Featured Product | Horse Tips | Did You Know? | Meet The Reps | Ron's Corner
MAGA ZINE
ISSUE NO. 2 | Summer 2017
Featured Product
WHEN IT COMES TO EPM, NOT JUST ANY TREATMENT WILL DO
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ew diseases are more frustrating than equine protozoal myeloencephalitis (EPM), and for good reason. The effects of EPM can be devastating for horse and owner, and diagnosis can be a challenge for veterinarians. Fortunately, advancements have been made in recent years to give veterinarians additional clarity in diagnosing EPM, as well as conveniently and effectively treating EPM.
A progressive and potentially fatal infection of the central nervous system, EPM is caused by a single-celled protozoal microorganism, most commonly Sarcocystis neurona (S. neurona) or Neospora hughesi (N. hughesi), and is primarily transmitted by opossums through their feces. EPM is one of the most common neurological diseases of horses in North America. Researchers estimate that approximately 30 to 80 percent of the U.S. horse population has encountered the parasite and produced antibodies. However, not all horses exposed become infected or develop clinical signs.
Diagnosing EPM One of the reasons why EPM is difficult to diagnose is because it can look like many other neurologic diseases or even obscure lameness. West nile virus, rabies, tetanus, wobbler syndrome, eastern and western equine encephalitis and equine herpesvirus myeloencephalopathy (EHM), and even trauma, can all cause neurologic deficits in horses. Without thoroughly evaluating the horse and performing appropriate diagnostic tests, it is difficult to effectively treat them. The challenge is that there is no definitive antemortem diagnostic test to confirm active S. neurona or N. hughesi infection. Current recommendations for diagnosing EPM include: • Thorough physical and neurologic examination to detect clinical signs consistent with EPM • Use of appropriate diagnostic aids (e.g., cerebrospinal fluid (CSF) analysis, viral serology, cervical radiographs and lameness evaluation) to rule out other central nervous system (CNS) or musculoskeletal diseases • Demonstration of S.neurona specific antibodies in blood and/or CSF using one of several immunodiagnostic tests:
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• Western blot (WB), indirect fluorescent antibody test (IFAT) or surface antigen enzyme-linked immunosorbent assay (SnSAG2 and SnSAG4/3-ELISA)
• IFAT can also be used to detect N. hughesi antibodies
• The use of serum: CSF S. neurona antibody titer ratios may provide the most accurate antemortem diagnosis for EPM caused by S. neurona1
Importance of early treatment When it comes to treating EPM, early intervention is best. Irreversible damage to the brain or spinal cord is more likely to occur if the parasite has been present for long periods of time. Without treatment, many horses progressively deteriorate to the point that they are unable to stand. Using a product that is rapidly absorbed means the damaging parasite has less time to attack the horse's nervous system.
PROTAZIL (1.56% diclazuril) quickly reaches therapeutic levels without the need for a loading dose at the start of treatment.2 This means PROTAZIL starts working fast against a disease where time matters.
PROTAZIL is the only FDA-approved product that comes in a convenient top-dress, pelleted formula. The alfalfa-based PROTAZIL pellets are well-accepted by most horses and consumed without the mess, fuss and stress of a paste. For more information on PROTAZIL and EPM, visit www.merck-animal-health-equine.com
Important Safety Information Use of ProtazilÂŽ (1.56% diclazuril) is contraindicated in horses with known hypersensitivity to diclazuril. Safe use in horses used for breeding purposes, during pregnancy, or in lactating mares has not been evaluated. The safety of ProtazilÂŽ (1.56% diclazuril) with concomitant therapies in horses has not been evaluated. See related page in this issue for details. For use in horses only. Do not use in horses intended for human consumption. Not for human use. Keep out of reach of children. For complete safety information please read label. 1
eed, SM, Hoe, JK, et al. Accurate antemortem diagnosis of Equine Protozoal Myeolencephalitis R (EPM) based on detecting intrathecal antibodies against Sarcocystis neurona using the SnSAG2 and SnSAG4/3 ELISAs. J Vet Intern Med 2013; 27: 1193-1200.
