News from Your Equine Health Care Provider | Vol. 4 |Fall 2018
Dr. Wes Sutter to Join Rood & Riddle Equine Hospital
IN THIS ISSUE
Dr. Wes Sutter to join RREH in December RREH Welcomes Drs. Devis & Beste RREH Community Support RREH to host Theriogenology Meeting Dr. Scott Pierce
-Repeated Scoping
Rood & Riddle Equine Hospital is very pleased to announce that Dr. Wes Sutter will be joining their highly regarded team of Board Certified Surgeons this year on December 1st. Dr. Sutter is well recognized for both his skills as a surgeon and as a lameness diagnostician and will be a welcome addition to Rood & Riddle’s impressive group of surgeons: Doctors Rolf Embertson, Larry Bramlage, Alan Ruggles, Scott Hopper, Brett Woodie, Katie Garrett, Jose Bras, Katy Dern and Karen Beste. Our current surgeons will continue providing clients with the expertise they have come to depend on. Dr. Sutter will expand our capabilities. Sutter’s primary veterinary interests are orthopedics and lameness. Dr. Debbie Spike Pierce, the chief executive officer of Rood & Riddle, stated “We are very excited to have Dr. Sutter join Rood & Riddle. Our surgery group has an unparalleled reputation for excellence in equine surgery and Wes will be an asset to the group.” Dr. Sutter added “I am looking forward to joining a great group of veterinarians who are first class in everything they do.” Dr. Sutter was born in Lander, Wyoming and received his bachelors of science in biochemistry from Colorado State University in 1997. He then completed his doctor of veterinary medicine from Colorado State University in 2000. Following veterinary school he completed a one-year rotating equine surgery and medicine internship at Rood & Riddle Equine Hospital in Lexington, Kentucky, making his upcoming move to Rood and Riddle, something of a homecoming. After finishing his internship, Dr. Sutter completed a surgical residency at The Ohio State University where he later served as an assistant professor in equine orthopedic surgery before entering private practice as a surgeon at Ocala Equine Hospital. After 5 years at Ocala Equine Hospital, he co-founded Lexington Equine Surgery and Sports Medicine and will practice there until he officially begins at Rood & Riddle in December. The surgeons of Rood & Riddle welcome Dr. Sutter to the practice.
Dr. Kathryn Dern
-Environmental factors and OCD Lesions
Dr. Bart Barber
Dr. Rolf Embertson
Dr. Larry Bramlage
Dr. Alan Ruggles
Dr. Scott Hopper
Dr. Brett Woodie
Dr. Katie Garrett
Dr. Jose Bras
Dr. Kathryn Dern
-Are Throat Issues Hereditary?
Rood & Riddle News
www.roodandriddle.com
Rood & Riddle Welcomes Dr. Daniel Devis & Dr. Karen Beste Dr. Daniel Devis was born and raised in Bogota, Colombia. He acquired an interest in horses at a young age at his parent’s farm, where his dad taught him everything about the traditional Colombian cowboy style riding, herding cattle and roping. He attended San Martin University in Bogotá, Colombia and received his Veterinary Medicine and Animal Husbandry degree in 2012. Daniel completed a year and a half rotating internship in surgery and anesthesia, followed by a two-year fellowship in equine lameness and diagnostic imaging, both at Lexington Equine Surgery & Sports Medicine. Dr. Devis obtained his United States veterinary license in 2017. His areas of interest are sport horses, pre-purchase exams, and basic ambulatory work. In his free time, Dr. Devis is an avid golfer, but you can also see him at a tennis court or just taking pictures since photography is one of his passions. Daniel Devis, MVZ, DVM
Dr. Devis enjoys life in the bluegrass and is excited to join RREH. He is excited to become part of the ambulatory team and to learn from the experienced veterinarians in the ambulatory deptarment. He expects to continue to provide excellent service and to expand his clientele in both the sales world and the show horse industry. His long term goal is to become a shareholder at Rood & Riddle. Dr. Karen Beste joined the Rood & Riddle surgical team on August 1and will be based out of our Wellington hospital.
