Merck Equine Partners in Practice Magazine: Spring 2021

ISSUE NO. 4 | Spring 2021

MAGA ZINE

SPRING VACCINES: To Titer or Not To Titer 04

RON'S CAMPFIRE

THE COMPLIANCECHANGING MAGIC

A STUDY IN SECOND CHANCES

of Tidying Up Routine Care

A Fresh Start for Horses and Teenage Boys Gone Astray

Profile of Courage

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Featured

SPRING VACCINES: TO TITER OR NOT TO TITER In horses that have experienced vaccine-associated adverse events, serologic testing may be helpful in analyzing risk versus benefit of booster vaccinations. By D. Craig Barnett, DVM Merck Animal Health Equine Veterinary Professional Services

oth horse owners and equine veterinarians are becoming more interested in the potential for serologic testing to help determine a horse’s need for booster vaccinations. To help define when serology makes sense, the American Association of Equine Practitioners (AAEP) recently released Guidelines for Serology in Horses with Adverse Events from Vaccination. As part of the AAEP Infectious Disease Committee, I had the honor of helping draft these guidelines.

associated adverse event (VAAE) and risk of another reaction may be more life-threatening than the disease itself. To reduce overall risk, measuring a specific antibody titer may help you assess the patient’s immunological status and provide guidance regarding risk vs. benefit of booster vaccination administration for the individual horse in question. If the results indicate the horse has antibody levels suggestive of protection, you could reasonably recommend delaying revaccination. Serology can make sense for rabies and tetanus Complexity enters in when considering which immune mechanisms are most predictive of protection against a disease. W. David Wilson, BVMS, MS, HonDACVIM, a fellow member of the AAEP task force that drafted the serology guidelines, calls

The most straightforward way to sum them up is that,

rabies and tetanus “poster children” for antibody testing. Why?

for core diseases, veterinarians should consider vaccination

Because antibodies in the blood appear to be the main correlate

schedules that follow vaccine labels. One exception may

for protection against these pathogens. What’s more, studies—

be a horse that has previously experienced a severe vaccine-

including one Dr. Wilson participated in—suggested that horses

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maintain antibody levels thought to be protective against rabies and tetanus for at least three years following an appropriate initial vaccination series.1,2 Therefore, if serologic testing shows antibody levels that should be protective against rabies or tetanus, you could consider delaying revaccination in reactive horses and recheck serum antibodies in a year. Dr. Wilson, who’s a professor emeritus of equine medicine in the Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, cautions that from a public health standpoint, a horse is not considered “properly vaccinated” against rabies unless it has been vaccinated within a year (i.e., according to the label). This may influence quarantine and other measures if a horse is exposed to rabies or bites someone.1,2 When serology results don’t apply Using titers to predict protection against Eastern/Western equine encephalomyelitis (EEE/WEE) and West Nile virus (WNV) is not well justified. “Even after natural infection, it’s unlikely that resistance is going to last much more than one year,” Dr. Wilson says. “Serum antibody levels can show whether the horse has responded to vaccination, but levels needed to correlate with protection are not well established.” Since EEE/WEE and WNV are prevalent and carry high mortality, vaccination per the label is recommended regardless of the levels of antibodies in the blood, especially in regions with year-round mosquito activity. 4

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For most risk-based diseases, such as equine influenza virus (EIV) and equine herpesvirus (EHV), serology titers are even less relevant in predicting protection. Duration of immunity against these diseases is short and, since they’re transmitted through the respiratory tract, protection is better correlated with local immune responses than with blood antibody levels, at least when using the tests available in North America. “Taking blood to measure antibody to project whether a horse is protected against flu, equine herpes 1, equine herpes 4, Neorickettsia that causes Potomac Horse Fever, rotavirus and so on, is a waste of time because the results aren’t helpful,” Dr. Wilson says. Serum antibodies also are not a good predictor of protection against strangles; however, measuring serum antibody levels can help avoid vaccinating a horse that may be at higher risk of developing purpura hemorrhagica due to high levels of circulating antibodies. Vaccination is an important component of disease prevention. In certain situations, serologic testing can play a role in building custom vaccination programs for individual patients, especially for horses with a history of serious VAAEs. When using serologic data to guide vaccination decisions, consider other factors, such as disease risk, consequences of disease and the horse's health status. For more information and guidance, view the AAEP Serology Guidelines.