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Hunyadi L, Papich MG, Pusterla N. Pharmacokinetics of a low-dose and FDA-labeled dose of diclazuril administered orally as a pelleted top dressing in adult horses. J of Vet Pharmacology and Therapeutics (accepted) 2014, doi: 10.111/jvp.12176
Merck Animal Health
HORSE OWNER TIPS Equine Protozoal Myeloencephalitis (EPM) When it comes to EPM the earlier a diagnosis is made and treatment can begin, the better the chances are for your horse's full recovery. If you're concerned about EPM, talk to your veterinarian and keep these risk factors in mind: - Mature horses are more commonly affected than very young horses - There is a higher incidence among horses used for western performance, racing and other strenuous activities - Events such as long-distance transportation, concurrent illness, or strenuous exercise increase the risk because they can suppress the horse's immune system
- Increased numbers of cases are identified during late summer and fall, but EPM can appear any time of the year - Risk is increased on premises where horse feed is not protected from opossums and/or pet food is left in the barn, which can attract them - Barns and pastures near wooded terrain are more likely to attract opossums - Horses residing on farms with a history of EPM cases are at increased risk
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Did You Know?
MERCK ANIMAL HEALTH HOSTS UPDATE ON EQUINE EMERGING DISEASES AT ACVIM
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erck Animal Health and a panel of distinguished equine infectious disease experts once again drew a packed lunch crowd at the recent ACVIM Forum, June 9, at the Gaylord National Resort and Convention Center in National Harbor, Md., for another informative session on equine emerging and re-emerging diseases.
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The session was moderated by Wendy Vaala, V.M.D., Dipl. ACVIM, and featured presentations from Frank Andrews, D.V.M., Dipl. ACVIM of Louisiana State University and Gillian Perkins, D.V.M., Dipl. ACVIM of Cornell University. Each presenter shared updates on a range of emerging and re-emerging disease threats, including: • Equine herpesvirus type 1 (EHV-1) and equine herpesvirus myeloencephalopathy (EHM) • Update on EHV-4 and other equine herpesviruses such as EHV-2 and EHV-5 • Equine protozoal myeloencephalitis (EPM) prevalence • S. equi - differentiating wild type from vaccine strain • Salmonella and antimicrobial resistance • Using serology to differentiate eastern equine encephalomyelitis (EEE) infection versus vaccination. Merck Animal Health is a proud sponsor of this popular luncheon session, which has grown year-over-year to more than 200 attendees. Whether a specialist or practitioner, veterinarians find this hour-and-a-half provides cutting edge and practical information to help keep them in the know and prepared for new and re-emerging equine disease threats.
We Love Mares...
WHICH IS WHY WE LOVE THE ANNUAL THERIO CONFERENCE The annual meeting of The Society for Theriogenology heads to beautiful Fort Collins, Colo., Aug. 2-5, and Merck Animal Health is once again proud to be a platinum plus sponsor of the annual event. Our longstanding commitment to The Society for Theriogenology began 13 years ago, and has grown over the years to exemplify many of the things we are passionate about at Merck Animal Health, including honoring the past and present leaders of our profession, as well as supporting and nurturing the future of equine reproductive medicine. What: 2017 Therio Conference and Equine Symposium When: Aug. 2-5, 2017
Event highlights, brought to you by Merck Animal Health: • Dr. Jerry Rains Memorial Abstract Competition • Student Quiz Bowl hosted by our very own Ron McDaniel. The event features teams of three students from each chapter and will include questions covering theriogenology in all species. Winning team members will each receive a personal prize, as well as a cash award for their chapter. • Student Equine Wet Lab, hosted by the Equine Reproduction Center at Colorado State University • Annual awards reception and dinner, followed by the Theriogenology Foundation Live Auction. - Longtime, distinguised reproductive veterinarian, Pat McCue, D.V.M., Ph.D., Dipl. ACT, will be honored
Where: Hilton Fort Collins Visit: http://www.therio.org/event/2017Attendee to register Summer 2017 | PARTNERS IN PRACTICE
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Meet The Reps
STEVE MONTEMARANO Territory Sales Manager Indiana, Michigan, Ohio, W. Pennsylvania steve.montemarano@merck.com 740-972-6554
Q&A Tell us a little bit about your horse background. I was born in Brooklyn, N.Y., not exactly the horse capital of the world. But there were two Thoroughbred racetracks nearby - Aqueduct and Belmont Park. Each Saturday there was a television program called "Racing From Aqueduct." It showed two races, including the feature. The hosts were Win Elliot, Charlsie Cantey, Dave Johnson and Frank Wright. There was a segment called "Ask Frank Wright" where he discussed an aspect of the horse industry. Even as a 4-year old I remember sitting on the linoleum floor of the apartment, out of my mind, waiting for that show. That's where my interest started, and it was reinforced on the racetrack. Many years later at the Keeneland September yearling sale a friend asked if I wanted to meet Charlsie Cantey ‒ a southern belle. My buddy built me up, and Charlsie gave a big warm hug. I haven't been the same since.
