News from Your Equine Health Care Provider | Vol. 1 | Spring 2017
Rood & Riddle Launches New Website After many months of anticipation the new Rood & Riddle website is up!
It features a streamline format that is easy to navigate and has a sleek, modern look. With the rebuild we have made several updates to previous content and have added new content and pages.
IN THIS ISSUE EQUINE HEALTH
Breeding Season Procedures
Some of the new additions include pages dedicated to the Rood & Riddle Comeback Award and the Rood & Riddle Thoroughbred Sport Horse awards.
The DEPO Debate: My Opinion Palpation and Ultrasound Gradings
Thoroughbred Sport Horse Divisional Winners Announced
Rood & Riddle Client Education Seminar Rood & Riddle in the News
Other updated content includes the Wellington page which has been expanded. It has become a “mini� website which includes the staff and the ability to request an appointment. The Saratoga page provides a brief summary of the hospital, the ability to request an appointment in Saratoga, as well as a link to the Saratoga site. The news and education section has archived articles of helpful and interesting topics for all levels of horsemen. Additional articles will be added periodically as timely topics present themselves. You are also able to sign up to receive the Rood & Riddle report on the website. The request an appointment page makes it easy to request appointments with each department or hospital directly. Our new client center lets you easily access your account to check balances, make payments or submit questions about your account. We have added an interactive map of the Lexington campus and have tour videos posted so you can get a glimpse into the inner workings of the facility. We offer guided tours of the hospital through Horse Country on Mondays and Tuesday mornings. To book a tour click here. The new site also features pages about our doctors and staff, all of the services that are offered at the hospital, and information on our intern and externship programs. The client feedback page lets you tell us how we are doing. We appreciate and welcome your comments. We hope you enjoy browsing our new website.
Breeding Season Procedures By: Tom Riddle, DVM
I
“Endometrial cysts should also be mapped prior to breeding to avoid confusion with pregnancy. I prefer to do this when the mare is not in heat because uterine edema can affect the ability to adequately determine the size and shape of cysts.”
n my early years of practice I decided to write a description of my breeding season procedures, so that my farm managers would know my basic “ways”. Each year thereafter I have modified this paper as I have learned and hopefully improved my way of practice. Please realize that every veterinarian has developed their own breeding season procedures, based on what works for them, keeping in mind that there are different and equally good ways to accomplish the same goal. Below is an excerpt from the introduction to my paper:
Tom Riddle, DVM
The following is a brief description of routine procedures utilized in my practice. Terminology and the abbreviations used for recording reproductive examination findings are included.
Barren Mares After mares go under lights in December and begin cycling, each mare should be evaluated on 2 heats before beginning breeding. Evaluations must be done when mares are in heat. Transitional heats may not be adequate for proper evaluation because of cervical tightness and lack of uterine edema. Evaluation should include: 1. Rectal palpation – checking ovarian size and consistency, follicle size and consistency, uterine tone,
cervical relaxation, pelvic structure 2. Ultrasound – checking ovaries, follicles, corpus luteum (CL), uterine edema, fluid, cysts. Endometrial
cysts should also be mapped prior to breeding to avoid confusion with pregnancy. I prefer to do this when the mare is not in heat because uterine edema can affect the ability to adequately determine the size and shape of cysts. Shape and size (in millimeters) of cysts may be entered on a “cyst map”, or the size and location may be listed, such as LA 25 (indicating a 25 mm cyst in the lateral division of the left horn). Left horn A
“The presence of increased numbers of neutrophils (pus cells) indicates inflammation and likely uterine infection.”