Merck Animal Health

Quick view: Serology titers in horses with known vaccine reactions* Rabies, tetanus

Serum antibodies likely correlate with protection and may be useful in horses that have previously experienced a severe VAAE

EEE/WEE, WNV

Serologic correlates for protection not well established; annual or bi-annual revaccination recommended regardless of titer

EIV, EHV

Serum antibody levels not well correlated with protection and cannot be recommended to predict need for vaccination

*To access the complete AAEP serology guidelines, visit aaep.org/document/aaep-guidelines-serology-horsesadverse-events-vaccination

VIEW AAEP SEROLOGY GUIDELINES

Merck Animal Health

HORSE TIPS Timely Health Tips to Share with Horse Owners To help clients understand why serology is relevant only for some diseases, use these explanations from W. David Wilson, BVMS, MS, HonDACVIM, a professor emeritus of equine medicine in the Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis.

When Antibody Titers Correlate with Protection The way a disease is acquired helps explain whether antibody titers could predict protection against a disease. ‘Injection’ into the bloodstream. A horse gets rabies through a bite and tetanus through puncture wounds. Antibodies in the blood appear to be the main correlate for protection against these diseases, which may reflect that they’re acquired by ‘injection.’ While Eastern/ Western equine encephalomyelitis and West Nile virus are acquired by ‘injection’ from a mosquito bite, the level of antibodies in the blood needed for protection aren’t clear. Aerosol inhalation. Diseases like equine influenza virus and equine herpesvirus are acquired when horses breathe in disease organisms. Therefore, the main correlates for protection are likely found in the respiratory tract rather than the blood.

COMPETITION SEASON IS HERE Be sure your patients are protected against contagious diseases, including equine influenza virus. PRESTIGE® vaccines are the only ones that contain Florida ’13, the most current flu strain available. Florida ’13 has demonstrated through both homology and sequencing work that it is the closest influenza strain to what is currently circulating in our horses.3 Harvey AM, Watson JL, Brault SA, Edman JM, Moore SM, Kass PH, Wilson WD. Duration of serum antibody response to rabies vaccination in horses. J Am Vet Med Assoc. 2016 Aug 15;249(4):411-8. Kendall, A, Anagrius, K, Ganheim, A, Rosanowski, SN, Bergstrom, K. Duration of tetanus immunoglobulin G titers following basic immunization in horses. Equine Vet J 2016 Nov;48(6):710-713. 3 Data on file. Merck Animal Health (2013-2020).

Ingestion. Foals become infected with equine rotavirus when they eat items or lick surfaces contaminated with infected feces. Because disease is acquired through ingestion, measuring blood antibody levels does not accurately correlate with protection.

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Ron's Campfire Profile of Courage In the office at Midland Acres in Bloomingburg, Ohio, Dan Ater sprawled in a chair, his lanky frame and body language more reminiscent of the Marlboro Man than an Ohio Hall of Fame trainer.

here are no greater stories to be told than those of the horse lover. Pull a chair up to Ron’s Campfire to read inspiring, touching or just plain funny tales from the people who make up our equine community. If you have a story or blog you’d like to share, we’d love to feature it. Please email Ron McDaniel (ron.mcdaniel@merck.com) to learn more or to submit contributions.

This installment of Ron’s Campfire is adapted from an original piece written by Steve Montemarano, Merck Animal Health Equine Senior Territory Representative (pictured above), and initially published in November 2017 Hoof Beats Magazine. 6

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“Honey B is a nice filly; I’m lucky,” he drawled, speaking simply about his 5-year-old trotting mare that is closing in on $100,000 in earnings this season. She is just one of the 35 head that have given Ater a career year in both wins and earnings, including his first $1 million season. “Some people have better numbers. I just try to help others,” he said. Joined by a cast of family members and friends, Ater trains his stable on his 51-acre family farm in Clarksburg. The work is physical and intense. Ater hugs a dark brown gelding and wonders if he’s too fat. He then jumps into an old water truck and sprays the training track. Then he climbs into another vehicle and harrows the five-eighths-mile surface. There’s no task beneath him, neither in the barn nor the boardroom. He’s a longtime USTA director, representing the Ohio Harness horsemen of District 1. There’s also a sensitive side to the rugged Ater. He’s been fighting cancer for years. He was first diagnosed with prostate cancer. Then in 2001, tests revealed pancreatic cancer. The doctors gave him five years to live. In 2014, the majority of his liver was removed in a 14-hour surgery. The next year, the cancer spread into his bones. But you’d never know it. He’s positive and fit with healthy color in his face. “Dan is the toughest son-of-a-gun I know,” said Jay Mossbarger of Midland Acres.

