms3.220

Sykes BW, Sykes KM, Hallowell GD. A comparison between pre- and post-exercise administration of omeprazole in the treatment of EGUS: A randomised, blinded clinical trial. Equine Vet. J. 46, 422–426, 2014b Sykes BW, Sykes KM, Hallowell GD. A comparison of two doses of omeprazole in the treatment of EGUS: A blinded, randomised, clinical trial. Equine Vet. J. 46, 416–421, 2014c

Lester GD, Smith RL, Robertson ID. Effects of treatment with omeprazole or ranitidine on gastric squamous ulceration in racing Thoroughbreds. J. Am. Vet. Med. Ass. 227, 1636–1639, 2005

Sykes BW, Underwood C, Greer R, Mcgowan CM, Mills PC. Pharmacokinetics and bioequivalence testing of five commercial formulations of omeprazole in the horse. J. Vet. Pharmacol. Ther. 39, 2016a

Malfertheiner P, Chan FFKL, McColl KEL, Leung W. Peptic-ulcer disease. Lancet 374, 1449–1461, 2009

Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC. The effects of diet and dose on the pharmacodynamics of omeprazole in the horse. Equine Vet. J. 49, 525–531, 2017a

Martin EM, Schirmer JM, Jones SL, Davis JL. Pharmacokinetics and ex vivo anti‐inflammatory effects of oral misoprostol in horses. Equine Vet. J. 51, 415–421, 2019 Merritt AM, Sanchez LC, Burrow JA, Church M, Ludzia S. Effect of GastroGard and three compounded oral omeprazole preparations on 24 h intragastric pH in gastrically cannulated mature horses. Equine Vet. J. 35, 691–695, 2003 Pellegrini FL. Results of a large-scale necroscopic study of equine colonic ulcers. J. Equine Vet. Sci. 25, 113–117, 2005 Ramey DW, Murrell J, Fischer T, Brauer T, Klohnen A, Lee M. Fecal blood hemoglobin and albumin does not diagnose gastric ulceration in the Horse. In: American Assosciation Equine Practioners: 62nd Annual Convention. Pp 256. 2016 Sandin A, Girma K, Sjöholm B, Lindholm A, Nilsson G. Effects of differently composed feeds and physical stress on plasma gastrin concentration in horses. Acta Vet. Scand. 39, 265–272, 1998

Sykes BW, Underwood C, Greer R, McGowan CM, Mills PC. The effects of dose and diet on the pharmacodynamics of omeprazole in the horse. Equine Vet. J. 49, 2017b Sykes BW, Underwood C, McGowan C, Mills P. Pharmacokinetics of intravenous, plain oral and enteric-coated oral omeprazole in the horse. J. Vet. Pharm. Ther. 38, 130–136, 2015b Sykes BW, Underwood C, McGowan C, Mills P. Pharmacokinetics and bioavailability of five commercially available formulations of omeprazole. J. Vet. Pharm. Ther. 39, 78–83, 2016b Sykes BW, Underwood C, Mcgowan CM, Mills PC. The effect of feeding on the pharmacokinetic variables of two commercially available formulations of omeprazole. J. Vet. Pharmacol. Ther. 38, 2015c Sykes BW, Underwood C, Mcgowan CM, Mills PC. Pharmacokinetics of intravenous, plain oral and enteric-coated oral omeprazole in the horse. J. Vet. Pharmacol. Ther. 38, 2015d

Sangiah S, MacAllister CC, Amouzadeh HR. Effects of misoprostol and omeprazole on basal gastric pH and free acid content in horses. Res. Vet. Sci. 47, 350–4, 1989

Sykes BW, Underwood C, McGowan CM, Mills PC. The effects of dose and diet on the pharmacokinetics of omeprazole in the horse. J. Vet. Pharm. Ther. 40, 172–178, 2017c

Sykes BW. Courses for horses: Rethinking the use of proton pump inhibitors in the treatment of equine gastric ulcer syndrome. Equine Vet. Educ. 31, 441–446, 2019

Sykes BWBW, Kathawala K, Song Y, Garg S, Page SWW, Underwood C, Mills PCC. Preliminary investigations into a novel, long-acting, injectable, intramuscular formulation of omeprazole in the horse. Equine Vet. J. 49, 795–801, 2017d

Sykes BW, Hewetson M, Hepburn RJ, Luthersson N, Tamzali Y. European College of Equine Internal Medicine Consensus Statement-Equine Gastric Ulcer Syndrome in Adult Horses. J. Vet. Intern. Med. 29, 2015a Sykes BW, Jokisalo J, Hallowell GD. Evaluation of a commercial faecal blood test for the diagnosis of gastric ulceration in Thoroughbred racehorses: A preliminary report [abstract]. In: Proc. 11th International Equine Colic Research Symposium. Pp 4. 2014a

Sykes BWW, Sykes KM, Hallowell GD. A comparison of three doses of omeprazole in the treatment of gastric ulceration in the horse: A randomised, blinded clinical trial. Equine Vet. J. 47, 285–290, 2015e

Eq Vet Pract 2020 June; 45 (2) 45

HAVEMEYER FOUNDATION Workshop on Acute Colitis Eq Vet J. 2020; 52 (2): 163-164 http://havemeyerfoundation.org/aboutfoundation.htm

The first Dorothy Russell Havemeyer Foundation workshop on acute colitis in the adult horse was held in Niagara‐on‐the‐Lake, Ontario, Canada, in July 2019. Here we offer an edited synopsis of the discussions. The full report in Eq Vet J is HERE. Further information on Havemeyer Foundation research projects, workshops and monographs is at http://havemeyerfoundation.org/monograph.htm.

AGENTS OF COLITIS Acute colitis is responsible for about 5% of admissions to equine veterinary hospitals, with the cause undetermined in >50% of cases and mortality ~40%. While acute colitis is typically defined clinically by the presence of diarrhoea, which usually does not occur in horses with small bowel inflammation, other potential signs include fever, neutropenia, inappetence, ultrasonographic evidence of increased colonic wall thickness and increased fluid within the caecum and/or colon. Case fatality increases with the presence of toxic neutrophils in peripheral blood. Horses presenting with two or more signs of systemic inflammatory response syndrome (SIRS) at admission have a high fatality rate. Colitis can be associated with several putative agents including Clostridioides difficile, Neorickettsia risticii and Salmonella spp. Data from Denmark revealed cyathostomiasis as the most common cause with Salmonella spp. never being detected. By contrast, in Australia, C. difficile and Salmonella spp. infection were common, although 57% of cases had no aetiology determined. Non-infectious causes of colitis including acorn poisoning and NSAID intoxication do occur. Clostridioides difficile was agreed to be the most diagnosed cause of equine acute colitis, but this might be biased by the limitations of current diagnostic approaches. The importance of direct toxin rather than gene detection in faeces or colonic content was recognised as important in diagnosis, since PCR‐based gene detection can pick up a carrier state. In North America, an increase in the number of cases of Potomac Horse Fever (PHF) has been noted with

46 Eq Vet Pract 2020, June; 45 (2)

identification of novel strains Neorickettsia species, not identified by current PCR‐based tests. The diagnosis of salmonellosis is problematic in settings where Salmonella spp. are common, such as veterinary hospitals, which may skew aetiological diagnoses when it is not contributing to the colitis. C. perfringens is likely over diagnosed in adult horse colitis. More scientific evidence is needed to support the role of C. perfringens in adult horse colitis including the role of type C or the newly described NetF‐positive strains and needs to be based on direct toxin identification rather than on gene testing. Earlier data suggesting the importance of the C. perfringens enterotoxin (CPE) in acute colitis have not been substantiated. Data presented suggested that C. perfringens is at best relatively unimportant in acute equine colitis. For the first time, Clostridium sordellii was suggested to be a presumptive cause of acute fatal colitis in adult horses; experimental infection studies may be required to confirm its role. Viral causes of acute colitis are uncommon, although equine coronavirus may cause outbreaks of diarrhoea that can mimic salmonellosis.

THE EQUINE INTESTINAL MICROBIOME AND THE PATHOPHYSIOLOGY OF COLITIS There is now extensive information on the characterisation of the equine intestinal and faecal microbiome relating to age, antibiotic use, colic, deworming, diet, exercise, immunity, pregnancy and shipping, but more study is needed to confirm the trends and understand strain‐specific variability among different healthy and sick states. Many questions to ponder: • Do aged horses have a higher propensity for colitis and if so, why? • There is typically a marked change in the reduction in diversity of the equine faecal microbiome during colitis; cause or effect?

• Is colitis simply a result of a dysbiosis [= screwedup microbiome]? • Are there rations that predispose some horses to colitis through changes in the large bowel microbiome? • Does each specific cause of diarrhoea have a characteristic change in the faecal microbiome? • Are there baseline trends in the faecal microbiome of horses affected by C. difficile, Neorickettsia spp. and Salmonella spp? • Will individual microbiome characterisation ever be used pre emptively to identify at risk horses? Caecal content transfaunation and faecal microbiota transplantation (FMT), have been used in horses, humans and other species although the basis of its efficacy is still not fully agreed. Well controlled clinical studies are necessary before these interventions can be recommended as a therapeutic option for horses with colitis. Are there super donors in horses; what is the best protocol for performing the FMT; how should we screen donors; what happens to the patient microbiome after transfaunation; is it of value; does it last? What role might other families of microbes, especially protozoa, play in the ‘healthy’ and dysbiotic intestinal microbiome of horses? ED.

DIAGNOSIS OF ACUTE COLITIS Aetiologic diagnosis is only achieved in ~50% of cases and may be being avoided since it is expensive, but also because some of the data (e.g. C. perfringens cpa gene detection) are of unknown and confused significance. In addition, treatment depends largely on symptomatic supportive approaches based on clinicopathological findings - PHF being an exception. Thus, it may be better to spend money on treatment than on the high costs searching for diagnosis. Multiplex PCR of likely pathogens in adult colitis panels are commonly used for attempts at diagnosis of equine enterocolitis. Some co‐infections are likely genuine, especially if there are underlying common predisposing factors such as antimicrobial drug use. However, determining whether what is identified in faeces is the agent-of-disease rather than an incidental finding is a challenge, especially with highly sensitive PCR‐based diagnostics. The cpa toxin gene should

not be in such panels since C. perfringens is quite frequent in healthy adult horses. Aetiological diagnosis of C. difficile infections has improved dramatically with the introduction of ELISAs to detect preformed clostridial toxins and is better than PCR‐based approaches that can pick up carriers. The sensitivity and specificity of diagnostic PCR panels need to be determined. The amount of faeces being sampled in suspected Salmonella spp. infections is a determinant of the relative sensitivity of the test. Testing for Salmonella spp. is complicated by a lack of clear quantitative analyses in PCR‐based diagnosis and with persistence of shedding in healthy, and thus in nonsalmonella colitis horses. Practitioners need to decide both the pretest probability [incidence] of disease, and whether a positive or negative test result will alter the course of treatment. If the pretest probability is low, it may be best to apply financial resources towards treatment. If the pretest probability is high, will a negative test result be totally accepted as correct? It may be as simple as providing the owner with peace of mind by restricting testing to detecting infection by potential zoonotic agents. Most common causes of colitis produce large bowel lesions which are morphologically indistinguishable. Currently, the lack of standard protocols for necropsies of horses dying of colitis impedes progress with postmortem diagnosis.

TREATMENT AND PREVENTION OF ACUTE COLITIS Although flunixin meglumine, polymyxin B, lidocaine and smectite (BiospongeTM) are widely used in the treatment of colitis, their value has not been well established in controlled clinical trials. • Why are we still using nonsteroidal anti inflammatory drugs if they can contribute to colitis? • Why use antimicrobial drugs when there is no good evidence of sepsis as it likely affects commensal bacteria remaining in the gut, worsening intestinal dysbiosis? • Should morphine be used to replace the expensive lidocaine for pain control? • Is meloxicam less harmful than flunixin meglumine, since it seems to reduce lipopolysaccharide‐induced fluid flux when compared to flunixin in vitro and since flunixin can delay tight junction closure?

Eq Vet Pract 2020 June; 45 (2) 47

Regardless of cause, treatment of colitis is aimed at improving cardiovascular perfusion, providing oncotic support, addressing endotoxaemia, restoring the gut microbiome and prevention of laminitis. Icing feet (cryotherapy) has been a very important advance in addressing the common complication of laminitis. Some data presented suggested that administration of plasma to horses with colitis did not improve survival, whereas other data suggested that horses administered plasma were more likely to survive than those treated with hetastarch. Prevention will depend on improved understanding of the agents of colitis, of the large intestinal microbiome and how it can be manipulated, and of the costâ&#x20AC;?benefit risk and efficacy of immunisation against established pathogens.

THE FUTURE OF COLLABORATION

COLITIS

RESEARCH:

Acute colitis is a little studied entity in equine medicine but needs systematic study. Expanding understanding of the equine intestinal microbiome in health and disease, with improved culture techniques combined with metagenomics to identify known and new pathogens, requires excellent collaborative science, as well as considerable research funding. A critical priority is consensus and consistency on guidelines for infectious agent testing. A common scoring system of colitis severity will allow collaborative prospective trials to be carried out of the value of existing and novel treatments providing statistical power to make useful conclusions.