B
Right horn C
D
E
F
G H
Body
3. Uterine culture – swab – checking for bacterial or fungal infection. (Fluid aspirate / small volume lavage may be indicated in some cases – chronic endometritis, chronic infertility, or cases with positive cytology and negative swab culture ) 4. Uterine cytology – smear from culture swab cover cap (Cytology is the study of the cell types from the uterus.) The presence of increased numbers of neutrophils (pus cells) indicates inflammation and likely uterine infection. The inflammation will be graded; moderate and severe are causes for concern. Cytology is also an excellent way to check for fungal infection as yeast cells/hyphae may be seen. I do not routinely recommend a cytology on maidens prior to breeding because the unbred maiden is extremely unlikely to have significant inflammation. If the maiden has clinical signs suggesting inflammation, then a cytology should be done. 5. Speculum exam – cervical color, relaxation, integrity of cervix (checking for tears or adhesions). 6. Manual exam - of cervix per vagina– necessary to fully evaluate cervix for defects such as lacerations or adhesions. (Cervix may have been damaged during a previous foaling.) This exam should be done when mare is out of heat. Unless questions arise, only one manual exam is needed.
Results of all examinations will determine whether treatments are necessary. To meet breeding shed requirements and to better ensure that the mare is clean for breeding, the (barren) mare should have a culture and cytology within the 30 days prior to first breeding. _____________________________________________ To access the complete paper, please click here Breeding Season Procedures or go to www.roodandriddle.com - News and Education tab - Helpful Articles - Breeding Season Procedures
The DEPO Debate: My Opinion By: Jennifer C. Jordan, VMD DACVS
T
he phone calls began in January of this year. Clients asking about rumors of a rule change regarding medroxyprogesterone. People were concerned. After I assured them that they would be given ample notice before any such rule change were to take effect, the next question I was invariably asked was how I felt about the matter. Given how often this issue has been raised in conversation over the last few months I felt it was a good topic to discuss here. Medroxyprogesterone acetate, also known as Depo-Provera®, is a synthetic progestin that has been used as a long term contraceptive in humans and has been administered to performance mares with the intention of blocking behavioral estrus. The drug has also been used in mares, geldings and less frequently stallions as a tool to modify behavior and make the animals less “spooky”. Although studies have shown that mei droxyprogesterone does not effectively suppress estrus in mares , there is evidence that the drug does have ii an effect on GABA receptor mediated inhibition in certain areas of the brain in rats. It is this latter effect that has brought this drug to the attention of US Equestrian. From my own personal experience I do not feel that medroxyprogesterone has much if any behavioral modifying effect on horses, although I do have clients who use it and believe it helps their horses. This is not a new drug. To my knowledge this drug has been used for decades in much the same way as it is used today. I don’t think anyone can make a case that this is in any way a dangerous drug (although occasional injection site reactions do occur). This is not a debate about the use of the drug to alter the estrus cycle; nor is this a debate about the safety of the drug, or a potentially harmful sedative effect that could cause danger to horse or rider. This is a debate about whether the drug is a performance-enhancing agent without a valid therapeutic use. Unfortunately, while I recognize the importance of regulating and testing for performance enhancing drugs, the emotional turmoil that this debate is causing and the financial cost of establishing a testing program for medroxyprogesterone hardly seem worth while given the weak if existent effect the drug has on show horses. I am further distressed that the basis for the time and financial commitment that has been spent on medroxyprogesterone is largely based on the biochemistry of the drug in rats. In fact to my knowledge there have been no peer-reviewed studies that have examined the effect of medroxyprogesterone on the equine GABAergic pathway. Although I support US Equestrian in its efforts to eliminate the use of performance enhancing drugs and act as advocates for our equine athletes, I feel that this particular battle may not be worth the fight. The second issue that is raised by this discussion is a more general question about the focus of the regulatory standards of our sport. Among the arguments for tightening the regulations on drugs like medroxyprogesterone is a comparison of the standard of US Equestrian to the standards of European and other federations as well as those of the FEI. While I think these comparisons are reasonable for jumper divisions that are similar across the world, it is quite difficult to apply those same standards to the hunter and equitation rings since those disciplines are essentially non-existent outside of North America. The reflexive reaction to a complaint about a horse having too much energy in the ring is to simply say ride it or lunge it more (aka. the best solution is a wet saddle pad). But walk around the show grounds at most major horse shows and you will quickly note one problem—in an attempt to provide an ever expanding number of divisions in a fixed number of horse show days, horse show management has created more show rings at the expense of safe places to ride or lunge horses. Rings are often open for riding in the morning but for a nervous horse that needs to get out multiple times before his class there are often only small cramped schooling areas or woefully inadequate lunging areas. This problem is further exacerbated by the fact that the current industry standard for a show hunter is basically a horse that looks partially anesthetized. This standard, combined with an increasing number of divisions for very weak riders and an increasingly limited ability to safely prepare the horses either physically or chemically, puts trainers in an untenable position. Quite frankly from my perspective more of US Equestrian’s time and energy should be spent trying to reconcile these issues rather than spending another minute discussing a safe drug whose purported performance enhancing activity is somewhere on a spectrum between weak and placebo.