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If you were a horse, what type of horse would you be? Well, the inclination is to mention some famous racehorse like Secretariat, his Standardbred counterpart, Bret Hanover, or the legendary Irish-bred Steeplechaser named Arkle. But the reality is they are so unique and rare that it would be a complete fantasy to imagine being that good. As sales reps, we're in the service industry, so I would be quite happy being a well-cared-for lead pony that was responsible for safely getting, let's say American Pharoah, to the starting gate. A good supporting cast is important to the main star's success. Maybe they'd put a pint of Guiness in my feed at the end of the day? Best horse advice you’ve ever received? I was lucky to have been around Thoroughbred racing during the "golden era." Having met many successful horsemen there are three lessons that stick out. First, my mentor, trainer Danny Perlsweig (trainer of 2-year-old champion and Derby favorite, Lord Avie), taught me "that under the eyes of the owner the horse grows fat." It's a reminder to watch your business and your horses closely. Secondly, he said, "you don't have to be too smart in the horse game, you just have to pay attention." A self-deprecating comment suggesting that even in this technology age it's important to be aware and use common sense. The third thing really made me think. We were buying racehorses, and they'd walk a yearling by to inspect. If you liked it you'd request that they walk the prospect again for a second look. This particular colt wasn't race worthy and I bodly put an "X" in the catalog. But then my cohort said, "may I see him go again, please." Crestfallen, what did I miss? He then said, "that yearling is horrible but did you notice how lovely the handler was." It was an epiphany on the significance of the big picture, not being so serious, and trying to find some humor in life. Outside of the equestrian world, what is your favorite hobby? I like writing, photography, gardening and the search for a good bottle of red wine under $20. These hobbies are always changing so they don't get stale. Lately, I've been reading about two astronauts from Ohio, Neil Armstrong and John Glenn. Who gets in rocket ships that had less computing power than a modern-day iPhone to orbit the earth and land on the moon? What an era. NHL hockey is a passion, too. They are the most down-to-earth and hard-working athletes you could meet.
How long have you been working for Merck Animal Health? I've worked in equine animal health for fifteen years with ten of those being with Merck. Previously, I worked in software sales, product management and development at the old "Bell System." Equine sales at Merck Animal Health has become a great career because you can make a good living and still work closely with the horses. What is your favorite part of being an equine sales representative? Helping horses, horse owners and veterinarians is motivating. Our whole group feels that way. If you ask good questions, and express an interest, it becomes an amazing learning experience.
JENNIFER LITTLE Senior Equine Specialist
N. California, Idaho, N. Nevada, Oregon, Washington, Alaska jennifer.little@merck.com 916-201-4418
Q&A
This industry can reflect what's optimistic in life. Years ago, I was a racehorse hotwalker and revered the chance to speak with the equine veterinarian. Now they look to me, and our group, for advice. That's gratifying. If there were one thing you would want your customers to know about you, what would it be? I someday still might win that Kentucky Derby or The Little Brown Jug! In the meantime, it's a privilege to serve the horse and equine community.
Best horse advice you’ve ever received? J. Ashton Moore (an acclaimed international judge and dressage, jumping and vaulting clinician) taught me that horses think only in linear terms and learn only in retrospect. Don't take it personally, they are not out to please or displease their rider. Outside of the equestrian world, what is your favorite hobby? I love to hike through the forest with my husband, Larry. The smell of the trees and cool air is very relaxing. How long have you been working for Merck Animal Health? I've been an equine specialist with Merck Animal Health for almost five years. What is your favorite part of being an equine sales representative? I'd follow my equine veterinarians all day long if they'd let me. I love to see, and hear about, the unique and challenging cases they tackle.
Tell us a little bit about your horse background. I learned to stay on a viscious pony named Bullet as soon as I was old enough to sneak out of the house and drag him up to a fence. Today, I ride primarily Dressage, but I love all breeds and disciplines. If you were a horse, what type of horse would you be? Definitely a Holsteiner! They have wonderful temperaments and a sense of humor. When they buck, it seems to be out of joy rather than an effort to dislodge the rider.