Doria RGS et al. Correlation Between Peritonitis and Incisional Infections in Horses. J Eq Vet Sci. 2020; 87: DOI: 10.1016/j.jevs.2019.102903 Nine horses underwent standardized laparotomy, intestinal exploration, and induced septic peritonitis induced with 1 mL cecal contents plus 1 ml blood in 1 L LRS. Standardized relaparotomy was performed two (n = 3), four (n = 3), and six (n = 3) months later to evaluate the abdominal cavity for adhesions and to collect the sutured ventral abdominal wall to evaluate and prepare it for histopathological and tensile strength study. All horses had evidence of post-operative endotoxemia, controllable peritonitis, heat and touch-sensitive ventral abdominal edema and surgical wound infection with presence of purulent discharge. Adhesion of the cecum or colon to the internal surgical wound was observed. Healing of the infected surgical wounds occurred by second intention and a space between the rectus abdominis muscles developed because of the presence of a scar, which was related to incisional hernia. Incisional tensile strength increased over time and was highest after 6 months. After the second surgical intervention, there was no infection of the surgical wound and healing by first intention occurred. It is suggested that surgical site infection may be a consequence of peritonitis in horses recovering from abdominal surgery. Infected surgical wounds heal by second intention, which favours the spacing between rectus abdominis muscles and the formation of incisional hernia.

Coleridge M et al. Comparison of lameness scores after a low 4-point nerve block to lameness scores after additional desensitisation of the dorsal metatarsal nerves in horses with experimentally induced pain in the metatarsophalangeal joint. Eq Vet Edu. 2020; 32(4): 199-203. DOI: 10.1111/ eve.12942 A wireless, inertial, sensor-based, motion analysis system was used to evaluate gaits of six horses: (a) before induction of lameness, (b) after administration of interleukin-1 beta into a metatarsophalangeal joint, (c) after anaesthesia of the medial and lateral plantar nerves and the medial and lateral plantar metatarsal nerves, and (d) after additional anaesthesia of the lateral and medial dorsal metatarsal nerves. There was no significant difference in the motion sensor lameness grades when comparing the horseâ&#x20AC;&#x2122;s gait after the low 4-point nerve block to the gait after additional anaesthesia of the dorsal metatarsal nerves, indicating that there is likely no benefit of medial and lateral dorsal metatarsal nerve anaesthesia when using regional anaesthesia to localise pain to the metatarsophalangeal joint during a lameness examination.

48 Eq Vet Pract 2020, June; 45 (2)

EQUINE VETERINARIANS ONLINE | WORKSHOP | nzva.org.nz/event/20eqfa

An introduction to race day and competition duty Learn the important skills required for race day duty and other equine events. A horse collapses mid race – what do I do? For many veterinarians the notion of race day or competition duty is daunting. Be better prepared to manage these scenarios by learning the obligations, protocol and skills required for equine events. Whether you are a general practitioner who officiates at the odd local show or an equine veterinarian in a practice covering multiple race days, this course will provide you with the tools you need to be successful in this role! The online course will cover a typical race/competition day agenda, common injuries, medical conditions, emergency situations and media management. Become better equipped to manage equine events and apply your new skills to everyday practice. With support from passionate tutors and an optional workshop at a racecourse, this is the perfect opportunity to expand your equine service offerings and become more comfortable managing emergency incidents at the track, events, and in the field!

Intended learning outcomes

» Manage the role and responsibilities required of a competition veterinarian. » Recognise the commonly encountered competition injuries and medical conditions and be prepared to treat them. » Devise techniques to make effective decisions under stressful circumstances. » Recognise potential media situations and mitigate potential outcomes.

COURSE DETAILS

Online: Starting 27 July Workshop: Due to COVID-19 workshop dates will be set at a later date.

TUTORS

Leigh de Clifford BVSc CertAVP MSc Róisín Mc Quillan MVB BAgrSc Fred Pauwels DVM, CertVA, DipACVS, DipECVDI (LA) Jenny Sonis DVM, MS, DACVIM (Registered Specialist Equine Medicine) Michelle Logan MA VetMB CertAVP (ESST) FANZCVS (Equine Medicine) Tony Parsons BVSc

TOPICS

• The role of the veterinarian at races & equestrian events • Race day considerations • Commonly encountered injuries • Commonly encountered medical conditions • Conditions particular to other disciplines • Media and public relations • NZTR regulations • Drug withholding times

PRICE

Online course only NZVA member: $350 Non-member: $500 Prices are quoted in NZD and include 15% GST.

This course has been generously subsidised by the New Zealand Equine Veterinary Association.

Optional workshop Pricing will be set at a later date.

CPD POINTS

The online course is worth up to 8 hours of CPD. Workshop programme to be confirmed. NZVA members get access to the MyCPD record. Provided by NZVA . For more educational resources and courses go to www.nzva.org.nz/educationhub

VETLOGIC PUZZLE - EVP JUNE 2020

4. SARAH hires more EQUINE NURSES than the HEAD NURSE at the PATEA practice. From these clues and using the grids hopefully you can work out the NUMBER OF EQUINE NURSES each HEAD NURSE hires for the foaling season at each of the EQUINE PRACTICE.

HEAD NURSE

NO. OF EQUINE NURSES

3. Regarding the GISBORNE and KAITAIA practices, one hires two EQUINE NURSES and the HEAD NURSE at the other practice is HEIDI.

PATEA

HOKITIKA

KAITAIA

EQUINE PRACTICE

SARAH

JESSICA

Image from Clipart Library

EQUINE PRACTICE

2. The GISBORNE practice HEAD NURSE hires one less EQUINE NURSE than the KAITAIA practice

HEIDI

1. The GISBORNE practice HEAD NURSE is GRACIE.

GRACIE

HEAD NURSE

GISBORNE

The Head Nurses at four busy EQUINE PRACTICES recruit and hire an extra number of EQUINE NURSES for the upcoming foaling season.

2 3 4 5 GISBORNE KAITAIA HOKITIKA

See page 73 for answer.

PATEA

EQUINE PRACTICE

NO. OF EQUINE NURSES

GRACIE HEIDI JESSICA SARAH

DRUG POSER When using ceftiofur: a. What do you dilute it with? b. Along with advice to accompany use of many antimicrobial drugs, what is one of the more common and potentially lifethreatening side effects to inform the owner/agent about? c. It does not pass the intact blood:brain barrier very well, but which tissue does it well penetrate that is of importance in selection for systemic therapy? Answer questions then see page 56 for answers and basic facts regarding ceftiofur Na.

50 Eq Vet Pract 2020, June; 45 (2)

AAEP 2019 State-of-the-Art Lecture

FRACTURE REPAIR Dean Richardson New Bolton Center University of Pennsylvania

Most of us are not equine orthopaedic surgeons so tend to be a tad flabbergasted by papers on the intricacies of fixing busted bones. However, it is important to know what has and can be undertaken to educate our clients appropriately – finances permitting. Here we offer a synopsis of the 12 take-home messages on fracture repair that Dean Richardson discussed during the Milne State of the Art Lecture titled “The Tao of Equine Fracture Management”, presented at the 2019 Annual Convention of the American Association of Equine Practitioners. Thanks also to: Michelle N. Anderson, TheHorse.com

1. Successful Fracture Repairs involve balance between the mechanics of surgery and the expected orthopedic repair process. 2. Most horses with orthopedic problems could adequately heal their injuries if there were not high expectations for their future performance or wildly disparate opinions about their suffering and its relief. 3. Three things lead to fracture surgery failure: i. Infection; Surgical wounds are more susceptible to infection and biofilms than traumatic wounds. ii. Inaccuracy; Newer imaging and surgical tools can improve accuracy of repair and reduce surgical tissue trauma. iii. Instability; It takes more and stronger surgical hardware to adequately stabilize damaged bones in horses than it does in other species.

Sabina Louise Pierce/U Penn, via Associated Press

6. Horses must recover and become active straight after surgery. This usually means more hardware. If the patient isn’t comfortable and moving soon after surgery, supporting-limb laminitis frequently is their demise. 7. Most fractures in horses occur in the limbs where there is poor soft tissue and muscle coverage, reducing protection and probably blood flow to repair sites. 8. Properly applied emergency splinting of a limb injury can be lifesaving and 15cm diameter PVC piping split lengthwise is a versatile and stable splinting material. 9. Adult horses need to be transported in close confinement to allow them to balance against the wall/ partition. However, foals with limb fractures are best sedated and recumbent, preferably with an attendant. 10. With traditional bone plates, the screws tighten the bone against the plate and moulding of the plate to conform to the bone surfaces aids stability. More biologically appropriate fixation can be achieved with newer stable fixation plates with threaded screw holes, allowing the screws to be locked to the plate. 11. Many small fractures are easy to repair however even such cases are more likely to have osteoarthritis or lameness without perfect repair; the owner must be cautioned about this. 12. Progress in equine fracture repair surgery is slow due to low case numbers each surgeon deals with, frequently because of clients’ financial constraints and low and motivation. This means that equine surgeons are relatively inexperienced and often inadequately equipped.

4. Size matters; Miniature Horses are easier to fix. 5. Equine orthopedic surgeons rely on human medical devices but must remember to make allowances for their patients being much heavier and are almost uncontrollably active compared with human

Dean Richardson is nevertheless optimistic that equine fracture management will continue to evolve to a point where the concept of ‘euthanasia first’ is a thing of the past.

Eq Vet Pract 2020 June; 45 (2) 51

INVITED COMMENTARY

WHAT WAS LEARNT FROM THE CLUSTER OF DEATHS AT SANTA ANITA RACECOURSE – 2019? A threat to World TB racing? C. Wayne McIlwraith Colorado State University wayne.mcilwraith@colostate.edu

In this article Wayne McIlwraith reviews the cluster of fatal injuries that occurred at Santa Anita Racetrack in California in early 2019. He discusses the consequences that developed which can rightly be considered as a threat to the TB Racing Industry world-wide. This discourse considers reported facts, critical quotes from the news media, observations on what is known regarding factors associated with fatal musculoskeletal injury and the subsequent good and bad consequences arising from the situation.

THE START OF THE CRISIS On February 23, 2019, a horse named Battle of Midway, previously the winner of the Breeders’ Cup Dirt Mile (Group-1), suffered a catastrophic musculoskeletal injury in a hind limb during training and was euthanized. When the Los Angeles Times reported the incident, the paper noted that Santa Anita, barely two months into its season, had experienced an unusual number of horse deaths,19 to be exact, 3 of them within a few hours of each other (Battle of Midway being one of them). The Stronach Corporation, owners of Santa Anita and Golden Gate in the San Francisco Bay area, closed the tracks and launched an investigation. They hired Mick Peterson of the University of Kentucky (see Eq Vet Pract 2018; 43(3):24-27] to come and inspect the track and it was reported by race track management that within 48 hours of inspection Peterson said that the track was ‘100%’; however this was not what Mick Peterson actually concluded - see below. A few days later another horse died and on March 5th, after another death, Santa

52 Eq Vet Pract 2020, June; 45 (2)

Santa Anita racing during COVID-19. March 14th. Credit: AP/Mark J. Terrill

Anita announced that it would close again. In total, 37 fatalities were recorded in 2019.

RESPONSE OF SANTA ANITA MANAGEMENT Considerable pressure from the People for the Ethical Treatment of Animals (PETA), from the Los Angeles County District Attorney and from California Senator Diane Feinstein to stop racing at Santa Anita. The management team at the Stronach Group went into action and basically blamed everything and everyone but themselves. On March 15th in the Thoroughbred Daily News there was an article that stated: “Off the heels of Thursday morning’s 22nd reported equine fatality at Santa Anita since its current meet opened, The Stronach Group has moved to ban race-day medication, including Lasix, at the Arcadia oval as well as its Northern California track Golden Gate Fields. The Stronach Group’s Chairman and President Belinda Stronach penned a lengthy open letter announcing the drastic shift in policy.” She also said: “It is unacceptable to the public and, as people who deeply love horses, to everyone at The Stronach Group and Santa Anita.” Describing this as a ‘watershed moment’ Stronach announced that in addition to banning furosemide [Lasix®] the new policy will increase the ban on legal therapeutic NASIDs, joint injections, shock wave therapy and anabolic steroids. Stronach’s list included any other therapeutic medication used by trainers and veterinarians as well as the use of whips.

Incidentally, the use of whips and of Lasix have never been shown to contribute to musculoskeletal injuries Probably the biggest problem was the insinuation by Belinda Stronach that fatal musculoskeletal injury could be eliminated! Obviously, much knowledge has been accumulated concerning the pathogenesis of musculoskeletal injury and the factors associated with it, and fatal racetrack injury rates overall have decreased. However, the goal is to minimize such injuries, but complete elimination is not realistic. After the trainer of Battle of Midway, Hall of Famer Jerry Hollendorfer had two more horses with fatal injuries, he was banned from Santa Anita and Golden Gate Fields by the Stronach Group using “House Rules” despite having no substantiated legal infractions of any type held against him. While Los Alamitos in California continued to allow Mr. Hollendorfer to have stalls and to race there, some other racetracks supported the blacklisting of Jerry Hollendorfer and this further puzzled this author and others. While Mr. Hollendorfer has a huge stable and races a lot of horses, I personally know that he cares greatly for them and will do everything to save them when they sustain injuries, whether they can race again or not.

