News from Your Equine Health Care Provider | Vol. 8 | Fall 2020
The Riddle Half (of Rood & Riddle) The Riddle Half Rood & Riddle News RREH Sport Horse of the Year Dr. Kate Christie
-What Do We Know about Ulcers?
Dr. Bart Barber
-Pre-sale Medication Regs ‘A Good Change’
Dr. Brad Tanner
-Leaving Dental Work to the Vet
RRVP News
Dr. Tom Riddle has added author to his list of talents. His book will be of interest to a variety of readers, including veterinarians who are considering a group practice, veterinarians who are interested in equine reproduction, and horsemen and women who want to learn more about breeding mares. With stories from his childhood and his career, Dr. Tom Riddle recounts his role in establishing one of the largest equine veterinary practices in the world. With a combination of humility and pride, Riddle tells how he and Dr. Bill Rood joined together and built a practice that has achieved both a national and international reputation for excellence in equine veterinary medicine. All profits from the sale of the book “The Riddle Half” will go to the Foundation for the Horse (AAEP) and the Theriogenology Foundation! “The Riddle Half is a great book and a great educational tool. I would say a MUST READ for all aspiring reproduction vets as well as for up and coming broodmare managers. It is also a great review for us old broodmare managers who have forgotten most of that stuff.”
—Rick Nichols, Vice President, Farm Manager at Shadwell Farm “This book is amazing—almost as amazing as Dr. Riddle’s generosity in donating the profits from its sale to the Foundation for the Horse (AAEP) and the Theriogenology Foundation.”
—Dr. Mike Thompson, Board-certified in theriogenology, president of the Society for Theriogenology in 2016, current president of the Theriogenology Foundation. “In the book, The Riddle Half, Dr. Tom Riddle shares all the hard-earned wisdom gained over forty-plus years of an amazing career in veterinary medicine. Moreover, he conveys the pattern of his life..., The Golden Rule. A “must- read” for veterinarians and broodmare managers everywhere!” Photo Credit: Anne M. Eberhardt/BloodHorse
IN THIS ISSUE
—John Williams, Former Manager at Spendthrift Farm The book will be available for purchase online at RRVP.com or by calling the Rood & Riddle Veterinary Pharmacy at 859.246.0112 www.roodandriddle.com
Welcome Dr. Katy Dern! Katy Dern, DVM, MS, DACVS, has joined the surgical team at our Lexington hospital. Dr. Dern will initally be working primarily as one of the emergency surgeons. Dr. Dern is originally from Colorado and Montana. She attended Washington State University for her undergraduate work, and Colorado State University for her veterinary degree. Following graduation from CSU in 2012, she completed an internship at Peterson and Smith Equine Hospital in Ocala, followed by an internship at Rood and Riddle Equine Hospital. After her internships, Dr. Dern completed a three-year surgical residency at The Ohio State University, while also earning a Master’s of Science Degree. She became board certified in equine surgery in 2018 and had been the surgeon at our Saratoga hospital since 2017. We welcome her move to Lexington.
Dr. Katy Dern
Rood & Riddle in Saratoga Dr. Elizabeth Elzer is originally from Virginia, where she spent ten years working as a farrier before she started veterinary school. She attended the University of Mary Washington for her undergraduate work, and the University of Pennsylvania for her veterinary degree. She completed an
internship at Rood & Riddle Equine Hospital in Lexington, followed by a second internship at the University of Pennsylvania’s New Bolton Center before returning to Rood & Riddle in Lexington for a three year surgical residency. She now brings her surgical expertise to the Rood & Riddle Equine Hospital in Saratoga.
Dr. Liz Elzer
Rood & Riddle Veterinary Pharmacy RRVP has received the USP <800> Hazardous Drug Handling Distinction by the Pharmacy Compounding Accreditation Board (PCAB). They were the 16th pharmacy in the United States (out of all pharmacieshuman and veterinary) to demonstrate compliance and receive this accreditation. The following steps were taken to complete: In 2018, RRVP completed a full new cleanroom addition as well as a remodel in the existing pharmacy, which was the first step in achieving compliance. The second step named and certified an individual, Kelly Zaccarelli, RPh, HDDP, to move implementation forward. A hazardous drug designated person (HDDP) is responsible for creating, implementing, reviewing and updating policies and standard operating procedures (SOPs), employee training and competencies, and ensuring “environmental control” of locations where HDs are stored and handled. The third step was to demonstrate compliance of all areas, which was accomplished with no deficiencies! Based on USP 800, the recently released industry guidelines that describe practices and quality standards for handling hazardous drugs in healthcare settings aimed at promoting the safety of patients and workers as well as environmental protection standards, PCAB’s hazardous drug handling standards reflect the efforts of a broad collective of industry experts. During the accreditation process we completed a full day rigorous survey to demonstrate compliance. With the delay by USP <800> implementation in December 2019, RRVP proactively moved forward. Thanks goes to the RRVP team for not only practicing to the best standards, but now exceeding those standards as well.