Karen Beste, DVM
After completing veterinary school at Texas A&M University, Karen Beste, DVM, completed two internships in Equine Surgery. The first was at Hagyard Equine Medical Center in Lexington, KY, followed by a second at Cornell Ruffian Equine Specialists in Long Island, NY. Pursuing her passion for surgery, she most recently completed a Large Animal Surgery Residency at Texas A&M University. Dr. Karen Beste is excited to join the Rood & Riddle family. She brings her long time companion Foxy, a 12-year-old German Shepherd, and her Quarter Horse, One Famous Friday “Bode”. In her free time she enjoys playing polo, traveling, and yoga. Dr. Beste is excited about working with the practice to provide a high level of care for the equine patient.
2018 Equine Upper Airway Symposium Attendees from across the country and around the world arrived in Lexington to attend 4 days of intense study and hands on learning. Doctors from as far away as Colombia and Japan, and as close as Tennessee and Ohio took advantage of the this educational offering here at Rood & Riddle. Subjects ranged from the anatomy of the upper airway and guttural pouches to nasal passage abnormalities and laser surgery techniques. They were also able to meet with sponsors Optomed, Henry Schein, Boehringer Ingleheim, Patterson Veterinary, Vetoquinol, and Keeneland. Lectures at the Equine Upper Airway Symposium
This year’s speakers included Dr. Johathan Cheetham and Dr. Norm G. Ducharme, from Cornell University, Dr. Eric J. Parente, from University of Pennsylvania, New Bolton Center and Dr. Justin Perkins from the Royal Veterinary College in London, England. These esteemed doctors joined our impressive home team of Dr. Rolf Embertson, Dr. Brett Woodie, Dr. Katherine Garrett and Dr. Peter Morresey. The 2018 Equine Upper Airway Symposium took place on September 20-23 on the Rood & Riddle campus.
Rood & Riddle Community Support Rood and Riddle is pleased to support the horse industry and the community throughout the year with sponsorships of many key equine related events. The shareholders, veterinarians and staff are delighted to be a part of functions which play a major role in education, fundraising and good old fashioned fun with horses. In July of this year Rood & Riddle served as the managing sponsor of Hats Off to Kentucky’s Horse Industry Day and the Rood and Riddle Kentucky Grand Prix. Beautiful weather and big crowds contributed to a fantastic day, which many felt was the best Hats Off Day and Grand Prix ever held. Hats Off Day’s mission is to celebrate and promote the horse industry. Approximate 15,000 people attended and while enjoying the incredible Kentucky Horse Park, cheered on Glasgow and Jimmy Torano as they won the Rood & Riddle Kentucky Grand Prix. In addition to Rood & Riddle, major sponsors included Central Bank, Zoetis and Boehringer Ingelheim. There were many other sponsors and volunteers who contributed to the tremendous success of the day. Rood & Riddle Equine Hospital is entering their sixteenth year as the sponsor of the Grade III Rood and Riddle Dowager Stakes at Keeneland,. Each year Rood & Riddle shareholders and their families join with associate veterinarians, management and senior staff members to enjoy a day of racing and camaraderie in the beautiful Keeneland Room. The Rood & Riddle Dowager is a highly regarded stakes race for fillies and mares run on the turf over a mile and a half. Some of the most prominent owners in racing have won this race, including George Strawbridge, Juddmonte Farms and Joe Allen. For the fourth year Rood & Riddle Equine Hospital and Veterinary Pharmacy has been named the Official Equine Hospital and Veterinary Pharmacy of the Breeder’s Cup Thoroughbred World Championships and is also serving as the sponsor of the Rood and Riddle Post Position Draw. The races this year will, of course, take place in Louisville, Kentucky at Churchill Downs and for the first year the Rood and Riddle Post Position Draw will be held at Equestricon at the Kentucky International Convention Center. 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 eighth year. This event, which takes place this year on Oct 27 - Nov 4, serves for many in the hunter jumper and equitation world, as the highlight of the year’s shows. For the last eight years, the National Horse Show has taken place at the beautiful Alltech Arena at the Kentucky Horse Park In Lexington, Kentucky. For those veterinarians who are attending the Annual Convention of the American Association of Equine Practitioners, Rood & Riddle Equine Hospital and Veterinary Pharmacy are once again partnering with Henry Schein Animal Health to sponsor the opening reception, which will be held this year in the Moscone Center in San Francisco, California. Rood and Riddle Equine Hospital was delighted to once again sponsor a Make-A-Wish Day Race at Keeneland this year on October 11. For eleven years, local Thoroughbred farms and organizations team up with Keeneland to grant wishes for many deserving children. At Keeneland, the children and their families will be treated to a VIP experience, complete with presenting a trophy after each of the day’s races, meeting jockeys and experiencing all the excitement of a day at the races. www.roodandriddle.com
Rood and Riddle to Host Equine Theriogenology Meeting
“Our theriogenologists are excited to make this opportunity possible for equine reproductive specialists and hope for a collaborative and inspiring opportunity for all who attend.”