SIFTING OUT THE FACTS To say that Belinda Stronach’s press releases were ‘crocodile tears’ would be a major understatement. In 2018 she had previously explained to the Los Angeles Times that she gauged success in racing by “first of all it would be profitability” and that “will be measured by the profits we make”. In the months before the catastrophic injuries, Santa Anita made several polarizing business moves in reshuffling the racing secretary, announcer and the track superintendent Dennis Moore who was arguably considered the best racetrack superintendent in the country. There are also some other significant, related events including when Dr Peterson came out to inspect the track surface he noted that, since the departure of Mr. Moore, daily moisture measurements of the track contents had stopped being taken and the harrowing had changed such that the track had definitely ‘sped up’. Also, a letter had gone out to the trainers (horsemen) in the autumn of 2018 saying that stalls would be allocated based on the number of horses from that trainer’s stable that had been entered in races

which, was considered strong inducement to enter horses that perhaps weren’t ready to race. Finally, the Stronach Corporation refused to cancel racing on one day after 20cm of rain had fallen and the horsemen wanted to cancel the races. Of note here is the system of racing in the US is that when there is a race meeting all horses need to be accommodated in stalls at the racetrack and trainers are allocated a certain number of stalls.

CLARIFICATION OF THE IMPORTANCE OF THE RACETRACK SURFACE In early May 2019, after Mick Peterson had been falsely quoted by Santa Anita management that the track was 100%, forcing us to write a letter to the editor of the Thoroughbred Daily News noting that while the safety of the surfaces has increased dramatically in the last 20 years the challenge remains; the inconsistency of racing surfaces over a range of weather conditions needs to be reduced. This was in response to claims to the effect that the racetrack was to blame, and was to try and distinguish between mismanaged, elective events that had contributed to fatalities compared with other factors that could be improved. We emphasized that injuries to horses and riders are the result of a failure of multiple systems, critically including thorough maintenance of all track equipment, careful monitoring of race surface moisture content and for every vet check before racing to be thorough. There is no singular panacea. Ten years previously the California Horse Racing Board (CHRB) had mandated that Thoroughbred racetracks in California needed to install synthetic surfaces to continue to get racing dates. While synthetic tracks have been shown to lower the injury rate per 1,000 starts, they must be installed correctly and to require daily maintenance, and that they have their own challenges regarding maintenance, particularly over the range of temperatures that the Californian climate provides. When correctly installed and maintained there is a significant reduction in catastrophic injury rate and, if there is heavy rainfall, they are the only answer to a safe surface. However, despite the statistics indicating that synthetic surfaces saved horses [Table 1], both Santa Anita and Del Mar went back to dirt so that racetrack superintendents had to try and maintain these tracks as best they could.

Eq Vet Pract 2020 June; 45 (2) 53

Table 1: Fatal injuries per 1000 US race starts on different surfaces* Surface

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2009 -2019

All

2.00

1.88

1.92

1.90

1.89

1.62

1.54

1.61

1.68

1.80

Turf

1.94

1.60

1.54#

1.74

1.38

1.75

1.22

1.09

1.36

1.20

1.47

Dirt

2.10

2.04

2.07

2.10

2.11

2.02

1.78

1.70

1.74

1.86

1.97

Synthetic

1.49

1.21

1.09

1.03

1.22

1.20

1.18

1.14

1.10

1.23

1.20

* SOURCE: http://jockeyclub.com/pdfs/eid_10_year_tables.pdf # NOTE: Fatal injury rate per 1000 starts in New Zealand on turf 2005-2011 was 0.72. Animals. 2017; 7: 62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5575574/

Science kicked in to help, by way of Mick Peterson. Mick had always felt that reduction in variation of the moisture content in dirt racing surfaces is one of the only ways that these tracks are going to be able to rival synthetic surfaces regarding safety. Recognition of the critical nature of a stable moisture content and maintaining the turf characteristics to optimize this has led to several advances in the management of dirt racetracks in the US. Ten years ago the race track surface testing laboratory [RSTL} was originally started in Orono, Maine with Mick Peterson as director and studies were based on the mechanical hoof tester that Mick developed as well as the use of ground-penetrating radar to ascertain even surfaces in the base of the race track. This has progressed to what is called a biologically applied testing consortium where 14 racetracks are now enrolled. Each track uses moisture testing equipment to send daily moisture content data back to RSTL and makes use of the hoof testing machine and a Doppler radar apparatus is planned for these tracks with financial support from the Jockey Club. While there has been talk of reinstallation of a synthetic, all-weather racetrack at Santa Anita the owners have not made any commitment thus far.

THE CONSEQUENCES OF CHANGE Although banning Jerry Hollendorfer from the racetracks appeared grossly unfair and lacking in due process, a strong degree of apprehension developed amongst trainers and veterinarians, particularly those trainers worried that if they had another catastrophic injury, they would also be banned from the racetrack. Consequently, there was a lot more care and consideration given to entering of horses by trainers and their attending veterinarians. Also,

54 Eq Vet Pract 2020, June; 45 (2)

inspections by regulatory veterinarians was increased; these were previously limited to prior to racing but now extended to prior to workouts, and to following racing and workouts. There were also some good things that happened subsequent to the Stronach statements on medication including the pre-race withdrawal times for NSAID drugs being extended from 24 to 48 hours, and prerace withdrawal time for intraarticular injection of corticosteroid drugs extended to 2 weeks prior to racing. Any ban on furosemide administration on race day did not hold up although several jurisdictions including California have gone to banning administration of furosemide to 2-year-old horses.

BREEDERS CUP NOVEMBER 2019 Although the rate of fatal injuries decreased compared to 2018 during the remainder of the Santa Anita calendar, we all had held our breath regarding the Breeders’ Cup to be held at Santa Anita on November 1st and 2nd 2019. Politicians had threatened that fatal injuries could be the death knell of racing. As it turned out there were two excellent days of racing until the last race, the Breeders’ Cup Classic when Mongolian Groom broke down in the stretch, was taken off in the equine ambulance for evaluation at the Santa Anita Equine Hospital and a comminuted fracture of the proximal phalanx in the left hind limb was diagnosed; I personally cannot remember a more comminuted fracture. As quoted in The Blood Horse: “Given the extent of the injury, Dr Ryan Carpenter, in consultation with Dr Wayne McIlwraith, veterinary surgeon and professor at Colorado State University; Dr Rick Arthur, equine medical director of the

California Racing Board and attending veterinarian Dr Vince Baker, recommended humane euthanasia of Mongolian Groom”. While this seemed to be the worst thing that could have happened at Breeder’s Cup, worse was yet to come. It became apparent from viewing a video showing Mongolian Groom going out to train a few days before the race and that he was obviously lame in that left hind limb. The Breeders’ Cup commissioned Larry Bramlage, Rood and Riddle Equine Hospital, KY, to compile a thorough report that came out on January 17th, 2020. In this 25-page analysis it concluded that while there was no veterinary ‘cover-up’ in the fatal injury suffered by Mongolian Groom in the 2019 Group-1 Classic, teams of veterinarians did miss opportunities to scratch the gelding before his left hind leg fractured catastrophically at Santa Anita Park on November 2nd in the highest-profile Breeders’ Cup race. However, Bramlage underscored a caveat several times during a subsequent teleconference: “Even if vets have the world’s greatest diagnostic technologies at their disposal, horses are always going to have aches, pains and routine stiffness that a skilled vet is going to have to identify and assess before deciding whether or not the issue warrants closer scrutiny via imaging. “There are real-world complications that can limit theoretical diagnostic capabilities. “I don’t think you will ever be able to image every horse that is entered. “The right way to do it is to trust the regulatory veterinarian to pick out the horse that meets the regulatory threshold of showing signs of needing more detailed imaging. These are high-level athletes and every high-level athlete has a certain degree of stiffness and needs to warm up before any race. The difficult question is determining if it is just routine soreness? There is a certain degree of stiffness that is expected”

AFTERMATH At the time of writing, COVID-19 has totally changed the landscape again and there is no Thoroughbred racetrack open in Southern California. COVID-19 is impacting racing everywhere including New Zealand and the situation looks grim as to when racing will start again. Unfortunately, PETA has managed to get the Los Angeles Health Department

to close racing at Santa Anita by playing the COVID-19 card when it has nothing to do with their agenda. It is another example of one step forward and two steps back. The one step forward can come slowly from excellent research and lots of time and money, whereas the two steps back can come quickly from politicians and lobby groups with the voice of the press via a writer who wants to have a good story. However, the fact remains that it is still difficult to explain to the man or woman on the street why we can’t save every horse, and some must be euthanized. Some people blame PETA for much of the bad publicity. When I received media training for partaking in the AAEP On-call Program one of the first things we were taught is ‘know your real audience’. I still consider that the real audience to be the man or woman on the street, your neighbour, the person that you meet on the plane, at a dinner party, or when you give a talk to a lay audience. Their questions are reasonable, and I always fall back to the scenario of catastrophic injuries occurring in human athletes and non-athletes. I use the example of distal tibial fractures in people to explain that if you lack soft tissue and therefore blood supply coupled with a fractured bone that has come through the skin allowing contamination there are going to be challenges with infection and failure of blood supply that can lead to amputation in people - but we can’t amputate limbs in 500Kg horses. We rely on all the research that has come from the work of many groups, particularly from veterinary researchers at the Universities of California at Davis, Colorado State University, The University of Pennsylvania, The University of Melbourne, The Royal Veterinary College, Utrecht University, and the Global Equine Research Alliance based at Massey University, to keep moving forward, but that has to be translated into simple stories for our neighbours to understand.

There have been several useful lessons from the Santa Anita saga and these lessons have not been ignored by other racetracks. New alliances have been informed that will help the welfare of the racehorse, and as the COVID-19 pandemic passes, as it hopefully will, we will have our sport, and the equine athletes that make it, better understood by the general population.

Eq Vet Pract 2020 June; 45 (2) 55

DRUG POSER - ANSWER When using ceftiofur: a. What do you dilute it with? Dilute with sterile water, not saline. Ceftiofur pharmacologic activity is decreased in saline. b. Along with advice to accompany use of many antimicrobial drugs, what is one of the more common and potentially life-threatening side effects? Treatment can cause antibiotic induced diarrhea. This is more common with systemic therapy than with local but can occur with either. c. It does not pass the intact blood:brain barrier very well, but which tissue does it well penetrate that is of importance in selection for systemic therapy? Does penetrate endometrial tissue.

Further basic facts regarding ceftiofur Na. 3rd generation cephalsporin Broad spectrum against activity against Gm+ and Gm- bacteria Doses and Routes of administration: 1. IV or IM a. Adult: 2.2mg/kg, q12 or q24h (q12h recommended if IV). b. Foal: 5-10mg/kg, q6h or q12h (10mg/kg recommended if less than 4 weeks old). 2. CRI: 3.3 ug/kg/min following a loading dose of 2.5mg/kg. Bolus systemic dosing can commence 12 hours following discontinuation of the CRI, at q12h. 3. IVRLP: off label use – use in replace of the next scheduled systemic treatment if horse is also on systemic ceftiofur. a. adult: cephalic/saphenous vein = 1-2 g; digital vein = 1 g. b. foal: cephalic/saphenous vein = 0.5 - 1 g, digital vein = 0.5 g. c. recommend concentrating ceftiofur to 100mg/ml 4. Intra-articular: off label use – 1 g per ‘large’ joint (stifle, tibiotarsal); 0.5 g for ‘small’ joint (fetlock). Recommend concentrating ceftiofur to 100mg/ml. Can be given simultaneously with systemic treatment. 5. Intra-uterine: off label use – 2mg/kg q12 or q24h, dilute to 30-200ml total volume. 6. Nebulized: off label use - 1-2 mg/kg via nebulizer q 12 or q24h, dilute ceftiofur to concentration of 25mg/ml. Special note: For any off label use the drug should be used according to the cascade principles and with appropriate warnings and instructions for owner/agent.

56 Eq Vet Pract 2020, June; 45 (2)

RESEARCH FUNDING 2020 grayson.jockeyclub.org

Passive Immunization of Foals With RNA-AB Against R. equi Jeroen Pollet, Baylor College of Medicine By inhalation therapy, we intend to deliver the genetic code for a protective antibody against Rhodococcus equi into the lung cells of newborn foals, to rapidly protect them against infection. Improving Fungal Diagnosis in Horses Soon Hon Cheong, Cornell University Developing a diagnostic test that can rapidly detect, identify, and determine the antifungal susceptibility profile of clinical equine samples to improve treatment outcomes of fungal infection in horses. Bisphosphonates and Fatal Musculoskeletal Injury Heidi Reesink, Cornell University Determining the prevalence of bisphosphonate use in racehorses and whether bisphosphonates are associated with fatal musculoskeletal injury is essential to equine welfare and the future of racing. Novel Treatment for Recurrent Exertional Rhabdomyolysis Stephanie Valberg, Michigan State University Determining if a potent antioxidant coenzyme q10, not subject to withdrawal times, can benefit horses with tying up by replenishing diminished muscle coq10 levels and decreasing oxidative stress. Enhancing the Efficacy of MSCs for Tendon Healing Lauren Schnabel, North Carolina State University This proposal examines the tendon inflammatory environment following acute injury and the effect of such an environment on mesenchymal stem cells (MSCs), with the goal of improving MSC treatment efficacy. AMPK Agonist Combination Therapy & ID in Horses Teresa Burns, The Ohio State University By completing this work, we hope to characterize a combination therapy to improve equine insulin resistance that is administered orally and well tolerated.