At a recent Ohio Selected Jug Sale in Johnstown, a relaxed Ater sat in a folding chair at the Midland Acres consignment, content amongst whinnying horses and friends. “Doctor Bob Schwartz is my best friend—none better,” said Ater about the man who attends to the veterinary needs of his stable while also working at Midland Acres since 1971. Schwartz and Ater have had close calls. At a previous Ohio Selected Jug Sale, a yearling got a hind leg stuck between steel bars dividing the stalls, suspending his rear end. They rushed in to help—risking life and limb. Ater hand-pried the bars apart in a super-human effort and the horse was saved. “That horse could’ve gotten boogered up,” said Ater, matter-of-factly. In a quieter moment, Ater contemplated life from a brown leather couch in his office. He said his four children are everything to him: Kyle, Nick, MacKenzie and Daniel. Daniel is 14 years old and understands his dad’s illness. Seated next to his father, the teen politely asked if he could unload sweet feed from a truck. After some instruction, he got up off the couch and left. As the office door shut, the elder Ater’s voice unexpectedly wavered—and he wept. “The older kids can take care of themselves, but I’m worried about Daniel,” he said. Ater then gathered himself and spoke about training better horses. His keen eye identified Sandys Victory at an auction in 2016. For $8,200, Ater thought he purchased a useful claimer. But the mare trotted in open company, earned nearly $130,000 one year, and achieved a mark of 1:53.4.

“She’s my girl,” he said. At sunset, Ater left the office to feed and water the horses. He checked each one for subtle signs of well-being. When he got to the last stall, the mare was lying down and hadn’t eaten. It was Sandys Victory. Ater became visibly worried. The mare’s flanks were bloated and she hiked a hind leg–a tell-tale symptom of belly pain. Ater took the mare’s temperature and called Schwartz to investigate. Shortly after receiving treatment, the mare perked up, nibbled hay, and drank. But she wasn’t out of the woods yet.

past, it was more about enjoyment than making money, he opined. With Ohio racing experiencing a renaissance, the Jug Sale boasted high prices, with one horse fetching $150,000. Many Ohio-based trainers couldn’t afford a purchase. Ater managed to acquire a colt by McArdle for $27,000, named Luck Is My Charm. That name mirrors Ater’s life.

Ater had his trailer hitched and ready to transport the mare to the Ohio State University Veterinary Hospital located an hour’s drive north in Columbus. But when he checked back on her, the colic episode had resolved. “I’d never been so happy to see a pile of fresh manure in my life,” he said. Despite racing for better money than ever, Ater said he laments that racing has changed over the years. In the

2021 Update This piece is a tribute to Dan Ater, who died May 24 at the age of 66. Dan Ater was inducted into the Ohio Harness Racing Hall of Fame in 2015, earning 1,686 wins as a trainer and 1,697 as a driver. Sandys Victory retired with earnings of $518,497 and produced a foal this year. Ater was proud to offer encouragement to others affected by cancer. The author and Ater bonded based on their cancer experiences. With horse racing under pressure these days, Dan Ater was a shining example of all that’s good in the sport. Edited and reprinted with permission of Hoof Beats Magazine and the United States Trotting Association.

“Racing is a book of dreams, the story of my life,” he said. “I’m going to live it until I die.”

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Merck Animal Health Business Tips

THE COMPLIANCE-CHANGING MAGIC OF TIDYING UP ROUTINE CARE By Chrissie Schneider, DVM, MS, DABVP Merck Animal Health Equine Veterinary Professional Services

Organization is having a moment, and you can use the trend to drive client compliance for wellness care. As you know, well-planned routine care prevents disease spread, offers better outcomes for patients and supports the financial health of your practice. But with dozens of clients and hundreds of patients across multiple farms—all with different needs and expectations—keeping track of each horse’s needs can be a logistical nightmare. For a simple, effective way to organize routine care while maximizing client compliance, create a custom spreadsheet for each farm. The form includes all the horses at a particular facility and concisely displays each patient’s high-level patient information and service dates. When used and updated regularly, the benefits of this organizational system are numerous. • The practice saves time as all horses’ information is easily accessible in one place. • There are no missed vaccine boosters, meaning fewer sick horses and reduced disease transmission. • There is increased compliance with recommended follow-up care (e.g., biannual dental care, fecal testing, endocrine monitoring). • Client relationships improve as personalized, detailed care is highly valued and appreciated. • Return trips significantly decrease for care that “fell through the cracks.” • The number of calls for “emergency Coggins” or “emergency vaccinations” significantly decrease. • And, most importantly, each horse gets the care it needs.