“From my own personal experience I do not feel that medroxyprogesterone has much if any behavioral modifying effect on horses, although I do have clients who use it and believe it helps their horses.”
“Quite frankly from my perspective more of US Equestrian’s time and energy should be spent trying to reconcile these issues rather than spending another minute discussing a safe drug whose purported performance enhancing activity is somewhere on a spectrum between weak and placebo.”
MCCue, PM: Depo-Provera® (Medroxyprogesterone) Does This Medication Block Estrus In Mares. Equine Reproductive Laboratory, Colorado State University. United States Equestrian Website: 2017 Workshop on Medroxyprogesterone Acetate (Depo-Provera®)
www.roodandriddle.com
Rood & Riddle Palpation and Ultrasound Gradings “Rood and Riddle’s veterinarians have “codes” which they use to describe their findings on the rectal ultrasound examinations of the mare’s reproductive tract. When our clients receive their monthly statements, these codes may appear after Palp, diagnostic ultrasound. Cheryl Moder from bookkeeping is going to show you how they list the findings.”
Follicles - Measured in millimeters. L - Left Ovary R - Right Ovary
PALP, DIAG.ULTRASOUND L40MS R25F E1 F1.5 CX3.5 Left ovary 40mm Medium soft Right ovary 25mm firm Edema - small amount Fluid 1.5 cm Cervix grade 3.5
F - Firm FM - Firm to Medium M - Medium MS - Medium to Soft S - Soft FL - Flaccid
Hemorrhagic - (Echogenic Fluid)
Hemo 1 - Small Amount Hemo 2 - Moderate Amount Hemo 3 - Large Amount
TW - Thick Walled MSF - Multiple Small Follicles (greater than 3, 10-15mm follicles) MVSF - Multiple Very Small Follicles (greater than 3 follicles ≤ 5mm) NSS - No Significant Structure on either ovary HAF - Hemorrhagic anovulatory follicle LUT - Leuteinized follicle
Corpus Luteum - CL
CL? - Inactive or questionable CL Reg CL - Regressing CL
Air -
Edema - E0 - No Edema
E1 - Small Amount E2 - Moderate Amount E3 - Large Amount E4 - Excessive Amount
A1 - Small Amount A2 - Moderate Amount A3 - Large Amount
Urinary Sediment -
Fluid - The average of the vertical measurement in centimeters. If the fluid is echogenic, this is designated by a + . Increased echogenicity is indicated by ++ ,+++. e.g. F3+ indicate 3 cm of slightly echogenic fluid.