SDFT Adaptation in Thoroughbred Racehorses Sushmitha Durgam, The Ohio State University The impact of training and racing on (mal)adaptations in superficial digital flexor tendon hierarchical structure will be evaluated to delineate the pathophysiology of this common injury in racehorses. Dynamics of Vitamin D in Hospital Foals Ramiro Toribio, The Ohio State University Critically ill foals often have low blood levels of vitamin D; our goal is to investigate if their levels over time are associated with the severity of their disease and mortality. Asthma, Performance and Omega-3 Fatty Acids in Racing Thoroughbreds Laurent Couetil, Purdue University Investigating the variability of asthma severity in horses racing across the U.S., its effect on performance and determine if omega-3 PUFA supplementation is beneficial. Anti-PNAG Plasma for Preventing R. equi Foal Pneumonia Noah Cohen, Texas A&M University Transfusion of plasma is the only licensed product for preventing Rhodococcus equi pneumonia and demonstrate that we have developed a plasma product superior to that available currently. Effect of Nebulized Lidocaine in Treating Equine Asthma Melissa Mazan, Tufts University Evaluating the efficacy of inhaled lidocaine in equine asthma in reducing airway inflammation and hyperresponsiveness by promoting an anti-inflammatory lung environment. Effect of NSAIDs On Anion Transport in The Equine Colon David Freeman, University of Florida This proposal is designed to improve management of horses with right dorsal colitis, an insidious lifethreatening form of colic for which all horses on phenylbutazone are at risk.

Eq Vet Pract 2020 June; 45 (2) 57

Nacardioform Placentitis University of Kentucky Sample collection and storage of tissue for future research and testing for nocardioform placentitis. Protein Based In Vivo Diagnostic for Endometrial Biofilm Mats Troedsson, University of Kentucky Successful management of bacterial biofilms in the uterus requires an accurate diagnostic in vivo assay that we propose to develop. Novel Delivery of Antimicrobials into Equine Joint Simon Bailey, University of Melbourne The development and testing of, a novel (gel) carrier formulation for the antibiotic Cefuroxime, injection into horses’ joints for application as a treatment of joint infections.

Diagnostic Assay for Recurrent Exertional Rhabdomyolysis Molly McCue, University of Minnesota Identify a comprehensive set of genetic markers that allow RER risk prediction before horses tie-up and preemptive management to decrease the frequency and severity of clinical disease. Inhibiting EHV-1 With Anti-Inflammatory Drugs Arthur Frampton, University of N. Carolina Wilmington Using a tissue culture model system to test the ability of specific drugs to reduce the damaging hyper- inflammatory response that is observed in EHV-1 infected horses suffering from equine herpesvirus myeloencephalopathy (EHM). Validation of Blood Flow Restriction Training in Horses Sherry A. Johnson, Colorado State University. The Storm Cat Career Development Award. Details on the new projects available at: grayson-jockeyclub. org/default.asp?section=2&area=Research&menu=2.

REMINDER: YOU CAN ENJOY YOUR E-EVP CURRENT ISSUE AND E-EVP ARCHIVE AT YOUR NZVA LOGIN PAGES. For current E-EVP: 1. Go to http://www.nzva.org.nz/ and sign in 2. Click on: Groups 3. Click on: Special Interest Branch: New Zealand Equine Veterinary Association

The

Equine Veterinary Practitioner

4. Click on: Find the latest Equine Veterinary Practitioner newsletter here >> 5. Voila! You will be at ISSUU with the E-EVP live. Maximise view at:

NEW: You now can click on a page number on the contents page to link to each item to the item! For Archive E-EVP: 1. Go to http://www.nzva.org.nz/ and sign in 2. Click on: Groups 3. Click on: Special Interest Branch: New Zealand Equine Veterinary Association 4. Click on: Find archived issues of EVP here >> 5. Voila! You now have PDF versions of our EVP Archive from 2014.

58 Eq Vet Pract 2020, June; 45 (2)

The Official Publication of the New Zealand Equine Veterinary Association

JUNE 2020 Vol. 45 No. 2

WE’RE HERE TO HELP CONTACT US TODAY (07) 888 8193

• 24/7 Emergency Referral Hospital • Full Reproductive Service • Performance and Sports Medicine • Sales and Yearling Consultancy and Radiology

ADVANCING VETERINARY SCIENCE IN THE HEART OF THE WAIKATO Our dedicated team of highly experienced Equine Veterinarians provide the latest diagnostics, treatment and best care available for your horse.

• Pre-purchase Examinations – including Hong Kong • Digital Radiography • Ultrasonography • Scintigraphy (Bone Scan) • Shockwave Therapy Dave Keenan BVSc MANZCVS Andrea Ritmeester BVSc (Hons) MS DipACVS Leigh de Clifford BVSc CertAVP PGDipVPS MVSc Barbara Hunter DVM MS DAVCS-LA

362 Hinuera Road West Matamata (07) 888 8193 matamatavets.co.nz

Bacci B, Stent AW, Walmsley, EA. Equine Intestinal Lymphoma: Clinical-Pathological Features, Immunophenotype, and Survival. Vet Pathol. MAR 2020; # 0300985820906889 DOI: 10.1177/0300985820906889 Primary intestinal lymphoma was diagnosed in 20 horses on biopsy and postmortem examinations in 16 cases. Lymphoma was found in the small intestine in 12 (60%), in the colon in 5 (25%) and in both small and large intestines in 3 (15%) cases. Grossly there was thickened intestinal wall (45%), mural nodules or masses (30%) and both thickening and nodules (10%) and classed [WHO] as enteropathy-associated T-cell lymphoma (EATL) type 1 in40%, EATL type 2 in 45% and T-cell-rich large B-cell lymphoma (TCRLBCL) in 15%. Histologically, 70% of cases were grade 1 and 30% were grade 2. Of EATLs, the infiltrate was mucosal only (12%), mucosal and submucosal (53%), or transmural (35%). EATL1 was submucosal to transmural (2/8 and 6/8), EATL2 was mucosal to submucosal (3/9 and 6/9), and TCRLBCL was always transmural. Median survival was 25 days for EATL1, 90 days for EATL2, and 188 days for TCRLBCL; not statistically significant. Of the EATLs, grade 1 had a median survival of 60 days and grade 2 had a median survival of 25 days; not statistically significant.

Pujol R et al. Suspected primary mycotic rhinitis and paranasal sinusitis in seven horses (2013-2019). Eq Vet Edu. APR 2020; DOI: 10.1111/eve.13275 Mycotic plaques were observed in the nasal portion of the ethmoidal labyrinth and ipsilateral nasal passage during rhinoscopy in one horse and in the paranasal sinuses during sinoscopy in six horses. Fungal culture was positive in five horses with Aspergillus spp. found in three. Surgical debridement was performed under rhinoscopic guidance and sinoscopic guidance through a trephine hole or directly via a bone flap. Medical treatment included topical application of clotrimazole, enilconazole, nystatin or amphotericin B directly to the affected area with mean of 10 ± 13 applications during hospitalisation and additional inhalation of nystatin or amphotericin B for mean of 8 days of nebulisation. Total hospitalisation was 13 ± 9 days. It took >5 months to observe complete regression.

Eq Vet Pract 2020 June; 45 (2) 59

Mortola E et al. Assessment of the immunocrit method to detect failure of passive immunity in newborn foals. Eq Vet J. FEB 2020; DOI: 10.1111/evj.13237 The immunocrit test, using a 40% ammonium sulphate solution, was used to measure the concentration of immunoglobulins in serum samples from 211 newborn TB foals and compared with results using agarose gel electrophoresis method. Values obtained by the immunocrit method were significantly correlated (R = 0.871; P < 0.001) with those measured by agarose gel electrophoresis. A cut-off value of 8 g/L of serum immunoglobulins by agarose gel electrophoresis and its equivalent of 9.5% for the immunocrit test was indicative of failure of passive transfer. The sensitivity and specificity of the immunocrit method at this cut-off point were 94% (95% CI, 90-97.3) and 82% (95% CI, 72.13-91.8) respectively. The immunocrit test is worth considering as a quantitative, quick, inexpensive, reliable and objective method to detect failure of passive transfer of maternal immunity in newborn foals.

Weber LA et al. Betulinic acid shows anticancer activity against equine melanoma cells and permeates isolated equine skin in vitro. BMC Vet Res. 2020; 16: #44. https://doi.org/10.1186/s12917-020-2262-5 Betulinic acid is a naturally occurring triterpenoid with promising anti-cancer properties. In this in vitro trial betulinic acid showed antiproliferative and cytotoxic effects on both primary equine melanoma cells and fibroblasts in a time- and dose-dependent manner. The lowest half-maximal inhibitory concentrations with cytotoxic effect were obtained 96 h after the beginning of drug exposure (12.7 μmol/L and 23.6 μmol/L for melanoma cells eRGO1 and MelDuWi, respectively). High concentrations of betulinic acid were reached in the required skin layers in vitro. In this preliminary in vitro study it was concluded that betulinic acid is worthy of trialling in topical treatment of equine malignant melanoma in vivo.

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US THOROUGHBRED RACING ECONOMIC INDICATORS: FIRST THIRD, JAN – APRIL 2020 Prize money and race days take a slump Indicator

2019

2018

% Change

$3,148,569,565

$3,380,927,018

-6.87%

$222,722,051

$313,030,470

-28.85%

878

1,155

-23.98%

U.S. Races

7,362

9,902

-25.65%

U.S. Starts

58,783

76,558

-23.22%

7.98

7.73

+3.27%

$3,586,070

$2,927,210

+22.51%

$253,670

$271,022

-6.40%

Wagering on U.S. Races* U.S. Purses U.S. Race Days

Average Field Size Average Wagering Per Race Day Average Purses Per Race Day

* Includes worldwide commingled wagering on U.S. races # Total wagering on U.S. races increased each year since 2015 and topped $11B for the second time since 2010.

Veterinary research and education funding available The Don McLaren Fellowship Fund Through the generosity of the McLaren family and in memory of Don McLaren and the huge contribution he made to our profession through his drug company, Bomac, a fund is available to further veterinary research and education. A significant proportion of this money is allocated to the equine sector. A total of $10,000 is available for equine research and education each year, and applications are now invited for 2020.

Priority will be given to veterinary practice-based projects, especially involving young veterinarians. Consideration will also be given to broader-based equine research work or suitable education-related applications. Applications close 31 October 2020 and the successful applicant(s) will be notified by 1 December.

Please apply in writing to: Leanne Fecser New Zealand Veterinary Association, PO Box 11212, Wellington nzva@vets.org.nz Applications must include: (a) Details of the proposal (b) Curriculum vitae

Eq Vet Pract 2020 June; 45 (2) 61

COLLEAGUE PROFILE WALLIE NIEDERER

Tokoroa & Districts Veterinary Services info@tokvets.co.nz

Here we share a Q&A session with a colleague to give readers an insight to the person behind the name one sees in EVP from time to time. If you have someone in mind who we might interview for a Colleague Profile, please let the EVP Editor know.

Preface – Lucy Holdaway As an avid horsey girl in 4th year at Vet School, the first time I met Wallie, was through a mutual friend at Horse of The Year Show in Hawkes Bay. I had herd great things about Wallie and his business partner Tony Parsons, so I was a bit star struck! Both Tony and Wallie oversaw doing the FEI horse inspections the following morning and Wallie insisted that I came along too. Well, I had a great night after that at the HOY bar and managed to show up the next morning to observe the trot up, all be it somewhat hungover. I had been slightly comforted by stories from Wallie that in some situations he had found himself doing trot ups, but barely able to see the end of the track and I felt much at ease, not that I was involved in any decision making that day! Wallie then invited me to do calving placement at his Tokoroa clinic later that year, and this work was so useful to me that I returned the following year and then got offered a job. While Tokoroa doesn’t have the best reputation in the country, much if it is unwarranted and it was a great place to live. The clinic there was fantastic and filled with such a great bunch of people I had no hesitation accepting the job, plus I was thrilled to be working for Wallie and Tony. Wallie and Tony, along with the third business partner Bill Teague, were always very encouraging and supportive of my interest in equine work, including dentistry. In the six and a half years I worked for them I learnt an undefinable amount about so many aspects of being a vet, for which I am forever thankful. I still am in regular contact with them despite not working there anymore and consider them very close colleagues as well as good friends. Hopefully the feeling is mutual - although possibly not after making Wallie do this interview. Tony, your next!! Tell us a bit about your career path

My first job was in Tirau working in mixed practice but also with the late Keith Gudsell who did a lot of thoroughbred stud work, so I got an early taste of equine work as well. Then on to owning a mixed practice with Bob Sadler in Tokoroa. I always had an interest in equine work and got involved in the air transportation of horses around the world. I applied for the job as veterinarian for the New Zealand Olympic team and was lucky enough to get it. I had a great number of years during the golden age when

62 Eq Vet Pract 2020, June; 45 (2)

the NZ team and the individuals did very well. I was always interested in management, as the practice grew so grew my management skills. Where did you obtain your veterinary degree, and did you take on any post-graduate studies?