If there were one thing you would want your customers to know about you, what would it be? I truly believe that every horse, and horse owner, deserves the best product to meet their needs, regardless of the manufacturer.
Contact your Merck Animal Health Rep to find out about any special offers.
Ssummer 2017 | PARTNERS IN PRACTICE
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Ron's Corner
RON ’S C OR N E R Volume 2
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n 1980, Willie Nelson recorded "My Heroes Have Always Been Cowboys." When I was a youngster that sentiment was true for me. Working cattle, breaking horses, roping and riding was all I wanted to do. I looked up to the ranch and rodeo cowboys I met. I still do, and though I respect and admire good hands with cattle and horses, I'm careful about who I call a cowboy. Our culture today seems to praise the superficial...actors, athletes, musicians, etc. I guess we always have. In contrast to that, I’d like to share an experience that had a profound impact on me. I was given the opportunity to be in the presence of heroes, real heroes. Let me preface these comments by stating that the folks I was honored to meet deny any notion that they’re heroes. I’ll let you decide. A few weeks ago, our Equine Team at Merck Animal Health had the privilege of going to the United States Air Force Academy Stables in Colorado Springs, Colo. The Academy Stables are managed by Billy Jack Barrett, a veteran who has spent the majority of his life serving others. Billy Jack and his wife, Anne, have raised several children, both biological and adopted children. Billy Jack knows the value of using horses to help kids that are hurting so it was a natural extension to use the horses at the Academy to help our men and women returning home after serving our country. Several years ago, Billy Jack was joined in this effort by Jeanne Springer, a compassionate, empathetic woman who is an incredible listener. Gifted with an ability to work with horses and people, she and Billy Jack put together a team that uses horses as part of the therapy for healing our warriors. Originally working under the Warrior Wellness program, they have now founded the Remount Foundation.
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Another thing veterinarians have in common with many of our veterans is not so obvious. It grieves me but it needs to be stated. In 2014, a Centers for Disease Control online survey of 10,000 practicing veterinarians found that more than one in six has considered suicide. Other studies found suicide rates among veterinarians are 4 to 6 times higher than the general population.
To assist them with the incredible work they’re doing with our warriors and their families, our team of equine reps and veterinarians were able to spend an afternoon training their staff, along with vaccinating and deworming their horses. Outwardly, it appeared that we were serving the Remount Foundation but, in reality, we were the ones being served. You see, as incredible as Billy Jack, Jeanne and all the Remount Foundation volunteers are, the greatest honor that day was spending time with five real heroes. Three men and two women carrying the physical and emotional scars of serving our country shared with us a glimpse of their experience and the impact the Remount Foundation has had in their life. The result was one of the most inspiring days I’ve ever experienced. One of those warriors, retired Air Force Maj. David R. Andrews, D.M., M.B.A., and Purple Heart recipient, has accepted the role of president of the board of the Remount Foundation. He shared a piece of his story with us and to say it was impactful is a serious understatement. Click the link (https://remountfoundation.org/) to hear Major Andrews share how the Remount Foundation impacted his life, and the life of his family.
Once you’ve watched his brief video, click the personal stories tab to read his comments; it’s powerful. I don’t have enough space to include the incredible insight I received visiting with these warriors so I’ll conclude with this. Two of the five warriors I was privileged to spend time with that day are pictured with me, Glen Cooper and David Andrews. It was sobering hearing these men, who have given so much to our country, insist that their heroes were the men and women who didn’t make it back, and the families of those who serve. They have a passion to see veterans, our men and women in the military, and their families seek help when times get tough. According to the Department of Veterans Affairs, 20 veterans a day commit suicide. Veterans account for 18 percent of all suicides yet make up less than 9 percent of the general population. Do we want to help our warriors and the Remount Foundation? Absolutely! If you feel led to help with this effort I hope you will too.
We can learn from men like David and Glen. If you get depressed, it’s not a character flaw. Don’t try to go through the dark spots alone. Seek help. Some of the strongest, bravest, most self-sufficient men and women in America have demonstrated that it’s not a weakness to seek help. They have given us an example to follow. That’s why, despite their humble attempts to dissuade my praise, I consider them real heroes. Hanging out with veterans and veterinarians is a blessing I’ll be forever grateful for! Thanks for serving us by serving the horse. Until next time, happy trails,
Ron McDaniel Director, Equine Sales
What veterinarians have in common with the warriors in the Remount Foundation is the horse. That much is obvious. Summer 2017 | PARTNERS IN PRACTICE
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