Rood & Riddle Report Spring 2021

News from Your Equine Health Care Provider | Vol. 9 | Spring 2021

Introducing StallSide IN THIS ISSUE

StallSide Driving Tour of Lexington Campuus Hats Off Day to be held July 31 Billing Statement Update Rood & Riddle News Dr. Bonnie Barr

-A NOVEL ROTAVIRUS CAUSING DIARRHEA IN VERY YOUNG FOALS

Dr. Steve Reed

-Herpes virus

RRVP From the Pharmacy

The Rood & Riddle Equine Healthcare Podcast

W

hether you are a horse enthusiast, a first-time horse owner or a seasoned equestrian, you will learn something new on StallSide, the Rood & Riddle Veterinary Pharmacy audio and video podcast.

Both educational and entertaining, you are able to watch or listen Rood & Riddle veterinarians discuss timely and engaging topics on equine healthcare.

Presented by Rood & Riddle Veterinary Pharmacy, StallSide focuses on common equine conditions faced by horse owners.

Each episode features a veterinarian or veterinarians from Rood & Riddle interspersed with guests from around the country and the world who are experts in the topic area. Future episodes of StallSide will include health care topics like care of the pregnant mare, foaling, neonatal care, laminitis, colic, dentistry, geriatrics and infectious disease.

Co-hosted by Dr. Peter Morresey and Dr. Bart Barber, the duo talks with each week’s guest clinician and delves into the fascinating and diverse world of equine healthcare.

Dr. Bart Barber stated, “We want to give listeners an insight into Rood & Riddle and veterinary medicine. Our goal is to strengthen the bond between animals, owners and veterinarians.”

Currently seven episodes have been released, guests include Dr. Tom Riddle, Dr. Bill Rood, Dr. Maria Schnobrich, Dr. Emma Adam, Dr. Kate Christie, Dr. Steve Reed, and Dr. John Hubbell.

“We cover the highs and lows of equine practice and the industry, never shying away from the difficult issues.” said Dr. Peter Morresey. “Always informative, we hope entertaining, and something of value to add to your day.”

You are invited to submit topics for future episodes at stallside@rrvp.com.

You can find StallSide on YouTube, iTunes, iHeart Radio, Audible, Stitcher, Spotify, Google Podcasts or wherever you listen to your podcasts. www.roodandriddle.com

Driving Tour Announced In response to the pandemic Rood & Riddle has started a self guided driving tour.

This unique tour will take you to 10 stops on the hospital campus. At each stop you will be able to listen to a recorded message describing the procedures and facilities at each tour stop.

All you need a is an FM radio and a booking with Visit Horse Country and you are able to take the tour in the comfort of your vehicle.

the practice.

Tours are available on Tuesday and Thursdays at 3 p.m. and can be booked at visithorsecounty.com.

Clients, visiting veterinarians, and veterinary students may book directly by calling 859.233.0371and asking for CT LaTonna Wilson or Whitney Fields.

Our CT computed tomography (CT) produces thin-slice, high resolution images of the region of interest and provides superior bony detail.

For adult horses the clinicians commonly use the CT scanner to evaluate fractures, compression of the cervical spinal cord, and sinus disease.

Computed tomography is also useful to image rib fractures in foals.

A CT scan is very quick and can be performed without general anesthesia in some cases. Our unit is mobile so it can travel into the surgical suites to assist during fracture repair procedures.

Above Left: Horse having a CT scan of its head Above Right: CT scan image of a horse’s head Above: 3D rendering of CT scan of fractured ribs Below: CT scan being utilized by Dr. Scott Hopper and Dr. Katie Garrett in a surgery

At the beginning of the tour, visitors will receive a 28 page guide that has photos and detailed descripitons of the inner workings of

Hats Off Day is Back!

Rood & Riddle is excited to

announce that after a year off, Hats Off Day to the Horse Industry will be back at the Kentucky Horse Park on July 31, 2021.

For the 18th year Rood & Riddle and Industry partners are joining together to put on Hats Off Day, It is the only day of the year that admission to the Horse Park is free.

Free admission to the Horse Park is offered all day, with Hats Off Day festivities (all free) starting at 3 p.m.

Hats Off Day activities include horse rides for adults and pony rides for children, stick horse races and arts and crafts stations. Free horse farm hats, generously provided by area horse farms and businesses, are given to the first attendees to arrive.

“Hats Off Day continues to educate Kentuckians about our commonwealth’s horse industry, which is the number one equine industry in the country,” said Dr. Tom Riddle, founder of Hats Off Day and co-founder of Rood & Riddle Equine Hospital. “My hope is that people will leave the Horse Park with a better understanding about the importance of our commonwealth’s signature industry.”

Stadium activities begin at 6:45 p.m. with an exciting demonstration by the Long Run Woodford Hounds and the presentation of the 2021 Rood & Riddle Comeback Award which will be presented to show hunter Celtic Fire and Rachel Kennedy.

Welcome to

Visitors Guide 2021

Saratoga News Dr. Paty Flores-Ahlschwede has been named to the to the New York State Thoroughbred Breeding and Development Fund Corporation by New York Governor Andrew Cuomo.

Saratoga has a busy spring and summer schedule with show sponsorships.

MAY- Rood & Riddle Equine Hospital in Saratoga is the Official Equine Hospital for Saratoga Spring I, II and III Horse Shows.

Paty Flores-Ahlschwede DVM

JUNE - Rood & Riddle Equine Hospital in Saratoga is the Official Equine Hospital for Saratoga Classic I and II Horse Shows.