Graduated from Massey in 72. Travelled overseas and spent time with Marty Simonson who is the American team Vet and with British Team Vet Peter Scott-Dunne Why did you choose equine as an area of practice?

I grew up on a beef and sheep farm in Southland and we always had ponies as kids. Later I whipped for the Taupo Hunt, so I have always had an interest in horses. Bumps and hurdles along the way to get to here?

Growing a business has many ups and downs some can be controlled, and others are out of your control. Outline the data and knowledge sources that are most useful to staying current in equine practice.

I am now retired from clinical practice however found personal communication, seminars and now the computer as most useful tools. What do you like most about your work, previous clinical role and current management?

I enjoyed interaction with good clients and also enjoyed seeing the equine athletes perform to the best of their ability. I really enjoyed the pressure of Olympic Games and other pinnacle events, keeping the horses sound over Three Day Events - dressage, cross-country and show jumping on the last day. What pissed you off the most about your daily grind?

Clients with unreasonable expectations. What was the most challenging part of your job as a clinical practitioner and recently as practice owner/ CEO and manager?

Dealing with clients and staff.

What advice would you give to someone thinking of following your line of practice, from clinical equine practitioner, to team vet, to practice owner?

Just do it; we all make our own luck to some degree: “The more I practice, the luckier I get” Gary Player. Should our BVSc [Massey] programme include substantial species or discipline specialization, or should that be mainly left to post-graduate training periods?

I believe in our day we had a very good grounding in all subjects and were able to specialise as we gained more experience. Times have changed and it is becoming more and more difficult for new graduates to get practical experience. In your opinion what has changed the most in the veterinary field from when you started as a new graduate until today; the good, the bad and the ugly?

We were able to have ago at anything, but today clients are now more informed and are more demanding. New graduates are very aware of litigation by clients, and hence their confidence takes a lot of building. What are your passions outside of work?

Family, farming, overseas travel, whitebaiting on the West Coast. What are you most looking forward to when you fully retire?

All of the above. A few personal questions: Sporting event/concert you would travel back in time for:

Billy Joel/Elton John concert. Last really memorable meal:

Fresh whitebait. Best-ever or best-tentative dinner party guests:

David Foster and Mark Todd. First ever concert:

Primary school! Favourite ever album/band:

Rumours – Eagles. Finish the sentence: “No woman or man should ever wear…..

PJs to the supermarket. Beer or wine/Stones or Beatles:

Wine and Beatles. What was the last lie you told:

How long have I been promising you to write this article Lucy?

Most interesting surgery you have done:

Colic surgery in the paddock prior to being able to refer surgery: horse survived. Best self- defence tip:

Keep calm and carry on. Person(s) who has influenced you most in your life:

Keith Gudsell and Brian Goulden. Best life lesson/life motto

I’m a pretty laid-back sort of person but come from a background of being relatively intolerant of poor performance. Always have a go and if you make a mistake learn from it.

POSTSCRIPT

Wallie Niederer was the 2018 recipient of the Lake Taupo Districts Sports Advisory Council Outstanding Contribution to Sport Award with the following citation: Wallie has been involved at the highest level of equestrian since 1984, when he was selected as team veterinarian for the New Zealand Equestrian Team at the Los Angeles Olympics. For the next three decades he dedicated his time, expertise and enthusiasm to the sport of equestrian. He has held key positions within Equestrian Sport including New Zealand Equestrian Team Vet, and Chef de Equipe and Chef de Mission in both the Olympic and World Equestrian Games. To the present day he holds the positions of FEI Delegate, Equestrian Sport NZ board member and convenor of the National Equestrian Centre in Taupo. In 2011 Wallie, as chair of the National Equestrian Centre committee, created a vision for the National Centre’s indoor arena. By 2013 he was instrumental in sourcing the funding for the project and in 2016, when construction began, he donated both his time and machinery to its completion. The arena benefits not only high performance but also grass roots riders. The facility is an asset to the Taupo District and is a legacy to Wallie and his team of volunteers. Congratulations Wallie!

Eq Vet Pract 2020 June; 45 (2) 63

Read, RM et al. Subclinical Ultrasonographic Abnormalities of the Suspensory Ligament Branches [SLBs] Are Common in Elite Showjumping Warmblood Horses. Front Vet Sci. 2020; 7(17): #117. DOI: 10.3389/ fvets.2020.00117 Sixty elite showjumping Warmbloods without recent history or clinical signs of SLB desmopathy were examined ultrasonographically. Eight static transverse and longitudinal section images of each SLB were acquired and anonymously assessed and graded (grade 0-3) for lesions. A branch score was assigned based on the most severe grade of any image slice in each branch series. There was a prevalence of 58% (554/960) grade 2 SLBs. Interobserver agreement was good (kappa = 0.65). Periligamentous fibrosis was highest in hindlimbs (64%). Twelve-month follow-up revealed only two horses were excluded from competition due to SLB injury. Thus these Warmbloods had a high prevalence of subclinical SLB ultrasongraphic abnormalities that may not contribute to lameness, to poor-performance or to being viewed entirely negatively at prepurchase examination.

Gold JR et al. Plasma disposition of gabapentin after the intragastric administration of escalating doses to adult horses. J Vet Int Med. 2020; 34(2): 933-940. DOI: 10.1111/jvim.15724 Gabapentin was administered by nasogastric intubation to nine clinically healthy horses at 10, 20 mg/kg (n = 3) and 60, 80, 120, 160 mg/kg (n = 6). Plasma was collected at zero to 64 hours post administration. Gabapentin plasma concentration increased with dose increments, however the area under the concentration curve from zero to infinity and maximal plasma concentration did not increase proportionally relative to the dose in horses.

Baird J et al. The association of Equine Parvovirus-Hepatitis (EqPV-H) with cases of non-biologic-associated Theilerâ&#x20AC;&#x2122;s disease on a farm in Ontario, Canada. Vet Microbiol. 2020; 242: # 08575. DOI: 10.1016/j.vetmic.2019.108575 Acute hepatic necrosis Five sudden deaths occurred in late summer on a stud farm in Ontario with two horses demonstrating signs compatible with hepatic encephalopathy, although no horses were necropsied. No horse on the farm had received an equine-origin biologic product in the preceding six months. Killed vaccines for rabies, tetanus and West Nile Virus had been given to all horses one month prior to the onset of the first sudden death. In the following three months a further four horses died suddenly or were euthanized with confirmed histopathologic diagnosis of acute hepatic necrosis [Theiler disease]. Equine parvovirus-hepatitis (EqPV-H) DNA was detected by quantitative-PCR in the serum of 62% (34/55) of the horses on the farm with viral loads ranging from < 3.75 x 103 to 3.64 x 107 copies/mL. EqPV-H DNA was present in serum of three horses with Theiler disease, five horses with subclinical liver disease, and in clinically normal, in-contact horses.

McIver VC et al. Effects of topical treatment of cannabidiol extract in a unique manuka factor 5 manuka honey carrier on second intention wound healing on equine distal limb wounds: a preliminary study. Aust Vet J. Early Access Feb 2020. DOI: 10.1111/avj.12932 Five 2.5 x 2.5 cm full thickness skin wounds were created on the dorsomedial aspect of the metacarpi of six STB horses that were contaminated with faeces on day 1. Each wound was then assigned to a treatment group: compounded 1% cannabidiol in unique manuka factor (UMF) 5 manuka honey; UMF 5 manuka honey; UMF 20 manuka honey; or saline. Each topical treatment was applied daily for 42 days and the wounds were bandaged daily for 13 days. Digital photographs of each wound were taken on day 1 then weekly for 6 weeks. Wound size, daily healing rate and total time to healing were recorded. Irrespective of treatment, wounds did not retract as expected in the first 7 days after wound creation. There was no difference in wound area, daily healing rate, days to complete healing between treatment groups. This was unexpected due to previous findings of the effects of UMF 20 manuka honey on wound healing using the same model. NOTE: Would it be interesting to see the effect of another control therapy having nothing applied topically and no bandaging?

64 Eq Vet Pract 2020, June; 45 (2)

Focus on Equine Worm Control Sustainable strategies now and into the future!

Equine Worming 1: What I need to know

We love a bit of feedback. Recently there’s been a recurrent theme to it around our equine product portfolio. We’ve had some great yarns to vets in clinics and horse owners, especially at events like Horse of the Year, or those ringing our 0800 customer helpline, all looking for more information on developing worm control programs. In response, the equine team at Bayer has put together some handy educational resources for vets and for owners. To help vets refresh or increase their knowledge on equine parasites we enlisted the help of Martin Nielsen DVM, Ph.D, DipEVPC and Associate Professor at M.H. Gluck Equine Research Centre at the University of Kentucky - a key opinion leader in equine parasitology. Martin has developed four online training modules on various aspects of equine worming, covering the basics right through to developing equine parasite control programs. They are available for free at vetspace.co.nz for clinic staff. These are a great tool for vets wanting to improve their consultations with clients, and to upskill all clinic staff, but we also felt that a new resource targeted at horse owners was needed. To have a really worthwhile discussion with their vet, owners need to have a solid background on sustainable parasite control strategies before getting down to organising the nitty-gritty of a personalised plan during a worm strategy vet consult.

Equine Worming 3: Using Faecal Egg Counts

Equine Worming 2: Parasitic Disease Syndromes

Equine Worming 4: Parasite Control Programs

Your Online Space for Continuing Animal Health Learning

So in early 2020 we launched the booklet Focus on Equine Worm Control - A guide to sustainable strategies for New Zealand horse owners. We’ve tried to make it easy to read, but still pack in some really useful concepts. The key topics of the book are: • What are the different worm species? • What are the different drench families? • What is drench resistance? • How to work with vets to avoid resistance • Management tools to control worms This booklet will hopefully keep horse owners up-to-date with current best practices but also encourage them to engage with you as their vet to develop the best sustainable strategies for equine parasite control for their horses and on their property. We all know that worming horses is not a one-size-fits-all topic and it’s an area that deserves steering horse owners towards expert veterinary advice for sustainable strategies. To complete the online modules go to www.vetspace.co.nz or to get your hands on a copy of the Equine Worm Control booklet contact your local Territory Manager.

Bayer New Zealand Ltd, 3 Argus Place, Hillcrest, Auckland 0627, New Zealand. www.bayeranimal.co.nz | 0800 446 121 Eq Vet Pract 2020 June; 45 (2) 65

STOP PRESS 20TH MAY 2020

Message from MPI re Theileria equi# for industry information. • A suspect positive test result for the disease Theileria equi was returned as part of standard export certification testing of a mare prior to shipment from New Zealand. • Further blood tests have been taken from the mare and we expect confirmation of whether the horse is negative or positive for the disease by the end of this week. • Theileria equi is a blood disease that causes anaemia and is spread from animal to animal by ticks. The ticks that are known to transmit the disease are a species not present in New Zealand. It is not infectious between horses. • The horse in question was imported to New Zealand from the EU early last year for breeding. No signs of disease in the animal have been reported in its time here. • The horse met MPI’s importing requirements in that it had received a negative test for Theileria equi within 30 days of shipment. Before shipment, horses are quarantined and treated to remove any ticks that may be present. They are also further inspected and quarantined on arrival. • Some countries, including Australia, that import horses from New Zealand require certification that New Zealand is free of Theileria equi. This suspect test result has meant that MPI cannot currently provide that assurance of country-freedom status. • A shipment of horses to Australia that was scheduled for the evening of 19 May was put on hold and another shipment scheduled for Friday 22 May could also be held. • The Ministry’s market access specialists are working with Australian authorities to explore alternative assurance options to allow exports to continue. • Biosecurity New Zealand is carrying out a full investigation to confirm this is an isolated case and will test other horses from the operation involved. • MPI is aware this situation may cause some concern to those in the equine sector and work is underway to resolve things as quickly as possible to ensure ongoing horse exports are not interrupted. #

Equine Piroplasmosis

Theileria equi and Babesia caballi are tick-transmitted piroplasms that cause haemolytic anaemia. Clinical signs include malaise, weakness, fever, anorexia, pale to icteric mucous membranes and tachycardia. Transplacental transmission can lead to abortions or to neonatal piroplasmosis that is invariably fatal. Diagnosis of acute piroplasmosis is based on microscopic detection of parasites in red blood cells. Serologic tests are used for detection of carriers. PCR is currently the most sensitive diagnostic technique. Imidocarb and diminazene are the most frequently used babesiacides for treatment. Reference: Sutton DGM & Sellon DC. Haematopoietic and immune systems. Ch 10 in Equine Medicine, Surgery and Reproduction 2nd Ed. TS Mair, S Love, J Schumacher, RKW Smith & G Frazer Eds. Oxford: W.B. Saunders. 2012: 195-210. https://doi.org/10.1016/B978-0-7020-2801-4.00010-9

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USEFUL LINKS We thought you might appreciate having a listing of useful URL links to allied contact groups in your E-EVP - so here is a start. Please contact us to add or change any address.