Rood and Riddle to Host Equine Theriogenology Meeting LeBlanc Equine Rood and Riddle Equine Hospital Is Theriogenology pleased to announce it will be hosting Collaborative a meeting of many of North America’s leading veterinary college equine Exchange reproduction specialists and their residents October 24 - 25, 2018 on October 24th and 25th this year. Lexington, Kentucky This meeting is being called the LeBlanc Equine Theriogenology Collaborative Exchange, to honor Dr. Michelle LeBlanc. Dr. LeBlanc who passed away in 2013, was a highly respected and ground breaking equine theriogenologist who was formerly on staff at both Rood and Riddle and the University of Florida College of Veterinary Medicine. Participants will participate in “wet labs” in which they will practice and perform many advanced reproduction techniques, such as oocyte aspiration and ovarian biopsy. Dr. Tom Riddle said “Our theriogenologists are excited to make this opportunity possible for equine reproductive specialists and hope for a collaborative and inspiring opportunity for all who attend.” Rood and Riddle appreciates the many sponsors whose financial support and contributions have made this Exchange possible.
REPEATED SCOPING by Dr. Scott Pierce Ambulatory Practitioner at Rood & Riddle QUESTION: : Is repeated scoping in a sale environment uncomfortable for a horse or likely to impact the results of the scope?
Scott Pierce, DVM “the procedure itself is not a huge problem but the horse’s reaction is the issue. Young horses scope the best when they relax.”
Reprinted with permission of the
DR. SCOTT PIERCE: Upper airway examination with an endoscope has been a commonly performed procedure since the mid to late eighties. Since that time, as technology has advanced so has the endoscope. Today’s scopes are smaller and more flexible. Many foals/yearlings/two year olds are scoped numerous times at the sale. Some a dozen or more times. In the hands of a patient veterinary examiner with modern equipment, the actual procedure itself is relatively painless, quick and minor. I have examined horses that have been scoped upwards of 20 times and their airway looked as normal as its first exam. This being said, the airway looked great but many horses are not very happy by this time. Not from the procedure itself but from the restraint. Most horses object to being twitched or lip chained over and over again. When the horse becomes extremely agitated and they fight the restraint, the airway function can be adversely affected. Mainly because the horse doesn’t relax and we know they scope the best when they are relaxed. Many young horses will displace and find it difficult to correct the displacement. In addition, extreme twisting of the neck during times of fighting restraint can give the appearance of moderate arytenoid asymmetry. To summarize, the procedure itself is not a huge problem but the horse’s reaction is the issue. Young horses scope the best when they relax. I encourage consignors to observe the attitude and behavior of a horse that is popular and being scoped numerous times and if they become agitated either have the airway videoed or gather the names and phone numbers of some of the examining veterinarians so that their opinion is readily assessable. Dr. Scott Pierce obtained his undergraduate degree from Northwest Missouri State. He then attended veterinary school at the University of Missouri and graduated in 1983. Dr. Pierce began working at Rood & Riddle in 1985 and later became a shareholder. Special interests of his include working with juvenile Thoroughbreds, upper airway endoscopy, public and private sales.