www.roodandriddle.com
2020 Breeders’ Cup The veterinarians and staff of Rood & Riddle are pleased that Rood & Riddle will be the Official Equine Hospital and Veterinary Pharmacy of the Breeders’ Cup for the sixth year. We appreciate the owners and trainers who have trusted us with the veterinary care of many of the horses competing in the Breeders’ Cup, and we look forward to joining with breeders, owners, trainers and farm managers as we work as a team to keep your horses safe, healthy and athletic. Rood & Riddle is also delighted to once again serve as Title Sponsor of the Breeders’ Cup Post-Position Draw, which will take place on Monday, November 2 as a virtual event. This all-important event is a fun and exciting way to celebrate the beginning of Breeders’ Cup week. The Draw will be streamed on breederscup.com, TVG and Breeders’ Cup social media platforms.
2020 National Horse Show Rood & Riddle Equine Hospital and Veterinary Pharmacy are serving as the Official Equine Hospital and Veterinary Pharmacy of the National Horse Show for an unprecedented eleventh year. This event, which takes place this year on Oct 23 - Nov 1, has served for many in the hunter jumper and equitation world, as the highlight of the year’s shows. For the last eleven years, the National Horse Show has taken place at the beautiful Alltech Arena at the Kentucky Horse Park In Lexington, Kentucky. To make sure everyone is still able to be with us safely from home, The National Horse Show will be offering free live streaming coverage of the event via ShowNet and ClipMyHorse TV. In addition to the COVDI-19 protocols, the 2020 National Horse Show will not be offering any VIP seating or Rider’s Lounge. These adjustments are for the safety of our members, competition organizers, staff, parents and all involved. To maintain social distancing standards, the 2020 event will not exceed 25% capacity in the Alltech Arena at any time.
Jet named 2019 Rood & Riddle Sport Horse of the Year The 2019 Rood & Riddle Sport Horse of the Year was awarded to Lila Sessum’s Jet during a virtual presentation at the Thoroughbred Owners & Breeders Association awards Dinner. The night’s presentations were hosted by Gabby Gaudet and held at Hill ‘N’ Dale at Xalapa. The 2006 son of Cat’s At Home out of Love Whisper by Friendly Lover had wins at WEF, Tryon, Ocala, Brownland Farm, and Gulf Coast during the 2019 season. He accrued earnings in excess of $15,000.
WHAT DO WE KNOW ABOUT ULCERS? by Dr. Kate Christie Board Certified Large Animal Internal Medicine QUESTION: What do we know about the causes and best treatments for ulcers? DR. KATE CHRISTIE: Equine gastric ulcer syndrome is a common condition in the performance horse with upwards of 90% of horses having evidence of gastric ulceration within two to three months of intensive training. Frustratingly, clinical signs vary from horse to horse and gastroscopy remains the only definitive diagnosis for ulcer disease in the adult horse. The majority of gastric ulcers occur in the non-glandular portion of the stomach and are associated with exposure of this area to the acidic contents of the stomach. Some of the most important conditions that increase exposure to stomach acids include long periods between eating and high levels of exercise and training. Ulcers can also be located in the glandular portion of the stomach, specifically in the pylorus or outflow tract of the stomach. Gastric ulcers in this region of the stomach are less completely understood, but may be associated with breakdown of natural protective barriers. Unlike other species, bacterial infection does not seem to play a role in equine gastric ulcer syndrome. Once a diagnosis of gastric ulcer disease has been reached, treatment and management should be tailored to each individual horse. A combination of pharmaceutical intervention as well as environmental management is often the most successful. Horses that go long periods of time without access to forage, especially those on a high grain diet, are at increased risk of gastric ulcers. Providing constant access to forage is key in the prevention and management of equine gastric ulcers. Adding alfalfa to the diet may also be helpful as it is naturally high in calcium and can act as a buffer for the highly acidic contents of the stomach. Medications used to treat gastric ulcers in horses have the main goal of decreasing the acidity of the stomach. Commonly used medications include omeprazole (GastroGard, UlcerGard) and until recently ranitidine (Zantac). Sucralfate is also commonly administered as a coating agent to help heal ulcerations. GastroGard is the most commonly used medication and is the only medication with FDA approval for the treatment of gastric ulcers in horses. A long-acting injectable omeprazole has shown promise and may offer an alternative to traditional omeprazole therapy although further study is needed. Glandular ulcers can be more difficult to treat and often require longer courses of treatment. In some cases, treatment with a medication called misoprostol may be recommended if these ulcers fail to respond to GastroGard alone. The only way to confirm resolution of gastric ulcers is repeat gastroscopy which is