AAEP - American Association of Equine Practitioners

Harness Racing NZ

AHT - Animal Health Trust

HBLB - Racehorse Health

ANZCVS - Australian & NZ College of Veterinary Scientists ARVS - Association of Racecourse Veterinary Surgeons BAEDT - British Association of Equine Dental Technicians

VETERINARY CLINIC

EQUINE

Massey Equine Veterinary Clinic NZERF - NZ Equine Research Foundation

NZEVA - NZ Equine Veterinary Association NZVA - NZ Veterinary Association

BHS - The British Horse Society

BEVA - British Equine Veterinary Association

DEFRA/AHT/BEVA - Disease Surveillance Reports

ESNZ - Equestrian Sports NZ

EVA - Equine Veterinarians Australia

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SPCA â&#x20AC;&#x201C; Society for the Prevention of Cruelty to Animals-NZ Thoroughbred RACEHORSE OWNERS Federation

NZTR - NZ Thoroughbred Racing

RCVS - Royal College of Veterinary Surgeons SAEVA - South African Equine Veterinary Association

EVJ - Equine Veterinary Journal

SIVE - Societa Italiana Veterinari per Equini

FEI - International Equestrian Federation

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WE OFFER We are a team of highly qualified equine veterinarians, including a registered Specialist in Equine Surgery with extensive experience. We provide the highest quality of first opinion, emergency, and referral services for all horses and ponies, from the paddock pet to the elite athlete.

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AVMA NEWS April 15, 2020 Kaitlyn Mattson and Malinda Larkin Details reported HERE

US Veterinarians are among those charged in widespread horse doping schemes involving unapproved drugs hidden from regulators and racetrack officials. Federal prosecutors have arrested several veterinarians, trainers, and other horse racing professionals on charges relating to systematic, covert administration of illegal performance-enhancing drugs according to court documents released March 9. Of the 27 defendants, 19 are charged in an indictment detailing conspiracies to manufacture, distribute, and receive adulterated and misbranded performance-enhancing drugs and to secretly administer those drugs to racehorses in New York, New Jersey, Florida, Ohio, Kentucky, and the United Arab Emirates, according to the press release from the U.S. Attorney for the Southern District of New York. “This is the most far-reaching prosecution of racehorse doping in the history of the Department of Justice,” – U.S. Attorney Geoffrey S. Berman.

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MASSEY EQUINE HOMEPAGE CHANGE FOR THE FUTURE It unlikely that many of us have considered a risk scenario as complex as the Covid-19 pandemic, and the government response to it. There is no doubt that it has greatly affected the breadth and depth of our profession, businesses (in our case teaching and research) and animal welfare. The impact would perhaps be the greatest in equine practice, as the more widespread implications for the New Zealand racing industry develop. If there is but one small silver lining in the cloud, it has occurred at a time of year when many equine practices are quieter. I know everyone is looking forward to completing any deferred veterinary work over the next few months. We too at the University have been greatly affected, and our students have been unable to participate in practical sessions through their rosters in the clinic. This has also affected the placements of the final year students in many of your practices. We will all have to work together to support them as they complete the practical components of their final year of study. I’m sure that this has influenced some of our work practices, increasing our capacity to work from home when necessary, and in the case of the Massey team, greatly modifying how we deliver the various components of the educational programme for our veterinary students.

PEOPLE Dr Anna May (DiplECEIM) whom we introduced as a sabbatical visitor in our last newsletter has settled down well, and has become a much valued member of the team. Some of you will know Dr Ben Sykes, another specialist in Equine Medicine and a world leading researcher into equine gastric ulcer syndrome, who has also joined us as a staff member. Prior to his appointment we were fortunate to have him visit on a number of occasions as a locum. Ben will divide his Assoc Prof Ben Sykes time between New Zealand and Australia, although the current travel restrictions have him “stranded” in Australia, and working with the team online with regular meetings on Zoom. Amarins Sijling, our Dutch intern, recently completed her internship with us and we wish her well in her professional endeavours. Our new intern, Matthias Lim was due to join us in April, but unfortunately is in limbo due to the Covid lockdown while he awaits his visa and veterinary license. He entered the country at the same time the two week requirement for quarantine was introduced, but has maintained an upbeat demeanour despite the challenges of being locked in the six weeks Covid 3 and 4 restrictions.

Chris Riley and Erica Gee have been closely involved in the Massey University’s Covid response at the Campus, School and Veterinary Teaching Hospital levels.

CONFERENCES AND OUTREACH Some of the Massey Equine team, along with several of you, were due to present at the World Veterinary Association Conference 2020 in Auckland, and at the ANZCVS Science Week. Unfortunately their cancellation curtailed plans to travel to these conferences but Chris Riley and Luca Panizzi were both able to present posters, along with other NZEVA members. Chris presented posters on the psychosocial impacts on volunteers and workers in emergencies and disasters involving animals, the use of a horse mannequin to relieve anxiety in hospitalised horses, and antimicrobial resistance in camelids. Luca presented a poster on an unusually large and invasive dentigerous cyst that he and the team removed from a patient. Chris is due to present further work at the recently announced virtual version of ANZCVS Science Week 2020.

TEACHING IN VIRTUAL WORLD A considerable amount of the team’s time has been spent restructuring and adjusting the equine veterinary curriculum and how best to deliver it with the new reality that has resulted from the pandemic. Erica Gee and Ben Sykes have led the team in a review of the core competencies required of newly graduated equine veterinarians in New Zealand. This meant weekly meetings walking through all the equine lectures, practical sessions and clinical training provided at Massey. As part of this process we have reviewed what materials can be delivered online through lectures, tutorials and study modules, and what needs to be delivered hands-on so that students can acquire the necessary technical skills. To that end we are delivering Dr Anna May a weekly E-roster to students that is set to encompass all the core background clinical materials that would normally be discussed while they are on their clinical roster. This has allowed for some innovation in the area including interactive tutorials that are designed in Kuracloud - another New Zealand learning

Eq Vet Pract 2020 June; 45 (2) 71

platform innovation. The development of these modules has been led by Emma Gordon and Ellison Aldrich. Briefly a clinical case scenario is created that allows the student to solicit information by selecting requests for history, tests, et cetera, and then seen the consequences of their diagnostic and treatment choices. These learnings are then used as the basis for more interactive sessions in ZOOM. We are fortunate that this has been well received by the students. With the reduction of Covid restrictions, students will then have a skills and competency focused practical roster week (P-roster), using the E-roster as the basis to optimise their learning and development of competencies. This new approach has allowed us to bring in some international speakers and resources to support teaching program and provide quality learning opportunities for students. Of course, our interns were also affected during the lockdown. In response we have developed a more comprehensive instructional program for our interns to increase the depth of their learning in support of their programme. This has included three intensive 2-hour tutorials each week, journal club, and case rounds. Although in many ways this has

been a challenging experience, it has allowed the team to reinvigorate their teaching and to further improve the quality of delivery. We are sure this will have long-term positive consequences on the quality of our graduates and postgraduate trainees.

RECENT PUBLICATIONS Padalino B, Riley CB. Editorial: The implications of transport practices for horse health and welfare. Front Vet Sci 2020; 6 https:// doi.org/10.3389/fvets.2020.00202 Kamm JL, Parlane NA, Riley CB, Gee EK, Roberts JM, McIlwraith CW. CellTrace Violet™ inhibits equine lymphocyte proliferation. Vet Immunol Immunopath 2020 https://www. sciencedirect.com/science/article/pii/S0165242720300635 Johnston AS, Riggs CM, Cogger N, Benschop J, Rogers CW, Rosanowski SM. 2020 Using time-series analysis techniques to enhance the understanding of musculoskeletal injury in Thoroughbred racehorses. Eq Vet J 10.1111/evj.13220 https://beva.onlinelibrary. wiley.com/doi/10.1111/evj.13220

Warm Regards from the Massey Equine Team

PROVIDING THE BEST OF HEALTH & PERFORMANCE CARE A Multi-Specialty Group of Vets and Researchers with a Broad Range of Expertise and Knowledge Our specialised services include: • Sport horse & Poor performance evaluation • Elective and emergency surgery including - Arthroscopy - Colic surgery - Airway surgery including laser surgery • Lameness diagnostics & Equinosis gait analysis • Internal medicine - Neurology - Ophthalmology - Neonatology - Cardiology • Digital radiology, fluoroscopy, ultrasonography, CT

Anaesthesia: Hiroki Sano BVSc DACVAA Vicky Walsh BVSc MACVSc Diagnostic Imaging: Mark Owen Dip IECVDI FACVSc MACVSc Paul Wightman BVSc MACVSc Internal Medicine: Sarah Mack BSc(Hons) BVetMed(Hons)

CertAVP(EM) DECEIM MRCVS

Emma Gordon BVSc, MS, DACVIM Reproduction: Erica Gee BVSc PhD DACT Surgery: Ellison Aldrich VMD, MS. SURGERY Luca Panizzi MVSc DACVS Chris Riley BVSc PhD DACVS

• Dynamic endoscopy videoendoscopy, and gastroscopy • Surgical dentistry & nutrition • Reproduction

T 06 350 5328 F 06 350 5747 www.equinehospital.co.nz

72 Eq Vet Pract 2020, June; 45 (2)

VETERINARY CLINIC

EQUINE

FREE WEBINARS & BULLETINS The British Charity Beaufort Cottage Educational Trust has begun a series of free video and slide webinar presentations launched from http://www.beaufortcottage.com/ A. The first of the video webinars on Wobblers - Steve Reed, Tim Phillips and Richard Piercy. B. BCET YouTube webinar videos on many topics including: • Pelvic ultrasonography - Sarah Boys Smith • Sub clinical imaging findings in the elite sport horse - Sue Dyson • Fractured ribs - Diagnosis and prognosis - Billy Fehin • Imaging the equine back - Marianna Castro Martins • Third phalangeal cysts in the Thoroughbred Racehorse - Tom O’Keeffe • Imaging and management of suspensory branch injury in racing thoroughbreds - Pete Ramzan • Has advanced imaging changed management of proximal suspensory desmitis - Sue Dyson • Soft tissue injuries of the foot are there red flags on plain radiography - Marianna Biggi • Radiographic findings in Juvenile Orthopaedic Disease - Debbie Spike Pierce • Sales selection - The trainer’s view point - Sir Mark Prescott • The Sales Exam - The veterinary viewpoint - Mike Shepherd C. Illustrated, downloadable PDFs including: • Preparing and assessing Thoroughbreds for sales - Gerald Leigh Memorial Lectures; 9 speakers. • Field Guide To The Flexed Dorsopalmar Radiographic Projection Of The Fetlock - Piet Ramzan. • The use of genetics to improve canine and equine breeds - Sarah Blott. • Genetic risk factors for equine respiratory disease – Vince Gerber • Upper respiratory function in young TBs presented for sale – Geoff Lane • Recurrent Laryngeal Neuropathy (RLN) - Norm Ducharme D. Grants and Awards from BCET may be available for Kiwi Practitioners

VETLOGIC PUZZLE ANSWERS, JUNE 2020 HEAD NURSE

EQUINE PRACTICE

NO. OF EQUINE NURSES

GRACIE

GISBORNE

HEIDI

KAITAIA

JESSICA

PATEA

SARAH

HOKITIKA

See page 50 for puzzle

Image from Clipart Library

Eq Vet Pract 2020 June; 45 (2) 73

Your chance to win free registration to 2020 NZEVA Conference • All you must do is submit a little paper on any equine veterinary topic for publication in Equine Veterinary Practitioner. • Brief Case Report, Novel Idea, Practice Tip, How-To Note, Enlightened Commentary and any other relevant material suitable to our readers will be eligible. • Items can be almost any length. But case reports may be ~1500 words - though this is not restrictive - and accompanying diagrams, tables, photos and charts are very welcome. • The winner is drawn from the hat by your EVP Chairperson and announced March 2020 so you can make all your plans to attend our NZEVA Annual Conference. • This is open to all equine technical, scientific and veterinary workers, but does exclude EVP Editorial Committee members and Massey researchers.

And this Year’s Winner was:

Richard Hermans VetOra, Putaruru richard.hermans@vetora.nz

For his paper: Neurological deficits secondary to caudal trauma. EVP June 2019; 44(2):34-36. Richard received free registration to our - NOW VIRTUAL NZEVA Conference at WVAC Auckland April 2020

INTERNATIONAL FORUM FOR THE AFTERCARE OF RACEHORSES (IFAR) Fourth International Conference Presentations and Videos from 4th IFAR Conference now Available HERE

The conference was held Feb 20th as part of the Asian Racing Conference (ARC) in Cape Town, South Africa. IFAR is an independent forum that recognizes geographical and industry differences among racing countries and is designed to enhance Thoroughbred aftercare worldwide. Working with the International Federation of Horseracing Authorities, IFAR will raise awareness of the importance of welfare for Thoroughbreds, improve education on lifetime care, and help increase demand for former racehorses in other equestrian sports. More information on IFAR at internationalracehorseaftercare.com.