HOW MUCH DOES ENVIRONMENT INFLUENCE OCD LESIONS? by Dr. Kathryn Dern Board Certified Surgeon at Rood & Riddle in Saratoga QUESTION: What do we know about environmental factors that could make a horse more or less likely to get OCD? DR. KATY DERN: Osteochondrosis (OC) is widely understood to be a disturbance of endochondral ossification (the formation of bone from cartilage) and is arguably one of the most clinically relevant developmental orthopedic diseases in the equine patient. Although it was once thought that OC lesions were static, sequential radiographic studies on foals, weanlings, and yearlings revealed that the characteristic lesions of OC could increase in size or completely regress (“heal”) up to 12 months of age. The timeline of this lesion formation and regression is different for each joint, and has supported the idea that there are number of environmental factors, in addition to genetics, that play a role in the progression of osteochondrosis. Although no definitive cause of osteochondrosis has been determined, factors such as nutrition and exercise have been shown to play a role in the development and progression of OC lesions. Of these possible etiologies, the role of nutrition has been most closely investigated. Initial research into the effect of diet on OC focused largely on dietary energy level, usually in relation to a high growth rate. Although the results of many of these studies seem to be conflicting, many support the conclusion that high growth rate (a combination of genetics and diet) is associated with an increase in the severity of OC lesions. It is important to note, however, that this is a combined effect: decreasing nutritional plane below maintenance levels will not decrease the incidence or severity of OC lesions and can lead to other dietary imbalances.
Kathryn Dern, DVM, MS, DACVS
“As with nutrition, it is clear that although exercise can play a supporting role in decreasing the incidence or severity of OC, no single factor is responsible for the course of the disease.”
Studies investigating the role of trace elements (copper, zinc, calcium, and phosphorus) have determined that low copper levels (which can be induced by increased zinc) are linked to decreased resolution of OC lesions, and copper supplementation, to a certain extent, was able to reduce the severity of cartilage lesions. Investigations into the role of calcium and phosphorus in OC have determined that high calcium diets failed to produce OC lesions, whereas high phosphorus diets (five times NRC) reliably produced lesions in foals. The role of exercise in the formation of OC lesions seems intuitive; it is well known that exercise is vital to the formation of a functional articular cartilage surface and OC is a developmental defect in articular cartilage. Investigations into the exact role of exercise in OC however, have yielded conflicting results. In some studies, increased exercise was correlated with decreased incidence in OC, whereas other research was unable to find decreased incidence in OC lesions with exercised horses but did notice a decrease in severity of existing lesions. As with nutrition, it is clear that although exercise can play a supporting role in decreasing the incidence or severity of OC, no single factor is responsible for the course of the disease. Since the process of cartilage metabolism and bone formation is highly dynamic, especially during the first year of age, it is widely thought that there are certain periods of times (“windows of susceptibility”) during which environmental factors can play a pivotal role in the severity of OC lesions. Research investigating these developmental periods, as well as the exact pathogenesis of osteochondrosis, will yield more answers and recommendations in the future.
Dr. Kathryn Dern is originally from Colorado and Montana and 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 followed by an internship at Rood and Riddle Equine Hospital. After her internships, Dr. Dern completed a three year surgery residency at The Ohio State University, while also earning a Master’s of Science Degree. She started as surgeon at Rood & Riddle in Saratoga in July, 2017 and became a Diplomate of the American College of Veterinary Surgeons in February of 2018.
“Since the process of cartilage metabolism and bone formation is highly dynamic, especially during the first year of age, it is widely thought that there are certain periods of times (“windows of susceptibility”) during which environmental factors can play a pivotal role in the severity of OC lesions.”
Reprinted with permission of the
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ARE THROAT ISSUES HEREDITARY? by Dr. Bart Barber Ambulatory Practitioner at Rood & Riddle QUESTION: Are roaring or other common throat issues hereditary? DR. BART BARBER: It is an interesting question, and I believe the answer is yes, though I believe at the current time we cannot answer this question definitively. There are no studies, of which I am aware, that address this issue. Therefore, the following is based on my own experience and opinion. There is a wide variation of how a horse’s throat looks and functions. It is safely assumed that there is a familial influence on the conformation of a horse’s knees, the slope of her pasterns and the length of her ears. It therefore makes sense to assume that genetics have an influence on the shape, size and function of the throat. Both sides of the genetic equation should be considered in this question. Half comes from the sire and half from the dam. It is a bit easier to examine the influence of the sire simply because of numbers. It is possible to examine the throats of over one hundred of the offspring of a particular sire in a single crop, compared with a mare who can only have one a year. I can think of several sires whose progeny, most veterinarians would agree, are not blessed with the most straightforward throats. The findings of the standing endoscopy on these offspring are commonly found to be less than ideal at what seems to be a higher rate than the norm. This does not necessarily mean that they don’t run or that they won’t sell well. To the contrary, some of these stallions are our most successful sires. Likewise, in the mares there have been several that I can think of who have had two or more of their offspring that have had suboptimal endoscopy findings. In my experience, it has not been consistent, meaning not all of the foals out a single mare have deficiencies. We should be cautious about jumping to conclusions in these circumstances. Without doing a complete study and examining the statistics it is impossible to determine whether or not this occurrence is significant or simple coincidence. It should be remembered that if detrimental throat abnormalities have a strong familial influence that we are already selecting against them. Horses with these deficiencies generally don’t race well and, at least for the males, don’t pass on their genes. There are some exceptions to this. There are some examples of very successful racehorses that have had tiebacks during their racing careers then go on to have a career in the breeding shed. Some of these horses do not seem to pass on this tendency to suboptimal throat function while others, subjectively, seem to pass it on at a slightly higher rate than the general population. There is a lot of work that could be done with this to determine how heritable these conditions are. Until then we should all proceed with caution in making too much of the coincidences and barn chatter. It is very likely that these conditions are multifactorial and that we will never be able to pin the cause onto a single factor.