typically recommended after a four-week course of treatment. Dr. Kate Christie grew up in Halifax, Nova Scotia, where she developed her love of horses actively competing in the show hunter world and watching Standardbred racing at the track with her grandfather. She received her undergraduate degree in Life Sciences as well as a Master’s degree in Pharmacology and Toxicology from Queen’s University in Kingston, Ontario where she continued her riding career and further developed a passion for veterinary medicine. Kate graduated from the North Carolina State College of Veterinary Medicine in 2014 and went on to complete a year-long rotating hospital internship at Rood and Riddle Equine Hospital (2014-15) prior to entering a Large Animal Internal Medicine Residency at the University of Georgia. She became boarded in large animal internal medicine in 2018 at the completion of her residency program. Kate remained at the University of Georgia as a clinical associate professor for one year and is excited to be returning to Lexington to join the Rood and Riddle internal medicine team. Her professional interests include gastrointestinal disease, infectious and non-infectious respiratory disease, and equine pharmacology. Outside of work, Kate enjoys spending as much time as possible with her retired show jumper, Skye. When not in the saddle, she enjoys trail-running, hiking, traveling and speading time with her husband and daughter.
Kate Christie MSc, DVM, DACVIM (LAIM)
“Providing constant access to forage is key in the prevention and management of equine gastric ulcers.”
“Medications used to treat gastric ulcers in horses have the main goal of decreasing the acidity of the stomach.”
Reprinted with permission of the
www.roodandriddle.com
PRE-SALE MEDICATION REGS ‘A GOOD CHANGE’ by Dr. Bart Barber Ambulatory Veterinarian QUESTION: What is the veterinary perspective on the new pre-sale medication restrictions in force at public auctions in the United States? DR. BART BARBER : From this veterinarian’s perspective, the changes that the sales companies have made are positive. The limitations that have been imposed add a degree of confidence to buyers while still allowing sellers and veterinarians to fully treat horses as needed with only a few exceptions. There are some subtle differences but the changes for both sales companies are very similar. One of the new rules that each have applied is that only one non-steroidal antiinflammatory drug (NSAID) and one corticosteroid may be used. There can be no stacking of drugs within the classes. There are lots of drugs in each of these categories and they have similar actions and effects within each class. That said, there are differences that make drugs in each of those classes superior for treating specific conditions. For instance, one NSAID is preferred to treat pain associated with colic while another is preferred for musculoskeletal pain. Certain steroids are better suited for treating allergic reactions while others are best at treating head trauma. The point is that there are reasons why one NSAID or corticosteroid is chosen over another and why there are several different choices. In the rare case that a horse has already been treated with one of these medications for a specific condition and another condition arises for which another medication in the same class is needed, decisions will need to be made. First and foremost the horse will be taken care of. It is important to point out that this situation would not automatically disqualify the horse from being sold. A positive test for multiple NSAIDs or corticosteroids merely gives the buyer the right to rescind the sale. The goal of the new regulations is not to limit treating horses appropriately but to limit indiscriminate stacking of NSAIDs and corticosteroids, which is in the best interest of the buyers, the sales process, the industry and, ultimately, the horse. It’s a good change. When the situation described above arises, it will be in the best interest of all parties to come together, use good judgment and horsemanship to determine intent, the best interests of the horse, and whether or not the process was compromised. These occasions will likely be rare and I believe that even in these instances we will be able to care for the horses without compromising the intent of the rules. Bronchodilators, including clenbuterol, have been limited in that they have been completely banned for a time period prior to the sale. There is a potential for abuse of these medications and again this is a positive change to protect the horse. When this change was announced some chose to not use this class of medications in horses at any age, for any condition and I believe that is a mistake. Taking this out of a veterinarian’s toolbox for use in foals could have fatal consequences. There are legitimate uses for these medications and they should be used when they are warranted. The sales companies have not limited their use when appropriate for age and condition, they have merely asked for disclosure. The balancing of allowing for appropriate use and imposing rules to curtail abuse is difficult. In this case it has been well thought out and will benefit all involved.