Cervix - Graded 1 - 4 Cx1 - Tight Cx4 - Relaxed (on floor) Example:
Consistency -
US1 - small amount US2 - moderate amount US3 - large amount
Color Pale Pink Red
Hyperechoic subtance in the uterus - HE (preceded by the location) Calcified endometrial cups - CEC Pregnancy- Measured in millimeters PLH - pregnant left horn PRH - pregnant right horn PB - pregnant body Efflux - Gross examination 0- Clear 1- Slightly Cloudy 2- Moderately Cloudy 3- Very Cloudy
HB - To indicate heart beat seen- location and size followed by HB Adj - twins are adjacent AEV - Anembryonic vesicle
Particulate Matter
+ - Small Amount ++ - Moderate Amount +++ - Large Amount
Rood & Riddle Thoroughbred Sport Horse Divisional Award Winners Announced The Rood & Riddle Thoroughbred Sport Horse Awards, co-sponsored by Rood & Riddle, United States Equine Federation and TOBA, are given each year to Thoroughbreds participating in their second careers as performance horses in jumper, hunter, eventing and dressage competitions throughout the year. Thoroughbreds are bred to be superior athletes and, therefore, excel in many disciplines. These awards were created to celebrate the horses that best represent their breed in these four disciplines. Competitors earn points toward the Rood & Riddle Photo Credit: EquiSport Photos Thoroughbred Sport Horse Awards at USEF-sanctioned Last year’s Rood & Riddle Sport Horse of the Year Award was events during the show season, and the open divisional presented to Sound Prospect awards go to the highest point earners. Rookie awards in each division ensure that newcomers are recognized as well. A Horse of the Year is chosen among the open winners by a panel of celebrities. This award is presented at the annual Thoroughbred Owners and Breeders Association awards banquet held in September.
“The Rood & Riddle Thoroughbred Sport Horse Awards are given each year to Thoroughbreds participating in their second careers as performance horses in jumper, hunter, eventing and dressage competitions throughout the year.”
Rood & Riddle hopes that these awards will raise awareness of the many uses of Thoroughbreds following their racing careers. 2016 Rookie Winners: • Hunter Division: Top Cat (Jockey Club Name: Business as Usual), by The Daddy out of Hacienda De Mar. Owned by Jo Jo White of TX. • Jumper Division: Just Jake (Jockey Club Name: Demis Bold Ruler), by Demidoff, out of Tighthold. Owned by Nick Novak of MN. • Dressage Division: Ken’s Kitten (Jockey Club Name: Ken’s Kitten), by Kitten’s Joy out of Cruise Line. Owned by John D. Gunther of KY. • Eventing Division: The Manager (Jockey Club Name: Got Edge), by The Cliff’s Edge out of Misty Sabin. Owned by Ann Jones of PA. 2016 Open Winners: • Hunter Division: Sea Walker (Jockey Club Name: Sea Walker), by Marlin out of Shop. Owned by Nicole Oliynyk of MA. • Jumper Division: Zine Dine (Jockey Club Name: Omnipotent), by Unbridled Time out of My Belle. Owned by Hailey Rogge of LA. • Dressage Division: Raphael (Jockey Club Name: Red Phase), by Montreal Red out of Joyful Pat. Owned by Rebecca Sturdy of IL. • Eventing Division: Rise Against (Jockey Club Name: Trabuco Kid), by Far Out East out of April Betty. Owned by Bunnie Sexton of CA.
“Rood & Riddle hopes that these awards will raise awareness of the many uses of Thoroughbreds following their racing careers.”
Here is a link to see all the previous winners. www.roodandriddle.com
Rood & Riddle Responds: Our Doctors answer your questions
“Since our opening in 1986, Rood & Riddle has committed to offering an annual client education event. Our client seminar is a great opportunity for people engaged in the equine industry to learn about the newest developments in
Rood & Riddle hosted it’s 32nd annual Client Educational Seminar at
the Embassy Suites in Lexington on February 22. Last year’s question and answer session was a big hit, so we expanded the format to fill the entire two hour session. Dr. Tom Riddle hosted this year’s seminar and the RREH doctors made their presentations to the previously submitted questions. The questions were chosen from submissions to our Facebook page. The ambulatory doctors were posed questions on a variety of subjects, including Rhodoccocus, Lawsonia, Leptospirosis, Strangles and prevention of carpal/tarsal collapse in premature foals.
Heart attacks, “bleeders”, EHV-1, biosecurity guidelines, and survival rate of dystocia foals were fielded by our Internal Medicine doctors.
veterinary care.”