Bart Barber, DVM “It makes sense to assume that genetics have an influence on the shape, size and function of the throat.” “It should be remembered
that if detrimental throat abnormalities have a strong familial influence that we are already selecting against them.”
“It is very likely that these conditions are multifactorial and that we will never be able to pin the cause onto a single factor. Good horsemanship and common sense should still be the rule.”
Reprinted with permission of the
Good horsemanship and common sense should still be the rule. Dr. Bart Barber, DVM, is a shareholder in Rood & Riddle’s veterinary practice and oncentrates on reproduction, primary and preventative ambulatory care, as well as operations at Rood & Riddle Veterinary Pharmacy.
Argyle named 2017 Rood & Riddle Sport Horse of the Year Many times after Thoroughbreds have completed their race careers, they are ideal candidates for another vocation. To call attention to these horses’ second career possibilities, Rood & Riddle Equine Hospital has created awards to be presented to the top Thoroughbred sport horses each year. The 2017 Rood & Riddle Sport Horse of the Year was presented during the Thoroughbred Owners and Breeders Associations National Awards dinner held on Sept. 8 at the Woodford Reserve Club at Kroger Field in Lexington, Ky. The trophy was awarded to three-day eventer, Arglye, owned by Skyeler Voss.
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California Chrome Chosen as 2018 Rood & Riddle Comeback Award Recipient The Richest Kentucky Derby winner and two time horse of the year California Chrome has been selected as the 2018 Rood & Riddle Comeback Award winner. This award is presented to a horse who has performed at the highest levels of competition, faced a medical/ surgical issue, received veterinary care by a Rood & Riddle veterinarian, and subsequently returned to compete at his/ her previous performance level. This year’s winner, California Chrome, of course, was the exciting winner of the 2014 Kentucky Derby. He then followed up his Derby win with a big win in the Preakness. Following this he continued to race successfully, and was scheduled to race in England in 2015, but he encountered physical issues which prevented him from racing there. After evaluation by Dr. Larry Bramlage, it was decided to treat California Chrome medically and rest him. He shipped to Dubai the following year where he won the 2016 Dubai World Cup, and became the world’s richest race horse. “We are extremely pleased to present the 2018 Rood & Riddle Comeback Award to California Chrome. He exemplifies the characteristics of an outstanding equine athlete who suffered a health issue, returned to elite competition and continued his winning ways” said Dr. Tom Riddle. The award was presented to representatives of Taylor Made Stallions, Denise and Perry Martin and California Chrome by surgeon, Dr. Larry Bramlage, who will be accompanied by Dr. Debbie Spike-Pierce, the chief executive officer of Rood & Riddle. Duncan and Ben Taylor said “We would like to thank Dr. Larry Bramlage, Dr. Bart Barber and Dr. Debbie Spike-Pierce and the entire Rood & Riddle Team in the recovery of California Chrome in his return to racing and Dr. Charles Scoggin for California Chrome’s success in his transition to stud duty”. California Chrome is now standing at stud at Taylor Made Farm and his first foals, which are outstanding, were welcomed into the world this year. Just as he excelled on the racetrack, great things are expected from his foals in the sale ring and at the races. In 2016 the Rood and Riddle Comeback Award was presented to Champion Thoroughbred racehorse and multiple Horse of the Year, Wise Dan, owned by Morton Fink and trained by Charlie Lopresti, and the 2017 Comeback Award winner was the World Champion Fine Harness Saddlebred mare, Tempt Me owned by Susan G. Bartlett and trained by Chuck Herbert.