74 Eq Vet Pract 2020, June; 45 (2)

QUARTERLY REPORT EQUINE CASES Surveillance 2019; 46 (4): 5-16. and Surveillance 2020; 47 (1): 11 – 18. http://www.sciquest.org.nz/surveillance

Biosecurity New Zealand’s Incursion Investigation team investigates suspected cases of emerging or exotic diseases in New Zealand. They are interested in hearing about any equine health issues that seem out of the ordinary, including but not limited to: • Parasites or unexplained disease in one or more horses associated with recent international travel • An unusual or unexplained outbreak in a group of horses, particularly involving: – acute respiratory disease – neurological signs – abortion/reproductive signs – unexplained mortalities If you suspect you’ve seen an exotic or emerging disease, please phone Biosecurity New Zealand on 0800 80 99 66 as soon as reasonably practical.

CLINICAL DIAGNOSTIC CASES SVS Laboratories

A 4-year-old Warmblood mare from Waikato presented with signs pleuritis following suspected aspiration pneumonia. A bronchoalveolar lavage (BAL) was performed and the washings were submitted to the laboratory for cytology. A layer of low-density material was present on top of the saline, consistent with a lipid or other oily substance such as paraffin. Cytologically, mixed inflammation and lipid material was present. A wedge biopsy of the affected lung lobe was submitted 3 weeks after BAL sampling. Findings were consistent with a diffuse chronic fibrinous and necrotising pneumonia with intra-histiocytic lipid globules, type II pneumocyte hyperplasia, fibrin, haemorrhage and oedema. Both cytology and histology were consistent with exogenous lipid pneumonia (synonyms: lipoid pneumonia; paraffinoma) in this case. Uterine lavage fluid from a mare in Waikato was submitted to the laboratory for cytology and culture. No history was provided with the submission. Cytology revealed large numbers of degenerate neutrophils

and bacteria, and culture revealed a heavy growth of Nocardia sp., consistent with Nocardia endometritis. This agent can be isolated from the genital tract of healthy mares but is also sporadically associated with infertility, endometritis, placentitis and abortions. A veterinarian submitted blood samples from a 3-day-old filly that had slightly discoloured corneas. The foal was a twin, but the larger twin had died. The foal had not been feeding from the mare but had been drinking well from a bottle. Serum biochemistry showed low globulins (9 g/L; reference range 24–44) and the IgG level was 126 mg/dL (> 800 indicates adequate passive transfer; < 400 indicates failure of passive transfer). Serum amyloid-A was 1,708 mg/L (reference range 0–8). A CBC demonstrated a neutropenia (neutrophils 1.2 x 109/L; reference range 4.3–11 x 109) and a left shift with band neutrophils at 0.8 x 109/L (reference range 0.0–0.4 x 109), consistent with inflammation and a concern for sepsis. Three weeks later the leukogram had returned to within the reference range. A section of skin had sloughed from a superficial wound, which was thought to be the portal of entry for sepsis, and the wound was healing well. Gribbles Veterinary Pathology

A 10-year-old Friesian horse from Auckland developed a hot, swollen and painful udder and was pyrexic. Culture of a milk sample yielded small numbers of Streptococcus dysgalactiae, consistent with streptococcal mastitis. Most cases of equine mastitis are reported to be caused by haemolytic gram-positive cocci. A 10-year-old Warmblood gelding from Northland developed a firm swelling of the entire right hindlimb after an injection. Serum biochemistry showed markedly increased muscle enzymes including CK 10,601 IU/L (reference range 0–310) and AST 2,778 IU/L (reference range 233–567). Areas of gas within the limb were suspected on sonography. Culture of a swab collected through a sterile incision yielded Clostridium sp. bacteria, supporting a diagnosis of clostridial myositis. Two Thoroughbred mares on a South Taranaki property produced stillborn foals. Histopathological examination of tissues from one of the foals revealed a necrotising

Eq Vet Pract 2020 June; 45 (2) 75

bronchopneumonia and hepatitis with numerous intranuclear viral inclusions, confirming EHV abortion. Most cases of EHV abortion in New Zealand are attributed to EHV-1 but EHV-4 may rarely be involved. EHV-1 may be associated with sporadic abortions or, especially if carriers are introduced to naïve herds, more widespread abortion outbreaks, respiratory infections and even equine herpes myeloencephalopathy1. A 13-year-old Appaloosa from the Bay of Plenty had a well-demarcated 5-cm ulcerated fleshy protruding mass on his sheath. When the horse was purchased a year earlier the mass had been only 1 cm in diameter. Histopathological examination of a biopsy revealed an unencapsulated, infiltrative neoplastic proliferation of squamous epithelial cells, forming anastomosing islands and lobules and supported by a dense fibrovascular stroma, confirming squamous cell carcinoma. A 1-year-old Thoroughbred filly from Waikato developed pyrexia and a purulent nasal discharge. Streptococcus equi ssp. equi was isolated from a nasopharyngeal swab, confirming a diagnosis of equine strangles. A veterinarian was called to examine a 2-year-old Standardbred horse from Canterbury that had a fleshy mass protruding from the rectum. Histopathological examination of sampled tissue revealed this to be a rectal adenoma. Rectal adenomas are commonly recognised in dogs but rarely seen in horses. A 19-year-old Clydesdale cross horse from Mid Canterbury developed a small mass on the edge of the third eyelid. Histopathological examination showed that this was a squamous cell carcinoma. The surrounding tissue had solar elastosis. It is likely that this tumour was induced by ultraviolet solar radiation. A 14-year-old Thoroughbred horse from Northland had bilateral uveitis characterised by blepharospasm, epiphora and miosis. There was no corneal ulceration. Clinical response to topical corticosteroids in combination with systemic non-steroidal antiinflammatory drugs was slow. Serum haematology and biochemistry revealed only minor changes, with eosinophils 0.4 x 109/L (reference range 0–0.03 x 109), creatinine 80 μmol/L (reference range 81–164), phosphate 1.05 mmol/L (reference range 1.2–2.2), albumin 33 g/L (reference range 34–41), bilirubin 13.2 μmol/L (reference range 40–100) and creatine kinase 392 IU/L (reference range 0–410). Serological testing revealed a 1:1,600 titre to Leptospira serovar Pomona in the microscopic agglutination test, suggesting the horse could have leptospirosis-associated uveitis. The syndrome of equine recurrent uveitis has been linked to leptospirosis infection, possibly with some component of autoimmunity in its pathogenesis.

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A Thoroughbred foal from Auckland had purulent fluid aspirated from a distal radial physis. Culture of a swab produced a heavy growth of Salmonella typhimurium phage type 56 variant. Salmonella spp. can cause osteomyelitis in this location secondary to septicaemia in foals, typically when they are less than 4 months of age. Other bacteria that may cause this type of lesion include Escherichia coli, Streptococcus spp., Klebsiella spp. and Rhodococcus equi. Three foals less than a week old on a large horsebreeding establishment in Otago became unwell and developed severe diarrhoea. The first two affected animals died despite intensive supportive treatment. The first foal had been sick for 5 days before it died. Necropsy of this foal revealed a severe enterocolitis. No significant enteric bacteria were isolated on routine culture, but histopathological examination revealed severe coagulative necrosis of the intestinal mucosa. The luminal surface of the affected mucosa was lined with abundant large blunt-ended gram-positive bacilli resembling a Clostridium species. The second foal had been sick for only 24 hours when it died at 2 days of age. Histopathological examination revealed similar changes in the intestinal mucosa, and routine bacterial culture was again negative. However, PCR tests of the intestinal contents for Clostridium difficile toxins A and B were positive for both foals, supporting a diagnosis of Clostridium-associated enterocolitis. A third sick foal was treated with metronidazole and a broad-spectrum antibiotic, using a stomach tube, and it recovered rapidly. It is unusual to see outbreaks of Clostridium-associated enterocolitis. It was of interest that in this case the mares and foals were living in a muddy paddock with large puddles, as there had been a lot of rain over a short period. The mares and remaining foals were moved to drier paddocks and no more cases were reported. New Zealand Veterinary Pathology

A single mature gelding from Central Otago presented with a history of recurrent laminitis and hirsutism. Endogenous ACTH was increased (177 pg/mL; normal results in autumn < 47 and at other times of the year < 29), leading to a diagnosis of pituitary pars intermedia dysfunction (PPID). Despite the history of laminitis, insulin was normal (62 pmol/L; reference range < 143). Insulin resistance can develop in horses with PPID, and increased insulin levels may be predictive for the development of laminitis. An abortion occurred on a property in MatamataPiako. On examination of the aborted fetus the thymus was enlarged with areas of liquefaction, which on histopathology were confirmed to be due to necrosis. In these areas some of the thymic reticuloendothelial cells contained basophilic intranuclear inclusion bodies. Similar inclusions were seen in hepatocytes associated

with small foci of hepatocellular degeneration and necrosis. The histological findings were consistent with abortion caused by EHV-1 infection. A yearling Thoroughbred filly was confirmed as the second case of strangles on a Taranaki property. Cultures of abscess material from the filly’s swollen submandibular lymph nodes yielded Streptococcus equi ssp. equi in an outbreak of this highly contagious disease. All equine yards should have a strangles prevention and outbreak control plan for this globally common disease2. The control plan should include zoning of areas of risk with quarantine measures of clinical cases, identification of in-contact non-clinical horses, biosecurity measures between zones and identification of carriers at the end of the outbreak. Although the strangles vaccination does not provide 100% immunity, it greatly reduces the disease incidence and severity in an outbreak, and a robust, regular vaccination programme is key to prevention.

Figure 1: Ciliate organism found on cytology of peritoneal fluid. Its morphology suggests Polymorphella sp. (Diff-Quik stain, 500x).

A 9-year-old Thoroughbred mare in Palmerston North presented with clinical signs of toxaemia. The mare had recently foaled. Abdominocentesis revealed opaque, red-to-brown fluid with marginally increased nucleated cells (1.8 x 109/L; reference range 0–1 x 109), increased RBC (0.8 x1012/L; reference 0), and elevated fluid protein (45 g/L; reference range 0–25). Despite the low cellularity, cytology revealed septic suppurative inflammation with mixed bacteria. Additionally, there were several large ovoid ciliate organisms characterised by a dense ovoid eccentrically placed macronucleus, multiple internal granules and vacuoles, and bipolar tufts of cilia (Figure 1). Based on morphology, these organisms were suspected to be Polymorphella sp., and the presence within the abdominal fluid with concurrent septic inflammation was strongly suggestive of large intestinal rupture. Post-mortem examination confirmed rupture of the colon, consistent with a foaling injury.

A yearling Thoroughbred colt presented in Auckland with a history of severe weight loss over a period of 4 months, followed by acute colic. On post-mortem examination an abscess-like lesion was identified surrounding part of the jejunum. Histopathology revealed that the lesion was composed of sheets of neoplastic lymphoid cells, which also infiltrated the mucosa, submucosa and muscularis of the small intestine. Scattered epithelioid and multinucleated cells were also noted. ZiehlNeelsen staining was performed to rule out concurrent mycobacterial infection and was negative. A diagnosis of intestinal lymphoma was made.

MPI INVESTIGATIONS OF SUSPECTED EXOTIC DISEASES Contagious equine metritis excluded [also see announcement on page 24].

A veterinary pathologist at a commercial laboratory called MPI to report vulvovaginitis in a 6-year old mare from Canterbury. The owner had noticed that the mare was in pain when moving, and physical examination showed swelling, ulceration and erosion of the vulva. Bacterial culture showed a mixed bacterial growth. Biopsy specimens submitted for histology showed acute inflammation but identified no evidence of a causative agent. Causes of vulvovaginitis include endemic EHV3 associated with coital exanthema and the exotic agent Taylorella equigenitalis, the cause of contagious equine metritis (CEM). An acute ulcerative response is not characteristic of CEM, and the mare had neither travelled overseas nor been bred. Dry swabs and a fresh scraping of the lesions were submitted to the AHL and tested by PCR for the DNA of T. equigenitalis and generic EHVs. All PCR assays were negative. The cause of the vulvitis in this mare was not determined, but CEM and coital exanthema were ruled out. Equine neurological disease investigated.