Dr. Bart Barber, DVM, is a shareholder in Rood & Riddle’s veterinary practice and specializes in reproduction, primary and preventative ambulatory care, as well as operations at Rood & Riddle Veterinary Pharmacy.
Bart Barber DVM “The goal of the new regulations is not to limit treating horses appropriately but to limit indiscriminate stacking of NSAIDs and corticosteroids, which is in the best interest of the buyers, the sales process, the industry and, ultimately, the horse. “
“Bronchodilators, including clenbuterol, have been limited in that they have been completely banned for a time period prior to the sale. ”
“There are legitimate
uses for these medications and they should be used when they are warranted. The sales companies have not limited their use when appropriate for age and condition, they have merely asked for disclosure.”
Reprinted with permission of the
www.roodandriddle.com
LEAVING DENTAL WORK TO THE VET by Dr. Brad Tanner Ambulatory Veterninarian
QUESTION: Why is it important to have a veterinarian perform dental work on your horse?
Brad Tanner, DVM, DAVDC-EQ
DR. BRAD TANNER: Responsible horse owners have mental checklists of the things that need to be done each year for their horses. These include deworming, vaccinations, Coggins test, health certificate and of course annual floating. The annual float is a treatment for the condition of sharp enamel points. No treatment, be it antibiotics, anti-inflammatories, etc. should be administered without an examination and proper diagnosis. Why should a dental float be any different?
“While
responsible owners are correct to have their horse’s teeth checked annually, the floating is not the most important thing happening — it is the exam.”
“Recognition
of abnormal dental wear or other pathology may be indication for dental radiographs or a CT scan to further investigate problematic teeth.”
“Our goal is to preserve functional occlusion of the teeth and allow continued grazing.”
Reprinted with permission of the
The tooth of a horse continues to grow (erupt) throughout life. Those areas of the tooth that do not get worn away become long and sharp. Left to their own devices these sharp teeth may cause cuts in the cheeks and tongue (see below). These sharp teeth cause increased discomfort in performance horses as bit and bridle change head carriage which forces increased contact of these teeth with the cheek tissue. Dental floating is the necessary treatment for this common condition in the horse. While responsible owners are correct to have their horse’s teeth checked annually, the floating is not the most important thing happening — it is the exam. A proper dental exam performed by your veterinarian can provide insight into your horse’s general health as well their oral health. This veterinarian has spent years of training in anatomy, physiology, medicine, surgery, imaging etc. and is equipped to recognize, diagnose and treat oral pain. The dental examination will include assessing facial symmetry, bone enlargements, lymph nodes, draining tracts, maleruptions, malocclusions, soft tissue lacerations and abrasions. The exam will also include a close inspection of each tooth surface with a dental mirror or an oral camera. These close looks often show painful problematic teeth with cracks, fractures or feed packing that may need to be investigated with additional imaging. Recognition of abnormal dental wear or other pathology may be indication for dental radiographs or a CT scan to further investigate problematic teeth. These imaging modalities are common practice in human medicine as the ADA (American Dental Association) recommends radiographs every couple of years, and with increased access to quality digital radiography this is also becoming more common in horses. Horse teeth do develop cavities and these can lead to fracture, pain, and sometimes sinus infections. These problems can be avoided with early detection and treatment. The treatment for these is cavity fillings (restorations) and can be done as a routine standing This image shows damage to a horse’s tongue that has arisen from sharp points on the teeth. procedure. Our goal is to preserve functional occlusion Photo courtesy Dr. Brad Tanner of the teeth and allow continued grazing. Given the opportunity horses on pasture will graze up to 16 hours daily. Dr. Brad Tanner received his DVM from Auburn University in 2005 and completed an internship at Rood and Riddle thereafter. He is a shareholder in the clinic, where he focuses on advanced dentistry, primary care and reproduction. Tanner became board certified in equine dentistry in 2019.
Join us for the Virtual Rood and Riddle Turkey Trot!
Virtual 5k Run and Walk Saturday, November 15th through Saturday, November 21st $15 entry fee to raise money for Angel Tree Project
Email rrehturkeytrot@gmail.com to register and receive further information Look out for the Rood and Riddle Turkey Trot facebook event page Www.facebook.com/events/351370632612224/ www.facebook.com/events/351370632612224/
Venmo or mail in registration fee
Everyone registered can receive either a dog bandana or a Rood and Riddle face mask while supplies last Prizes for the top three finishers and a raffle prize for everyone registered
www.roodandriddle.com