Rood & Riddle in Wellington Rood & Riddle in Wellington has been named as the “Official Ocala Jockey Club International 3-Day Event Veterinarian and Farrier”. The event will take place November 15th -18th at the Ocala Jockey Club in Reddick, Florida. Dr. Chris Newton will head up our team of Rood & Riddle attending veterinarians and several of our farriers will also be in attendance. In addition, there will be an evening hosted by the Jockey Club which will include short, educational presentations by Rood & Riddle veterinarians. This will be the third year for this competition. In the last two years, the event ran three FEI divisions (CCI1*, CCI2* and CIC3*). This year, due to the early popularity of the event and venue the sanctioning bodies awarded the Ocala Jockey Club to add the CCI3* division as a new level for the 2018 event. The 2017 Event qualified 6 competitors from 4 countries to the 2018 World Equestrian Games, and grew to 178 entries from the 2016 inaugural Event which attracted 115 entries from nine countries across four continents and top level riders such as Rio 2016 Olympic Bronze Medalist Phillip Dutton, Rio 2016 Olympics Gold Medalist and Silver Medalist Astier Nicolas from France, as well as other Olympians Boyd Martin, Clayton Fredericks, Leslie Law, Lynn Symansky and other elite eventers.
Rood & Riddle in Saratoga On Wednesday, August 22, Rood & Riddle in Saratoga was named the honoree of the 2018 “Racing for the Children” which supports “Anna House”, a full scale childcare and early childhood education facility located at Belmont Park. The mission of the Belmont Child Care Association, Inc. is to provide a safe, supportive, and academically inspiring environment for the children of parents working in the thoroughbred racing backstretch area located at New York’s historic Belmont Park, Aqueduct Racetrack, and Saratoga Race Course and is committed to promoting early childhood education. Rood & Riddle in Saratoga is privileged to be involved with and support such a worthwhile cause! On Thursday, August 23, Rood & Riddle in Saratoga also hosted its first on-site “Backyard Barbeque”. Supported by Zoetis, Patterson Veterinary, Franklin-Williams Company, Boehringer Ingelheim and Horsepower, the evening included not only amazing food and drink, but also tours of the newly completed hospital expansion and a lively, fun band!
Battle in the Saddle This year Rood & Riddle was well represented by Lindsay Leach riding her horse Baron and Samara Snitker riding her horse Dot along with celebrity rider Joe Sharp. The Rood & Riddle team penned all three of their calves and finished in the top six out of twenty two teams! This exciting event pairs two amateur riders with a celebrity guest rider on each team. Teams will compete against each other to determine who has the skills and bravery needed to pen a group of cattle in the quickest time. And all of this fun is in the name of charity – to raise funds for the Kentucky Horse Park! www.roodandriddle.com
the EQUINE Pharmacy
NaturalHoof Now Readily Available! Dr. Morrison and the Podiatry team at Rood & Riddle worked closely with nutrition consultants to create a Hoof Supplement that provides an ideal environment for the hoof to grow, strengthen and rebuild. Rood & Riddle Veterinary Pharmacy is currently distributing this supplement exclusively. If you have any horses that need supplemental hoof support, consider NaturalHoof. Key in the formulation of this supplement is Dr. Morrison’s strong stance that horse owners are, in general, over-supplementing horses. A balanced diet for our horses includes a full spectrum of the trace minerals for a healthy horse and supplementation should be need-based. We are seeing great success from horses being supplemented with NaturalHoof. The hoof pictured (left) is after 8 weeks of supplementation (the new growth is very apparent at the top of the hoof).
The idea was to find the right ingredients for hoof growth, from the most bio-available sources, to address a specific problem. There are no unnecessary ingredients in this formula, meaning no oversupplementation. Not adding unnecessary “buzzword” ingredients means Performance Equine Products was able to spend extra money and effort finding the best source for the ingredients desired.
These images show the same hoof after 3 months on the supplement.
Contact Rood & Riddle Pharmacy for more information (859)246-0112 or info@rrvp.com