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Tidy up your routine care with this customizable spreadsheet!

CLICK TO DOWNLOAD

Did You Know?

A STUDY IN SECOND CHANCES Twenty unregistered, unbroke yearlings bound for nowhere; as many teenage boys bound for trouble. Cowboys trailer the horses, rejected subjects from an academic study. Ten mares. Ten geldings. They find a purpose—and a home—at Dr. Craig Barnett’s ranch in Paola, Kansas. There the horses become part of a field trial on PROTAZIL®. The horses are from a remote herd, so they have little disease exposure. They also have little exposure to people. They can’t be haltered. Their feet can’t be picked up. But Dr. Barnett, Director of Merck Animal Health Equine Veterinary Professional Services, and his wife train the horses to enter stocks. Twice a week, the Barnetts bring the horses into the stocks, do their work and turn the horses back out to the pasture. Over the course of the 15-month study, the horses become gentle. Their feet are still always firmly planted on the ground and there’s no riding them, but they’re good, solid horses. Kindred spirits And there are good, solid boys who have gone astray but found their way to Agapé Boarding School in the middle of Missouri. Some of the boys participate in Agapé’s horsemanship program. Young men in the colt class, as it’s called, halter-break horses and teach them to lead, walk over tarps and pick up their feet.

Powerful connections “Merck is passionate about horses. We’re even more passionate about how horses help people,” McDaniel says. “And the horse world is a small world. When people find out about the Agapé horse program, they want to be a part of it.” That’s how Dr. Marc Markway ended up making the two-hour drive from Eldon, Missouri, to the Agapé school to spay the 10 mares. With the mares more calm, the Agapé students got them halter-broke and now most of the mares have been adopted. Some of the geldings were sold early after word got out about their temperament and the solid foundation they learned from the Agapé students. The remaining geldings are going through the full program. Dr. Barnett and McDaniel will visit Agapé this spring to donate and administer vaccinations to the geldings and the entire Agapé herd. Healthy horses. Healthier young men. Soon, the horses and boys will be ready for the annual Agapé Ride Prosperously sale, held the Saturday before Father’s Day in June. A fresh start. A herd of horses and as many teenage boys bound for…anywhere.

Unconditional Video

“With the field trial concluded, we wanted to give these horses a long, fruitful life,” says Ron McDaniel, Merck Animal Health Director of US Equine Sales. “So we called Agapé and asked if these horses could be a help to their program.” Cowboys trailer the now 2-year-old horses and take them to the Agapé ranch. “I was there when we unloaded the horses,” McDaniel says. “You could feel the energy and see that the boys were excited.” Agapé is home to an established herd. With Merck donating the horses, the longstanding Agapé program was assured a horse for every student who wanted to participate in the colt program.

Meet the people and horses involved in the Merck Animal Health partnership with Agapé Boarding School. WATCH VIDEO

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Meet the Team

Q&A AMBER PIERCE SENIOR TERRITORY REPRESENTATIVE Norman, Oklahoma amber.pierce@merck.com

Tell us a little bit about your horse background. My love of horses started early, as I grew up on a boarding farm in Michigan. I showed my first horse in 4-H and competed in a variety of Western and English events. I attended Michigan State University (Go Green!) and was a member of their horse judging team. After graduating with an animal science degree and being inducted into the American Registry of Animal Scientists as an equine specialist, my life and career took me to Mexico. While there, I stayed horseback and competed in jumping. By the time I moved to Utah in 2015, I had two sons who also love to ride. In Utah, I began competing in Versatility Ranch Horse (VRH) events in the American Quarter Horse Association. We moved to Oklahoma when I accepted my position with Merck Animal Health and are looking forward to showing here, too. Slowly but surely, my horse (a roan mare named MRI Solo Design) and I are working on adding to our list of VRH competitive events. If you were a horse, what type of horse would you be? I’d be a rodeo bronc. (I always root for the broncs at the rodeo!)

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What's the best horse advice you’ve ever received? Be humble; it’ll save your horse a step. Outside of the equestrian world, what is your favorite hobby? My non-horse hobbies? Do other horse people have time for more hobbies?!? How long have you been working for Merck Animal Health? I’m a newcomer who started in October 2020. My territory is Oklahoma, Northeast Texas, Louisiana, Arkansas and Southern Mississippi. What is your favorite part of being a sales representative? I absolutely love that I get to play a part in helping veterinarians provide excellent equine care. If there were one thing you would want customers to know about you, what would it be? I genuinely want to partner with you to help you succeed.

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