“Questions were answered on a variety of topics including internal medicine, reproduction, surgery, breeding farm practice, and anesthesiology.”
Dr. Bonnie Barr making her presentations on Strains of EHV-1 and Biosecurity
Our surgeons tackled the topics of angular limb deformities, transphyseal bridges, and critical timing with dystocias. Safety of general anesthesia was addressed by Dr. John Hubbell. The reproduction team covered questions on nocardioform placentits, blocked oviducts, endometritis, and hysteroscopy. Dr. Peter Morresey spoke on the survival rate of dystocia foals
The following doctors made presentations: Drs. Barr, Bradecamp, Bramlage, Brown, Cook, Embertson, Gilsenan, Hyde, Hubbell, Metcalfe, Morresey, Paasch, Ruggles, Schnobrich, and Scoggin. Each year the number of attendees has grown and this year we hosted approximately 300 interested horsemen and women.
Rood & Riddle Welcomes Back Dr. Kevin Hyde Dr. Hyde originally joined RREH in June of 2005. After practicing in California from 2011 until January of 2017 he has come back to the Bluegrass State to join our group of Ambulatory doctors. Ali Broyles, DVM grew up in Murfreesboro, Tenn. where she developed a passion for working with horses. Dr. Broyles graduated from Middle Tennessee State University 2004. She then moved to Guthrie, Tex. where she worked for a year and a half at Four Sixes Ranch. Dr. Broyles earned her veterinary degree from Texas A&M University in 2010. Immediately following, Dr. Broyles completed a yearlong internship at Rood & Riddle Equine Hospital in Lexington, Ky. Following completion of her internship, Dr. Broyles along with her husband purchased a veterinary practice in Spur, Tex. For three years, she worked with her husband at the practice and also part time as a racetrack veterinarian in Fla., Iowa and Okla. for Equine Sports Medicine. Dr. Broyles returned to Rood & Riddle in June 2014 to begin an equine surgery residency. At the completion of the residency program, Dr. Broyles will be joining the Rood & Riddle team in Saratoga Springs and later will return to Texas to the practice she and her husband co-own.
Big Ass Solutions Shows Support of Rood & Riddle in Wellington Through Fan Donations Big Ass Solutions has generously donated three Yellow Jacket fans to our Wellington practice to be used in our isolation barn and surrounding areas. We are very appreciative of our mutual partnership and look forward to working with them in the future. Thank you Big Ass Solutions! Check out the video “Horse Country: Lexington, Kentucky,� an ABR Films presentation sponsored by Visit LEX and Horse Country. It features many of the locations that can be toured through Horse Country including Rood & Riddle Equine Hospital. You can see it at https://vimeo.com/213721899 www.roodandriddle.com
Rood & Riddle in the News Dr. Steve Reed, DVM, Dipl. ACVIM was LIVE on March 16, answering questions on Equine Herpesvirus which was hosted by The Horse. Here is the link to hear a replay.
Steve Reed, DVM, Dipl. ACVIM
Dr. Reed earned his DVM at The Ohio State University, followed by a residency at Michigan State University. He started his academic teaching career at Washington State University from 1979-1983, and then returned to The Ohio State University where he spent 26 years as a professor and mentor in the Equine Medicine department. Dr. Reed is a Diplomate in the American College of Veterinary Internal Medicine and is a noted author and editor of numerous scientific articles and textbooks. Dr. Peter Morresey, BVSc, MACVSc, Dipl. ACT, ACVIM, CVA discusses catching a problem early, minimizing mare and foal stress, and keeping the mare in best reproductive health as the best way to protect the owner’s investment. This article was published by The Horse.com and can be found with this link.
Rood & Riddle Congratulates Dr. Peter Morresey for becoming RREH newest shareholder Dr. Morresey joined the practice in June of 2005 and has been an intregal part of the Internal Medicine team ever since. In January of this year he joined the shareholders as their 23rd member.