An equine veterinarian called the exotic pest and disease hotline to report neurological disease in two weanling horses. In the week prior to onset of clinical signs, the two weanlings (a filly and a colt) had been boxed in temporary stables to prepare them for surgery. Both horses presented with nasogastric reflux, muscle weakness, and rapid heart and respiration rates. While the filly was bright and alert, the colt was depressed and showed signs of colic. Both horses were transported to a local veterinary hospital for observation and continued care. The colt was examined by abdominal ultrasound and abdominocentesis. There was an accumulation of gas in the colon, and the presence of purulent material from abdominocentesis indicated peritonitis. Owing to the colt’s worsening condition it was euthanased that evening, and the filly was found dead the following morning. At postmortem examination both horses were found to have gastric dilatation and rupture. Samples Eq Vet Pract 2020 June; 45 (2) 77

were collected for histology, virology and toxicology. A detailed walk-through of the paddock that the weanlings were in identified two weeds that were considered atypical in pasture. Specimens were collected for identification and toxicology. Histology of the brain, heart, liver, lung, kidney was unremarkable. Various sections of the gastrointestinal tract were normal apart from serosal inflammation with the presence of plant material, which confirmed peritonitis. The plants collected were identified as Anthemis cotula (mayweed) and Datura stramonium (jimson weed). D. stramonium, a member of the nightshade family, is a known toxic plant in New Zealand, with all parts of the plant containing dangerous levels of the alkaloids atropine, hyoscyamine and scopolamine. The clinical and pathological effects of datura on horses have been described3, with a key feature being gastric dilatation and rupture. Hyoscyamine inhibits the action of acetylcholine, the main neurotransmitter of the parasympathetic nervous system. It decreases the motility of the gastrointestinal tract and reduces the secretion of acid from the stomach and other fluids from the gut and airways. Inhibition of the parasympathetic fibres of the vagus nerve increases both the heart and respiration rate, and reduces peristalsis. The paralytic ileus that ensues causes constipation and allows the accumulation of intestinal gas, which refluxes into the stomach where it causes dilation and, in acute cases, stomach rupture. Horses on this farm were the subject of a previous investigation in 2013 into illness characterised by ataxia and weakness, and although a cause was not identified it was considered likely to be the result of ingesting a poison. The earlier cases occurred in the same paddocks where the Datura plants were identified, and it seems plausible that the previous event may have also been due to the ingestion of this plant. The clinical signs seen in the horses during the current investigation were consistent with a parasympathetic block and the result of Datura sp. poisoning. Exotic disease was excluded and the investigation stood down. African horse sickness excluded announcement on page 79].

[also

see

A private veterinarian called the exotic disease hotline to report a significant horse mortality on a Marlborough dairy farm. Four Clydesdale horses died over a 12-hour period, with the remaining three showing signs of respiratory dyspnoea. The dead horses had blood-tinged respiratory secretions. Necropsies carried out on two of the horses indicated that the most significant finding was pulmonary oedema. These findings were confirmed from histological examination of lung tissue collected at the time. There were no significant findings from serum biochemistry of blood collected from the clinically affected horses. Given the signs of pulmonary oedema, an investigation was opened to exclude African Horse

78 Eq Vet Pract 2020, June; 45 (2)

Sickness (AHS), although this differential diagnosis was considered unlikely given the requirement for an exotic vector and the absence of an introductory pathway that could explain the entry of both the agent and its vector. Lung tissue collected at necropsy and submitted to the Australian Animal Health Laboratory tested negative for AHS by PCR and no virus was detected from virus isolation attempted on the tissue samples. The most likely cause of death and clinical signs of the affected horses was a toxin. A horticultural soil fumigant had been used on the neighbouring property several weeks prior to the mortality event. Exposure to the active ingredients of the fumigant (chloropicrin and 1,3-dichloropropene) was investigated as a potential cause of the acute respiratory signs and mortality. However, despite intensive laboratory testing of a range of tissues collected post-mortem, results were inconclusive. Thus, while exotic disease was excluded, the agent responsible for the event was not determined. Equine infectious anaemia excluded.

A Massey University veterinarian called the MPI exotic pest and disease hotline to report a 16-year-old gelding with possible equine infectious anaemia. The horse was icteric, had splenomegaly, was febrile, and had suffered recurrent bouts of anaemia that had responded to intravenous dexamethasone, but to no other treatment. The horse was eventually euthanased owing to the cost of the ongoing intravenous steroid therapy. Blood samples submitted to the AHL (Wallaceville) tested negative for equine infectious anaemia in the agar-gel immunodiffusion test. Equine infectious anaemia was excluded, and an immune-mediated cause of anaemia and splenomegaly was suspected. The investigation was closed. 1. McFadden AM, Hanlon D, McKenzie RK et al. The first reported outbreak of equine herpesvirus myeloencephalopathy in New Zealand. N Z Vet J, 2016; 64(2): 125-134. https://pubmed.ncbi.nlm.nih. gov/26414406/ 2. Boyle AG, Timoney JF, Newton JR et al. Streptococcus equi Infections in Horses: Guidelines for Treatment, Control, and Prevention of Strangles-Revised Consensus Statement. J Vet Intern Med. 2018; 32(2): 633–647. https://www.ncbi.nlm.nih.gov/pmc/ articles/PMC5867011/ 3. Binev R, Valchev I, Nikolov J. Clinical and Pathological Studies of Jimson Weed (Datura stramonium) poisoning in horses. Trakia J Sci. 2006; 4(3): 56–63. http://www.uni-sz.bg/tsj/Vo4No3_1/Binev%202.pdf

AFRICAN HORSE SICKNESS SPREADS TO THAILAND: VIN.news.AHS; TheHorse.com

Could we get it here in Aotearoa? Regarded as the deadliest disease of horses, African Horse Sickness (AHS) has recently been reported for the first time in Thailand and has caused the deaths of at least Â 463 horses as of April 28th. AHS affects most Equidae and has spread from Africa through Asia to Thailand where its main vector is the midge Culicoides imicola, but can be spread by other midges, mosquitoes and ticks. Vaccination, that has begun in Thailand, is useful to reduce the severity of disease but is not protective.

Culicoides_female_biting_midge Wikimedia Commons

Could we get it AHS in Aotearoa? Not unless one or more of our insects can act as a vector, or a new vector makes its way into NZ and establishes with the AHS Orbivirus: With climate change, this is entirely possible. See: Viruses. 2019 Sep; 11(9): 844. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783979/ OIE-AHS Reports https://www.oie.int/wahis_2/public/wahid.php/Reviewreport/Review/viewsummary?fupser=&dothis=&reportid=33768

EVDS www.evds.vet Providing quality equine veterinary tools and training for vets since 2002

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BE IN TO GET $150.00! All you have to do is write a clinical report of about 1500 words that is published in the EVP, and your contribution may be eligible or one of several prizes of $150.00 that the EVP has available each year. The EVP Editorial Group wish to promote the sharing of your interesting cases and practice tips with the wider equine veterinary community, so please contribute. Every case, technique, test and interpretation is different, no matter how experienced we are or how routine the case is, so there is always something for us to learn from each other. Take photos, dig out your diaries, get keyboard tapping and share your views with colleagues. You could be $150.00 richer for it! Please send your clinical reports to the EVP Editor, Joe Mayhew, at evp.editor@gmail.com for consideration. Joe would also be happy chat with you about any articles or ideas you might have. Please contact Joe at evp.editor@gmail.com or on 0274373651.

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Eq Vet Pract 2020 June; 45 (2) 79

Knottenbelt, DC et al. A pilot study on the use of ultra-deformable liposomes containing bleomycin in the treatment of equine sarcoid. Eq Vet Edu. 2020; 32: 258-263. DOI: 10.1111/eve.12950

canterbury equine clinic

The efficacy of a novel topical liposome-encapsulated preparation of bleomycin (Bleosome™) was studied in 118 clinical cases of equine sarcoid and efficacy was compared with two other standard conventional treatments, tazarotene and 5-fluorouracil (5-FU) as well as with the Bleosome™ in combination with each of these two conventional treatments. Fifty-two of the 118 sarcoids (44%) were resolved after 12 months* with the combinations of either 5-FU and bleomycin, or tazarotene and bleomycin resulting in resolution of 77 and 78% of the lesions, respectively. These preliminary results suggest that bleomycin in a liposomal carrier may be a simple and useful treatment modality for superficial, diffuse and verrucose sarcoids.

Canterbury Equine Clinic is a 100% fully equipped equine facility providing the highest quality veterinary services

*NOTE: ~20-30% of sarcoids have been documented to completely or partially regress spontaneously [Christen-Clottu O et al. J Vet Intern Med. 2010;24(6):1483‐1489]

Ramzan PHL, Wylie CE. Career outcome of Thoroughbred racehorses with metacarpo-, metatarso-phalangeal joint dorsal chip fracture managed nonsurgically and surgically: A retrospective cohort study. Eq Vet J. APR 2020; DOI: 10.1111/evj.13253 Dorsal MCP/MTP osteochondral chip fractures were identified in 98 treated (70 non-surgical, SX; 28 surgical, SX) horses and compared with 648 control horses. There was no significant difference (P > 0.05) among non-SX, SX, and unexposed horses in respect of total career starts, or likelihood of ever winning, placing, or earning money in a race. SX horses had a significantly higher rate of wins/start than nonSX horses (rate ratio 1.6, CI 1.1-2.4, P = 0.02) and unexposed horses (rate ratio 1.9, CI 1.3-2.8, P = 0.001). Total career earnings for the SX horses were 4.1 times that of the unexposed horses (95% CI 1.214.5, P = 0.03), although total career earnings did not differ significantly between non-SX and unexposed horses (P = 0.8). Main limitations were small number of surgically managed horses and potential selection bias for surgical management. However nonsurgical management of this injury appears to be a reasonable management choice as it was not associated with significant effects on racing career performance – at least in this study.

80 Eq Vet Pract 2020, June; 45 (2)

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POETRY AND SONG OFFERING HELLO IN THERE John Prine 10.10.1946 – 7.4.2020 https://www.youtube.com/watch?v=OVhA01J0Zsg My old soulmate John Prine has died. Another CoViD-19 casualty. He leaves behind a wonderful legacy. Right now, the world has stopped us in our tracks and made us think about what we have done to it. We are all taking more time to pause, look and listen and to [virtually] embrace those around us. This song of John Prine’s distills the essence of what’s important, especially in difficult times when communication, kindness and love are what we all desire and need. His message in Hello in There needs no explanation, it is a reminder to all of us that we can make a difference to someone’s life. This song doesn’t require a comfortable chair and a good wine - it simply asks us a question that is easily answered. Watch what happens to those ‘hollow ancient eyes” when you answer the call to action, then simply wander on with a wee smile, reflecting on how it costs nothing to give. Don’t forget to give John Prine a wee smile too. PS: I am sure John would like to go out on a more mellow note so here’s a wee bonus. John Prine joined up with The Cowboy Junkies to sing a most beautiful song, If you were a woman and I was a man. The singing, the mouth harp, the guitar riff interlude and the clarinet close-out all meld together magically. The only other accompaniment this song invites is a loving companion. A vintage Veuve Clicqout is an optional extra. BB

By Ron Baker

Lyrics We had an apartment in the city Me and Loretta liked living there Well, it’d been years since the kids had grown A life of their own, left us alone John and Linda live in Omaha And Joe is somewhere on the road We lost Davy in the Korean war And I still don’t know what for, don’t matter anymore You know that old trees just grow stronger And old rivers grow wilder every day Old people just grow alonesome Waiting for someone to say, “Hello in there, hello” Me and Loretta, we don’t talk much more She sits and stares through the back door screen And all the news just repeats itself Like some forgotten dream that we’ve both seen Someday I’ll go and call up Rudy We worked together at the factory But what could I say if he asks “What’s new?” “Nothing, what’s with you? Nothing much to do” You know that old trees just grow stronger And old rivers grow wilder every day Old people just grow lonesome Waiting for someone to say, “Hello in there, hello” So if you’re walking down the street sometime And spot some hollow ancient eyes Please don’t just pass ‘em by and stare As if you didn’t care, say, “Hello in there, hello”

Eq Vet Pract 2020 June; 45 (2) 81

Rostang A et al. Pharmacokinetics of low-dose methotrexate in horses. J Vet Pharm Therap. 2020; MAR 2020; DOI: 10.1111/jvp.12857 Six horses were administered 0.3 mg/kg MTX IV, SC or PO in a crossover design study. After a 10-week washout period, MTX was administered SC to three of these horses at 0.3 mg/kg/week for 3 months. Absolute bioavailability of MTX was 73% following SC administration but less than 1% following PO administration. Plasma clearance was 1.54 ml/min/kg (extraction ratio = 2%). After 24 hr, plasma concentrations were below the limit of quantitation. No adverse effects were noted except for a moderate reversible elevation in GLDH. A SC dose of 0.2 mg/kg/week may be safe and relevant in horses as a specific dosing regimen for this immunomodulatory drug for long-term treatment, although this has yet to be clinically confirmed.

Vengust M et al. First report of equine parvovirus-hepatitis (EqPV-H)-associated Theiler’s disease in Europe. Eq Vet J. MAR 2020; DOI: 10.1111/evj.13254 Three of four horses from the same stud farm diagnosed with fatal acute hepatic necrosis or Theiler disease had a history of tetanus antitoxin administration 7-11 weeks previously. Liver tissue from all four horses tested positive for EqPV-H with PCR. In situ hybridisation revealed a widespread distribution of viral nucleic acid in liver calls in one case, and a sporadic distribution in the other three cases. These cases represent the first cases of EqPV-H associated Theiler disease in Europe

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