Dr. Peter Morresey, BVSc, MACVSc, Dipl. ACT, ACVIM, CVA
Andrea Whittle
Dr. Morresey began his veterinary career in New Zealand as a mixed animal practitioner following graduation from Massey University in 1988. He accepted a Theriogenology residency in 1996 at the University of Florida (UF) in Gainesville where he had the privilege of learning the intricacies of the mare from his mentor Dr. Michelle LeBlanc. Dr. Morresey is a member by examination of the Australian and New Zealand College of Veterinary Scientists, and holds Diplomate status in both the American College of Theriogenologists and the American College of Veterinary Internal Medicine.
Andrea Whittle, Internal Medicine clinician’s tech, represented RREH at the UK Equine Career & Opportunity Fair on March 7. Approximately 30 participants set up booths to discuss various careers within the equine industry. The career opportunities ranged from veterinary internships to pharmaceutical sales to non-profit adoption agencies. Between 300-400 attendees wandered Spindletop Hall looking for their opportunity to work within the equine industry.
M*A*S*H Veterinary Style
Nicole Bone, our surgery and anesthesiology technician supervisor, recently went to Mae Chaem, Chiang Mai, Thailand. She went as a volunteer in an outreach clinic through a study abroad program called Loop Abroad. Loop Abroad started in 2009, a place for students volunteers to study ecology and animal conservation. They introduced the first college veterinary service program in the summer 2013 and are proud to continued evolving the veterinary programs so that students can learn more, do more, and help more animals in Thailand and beyond. They now welcome hundreds of students over dozens of programs with an uncompromising focus on supporting animals in need and partnering only with ethical, local organizations with strong reputations in the animal conservation community-at-large. This clinic lasted 4 days in two separate tribe towns with the intent to sterilize as many animals as possible. Nicole stated “We were able to get 115 dogs and cats spayed and neutered as well as treat some dogs exhibiting symptoms of highly transmissible diseases.” All the animals that came to see us also received rabies vaccinations, antibiotics, pain meds and flea/tick meds. Mae Chaem is a very rural hill tribe area of northern Thailand. Their access to veterinary care is extremely limited with an ever growing population of strays. The veterinary team that she traveled with comprised of 3 US veterinarians, 1 Thai vet, 2 US licensed veterinary technicians (including Nicole) and 7 preveterinary students. Nicole says that “it felt like MASH veterinary style. It was amazing how much you can live and work without as well as how ingenuitive one can become in a short period of time. It was a great experience and felt like we made a real impact on the area. Loop abroad is hoping to put on another clinic some time late this year.” They rely heavily on donations to get the outreach clinic funded and operational.
“We were able to get 115 dogs and cats spayed and neutered as well as treat some dogs exhibiting symptoms of highly transmissible diseases.”
It was amazing how much you can live and work without as well as how ingenuitive one can become in a short period of time.
The volunteers stayed at BEES, which stands for Burm and Emily’s Elephant Sanctuary. It is a very small elephant sanctuary containing only 3 elephants with the hopes to expand slowly. They rescue and retire elephants that have been used for logging and tourism since they were very young. The elephants that are currently retired to the sanctuary are females between the ages of 50 and 70 years old. They have lived very hard lives and are extremely grateful to be retired. After the fourth day of the spay/neuter clinic, we were able to take a trek with the elephants from the sanctuary into the northern jungle to see them in their natural habitat as well as walk with them, bathe them and feed them their favorite treats (peeled bananas, watermelon and pumpkin/squash). www.roodandriddle.com
Flea and Tick Season is Here! Rood & Riddle Veterinary Pharmacy is excited to have brought in most major flea and tick products for the convenience of our customers. We have both prescription and over-the-counter options for your pet! Because of our mild winter, experts are expecting this to be a particularly bad tick season so make sure that your best friends are protected. Ticks carry many diseases that can have long-term symptoms in your animal. As the saying goes, an ounce of prevention is worth a pound of cure! Ask your vet what product they recommend for your pet and get it at RRVP today! Ask your vet what product they recommend for your pet and get it at RRVP today!
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