AUGUST - Rood & Riddle Equine Hospital in Saratoga is the Official Equine Hospital for the Saratoga Summer Horse Show.

Wellington News Rood & Riddle in Wellington once again was the Official Sponsor of the 2021 Ridge at Wellington Turf Tour held at Black Watch Farm in Wellington, Florida. The Turf Tour draws top jumpers from around the world to compete in a diversity of competitions from Child and Adult Jumper classes to a $3,000 Speed Stake, $5,000 Rising Star Classic Jumper class and $15,000 Grand Prix.

Rood & Riddle in Wellington also sponsored The $200,000 Pan American Stakes (G2)that was contested on Florida Derby Day at Gulfstream Park.

Trophy presentation at the 2021 Pan American (G2)

Lothenbach Stables, Inc.’s Churn N Burn, making his just his 10th career start and first in a stakes, was left alone on the lead and had plenty left to turn back all challengers and win.

Congratulations to Dr. Stephanie Walbornn who won a very competive grant from the AQHA for “Effect of Day Estrus Cycle at TVA on Rates of In Vitro Oocyte Maturation and Blastocyst Production after ICSI” This project is in collaboration with Dr. Katrin Hinrichs at University of Pennsylvania College of Veterinary Medicine.

A New Book on the Horizon Be on the lookout for a new Rood & Riddle book. This book will feature individual chapters from many of our veterinarians. They will discuss their lives, careers, interesting cases, and more!

We are estimating it will be released in the fall of 2022.

Chelsea Hackbarth, the news editor of the Paulick Report, will be writing the book based on interviews that she conducts with our clinicians. www.roodandriddle.com

New Rood & Riddle Statements M

ost people are aware we switched our medical records/billing software in January. This has proved to be a very difficult transition and we thank you for your patience. Just as Rood and Riddle is on the cutting edge of veterinary medicine, our software needs to be the most comprehensive program available.

Deborah Spike-Pierce

DVM, MBA President/ Chief Executive Officer Rood & Riddle

We spent several years visiting practices in the United States and abroad evaluating practice management software. We had gone so far as to commit to a different company two years ago and then had to cancel our agreement when we realized it couldn’t provide everything we needed. Our new software will be able to do all we require, but we are still in the process of fine-tuning how statements appear. We do want to emphasize that all of the medical records are accurate, complete, and secure (as they have always been); the hurdles center more on how information is presented.

One advantage of the new software is that you are now able to call into the hospital and get an immediate up-to-date balance on your horse or account. This is due to the real-time billing nature of the software.

However, this has also created some challenges. For example, if an item isn’t entered into the software on the date it was performed we have a dating issue. This is most apparent with ambulatory services, but we are working on solutions.

Most software companies start in companion animal practices and then develop software for equine practices. Equine practice can be quite different than small animal especially when it comes to circumstances like multiple owners for an individual horse. This situation has created an issue with accurate dating since the software splits the invoice to bill the individual owners and dates these invoices with the date the bill was split, not the date of the service. Another difference is that companion animal veterinary practices typically receive payment when the animal leaves the hospital rather than billing at a later date. This has led to some issues with payment allocations and your payments were being applied to the most current balance instead of to the oldest balance. This will be corrected on the next version of the software which will be available in mid-May. This transition has proven to be a slow and difficult process, however this is to ensure accuracy in every aspect of your horse’s medical and financial record. As always, our accounts receivable department is happy to field any questions that you may have and we truly appreciate your patience.

A NOVEL ROTAVIRUS CAUSING DIARRHEA IN VERY YOUNG FOALS

by Dr. Bonnie Barr Internal Medicine

This foaling season there were a larger number of very young foals with diarrhea around Central Kentucky. The foals were born healthy but around 2 days of age diarrhea was observed. A majority of these foals were depressed and did not want to nurse. The feces were watery in consistency, often yellow in color. A few of the foals also developed an ileus, poor gastrointestinal motility, which resulted in abdominal distension and gastric reflux. Lab work mostly indicated a low white blood cell count, electrolyte abnormalities and dehydration. On the farms if one foal was sick a majority of the others in the barn were sick. Although this disease seemed highly contagious, with proper treatment, signs occurred for approximately 3- 4 days and little mortality was reported.

In general the most important factor in the treatment is maintaining fluid and electrolyte balance with oral or intravenous fluids. Balanced polyionic fluids, such as Lactated Ringer’s solution or Normosol R, are good choices for intravenous fluid therapy. Occasionally the foal will have severe electrolyte derangements, which require additional supplementation with bicarbonate, sodium or potassium. Prophylactic antimicrobial therapy is usually instituted in these young foals because this age group is more prone to bacterial translocation across the compromised gastrointestinal tract, which can result in secondary problems. The best choice of antimicrobials includes a combination of a beta-lactam (Penicillin) and an aminoglycoside (amikacin or gentomycin) or a third-generation cephalosporin (Ceftiofur). Oftentimes metronidazole was included as part of the treatment because a clostridial bacterium had been isolated in many of the foals. Other aspects of treatment included ensuring passive transfer, administration of gastrointestinal protectants, probiotics and supplementation with lactase.

Another important aspect of treatment is providing nutritional support because these young foals have a limited amount of body reserves. Oftentimes oral intake is restricted in order to reduce milk (fermentable carbohydrate) in the stomach or the foal may not be nursing well. In either case a dextrose solution (5%-10%) can be added to the treatment to provide extra nutrition. Some cases in the hospital require prolonged restriction and supplementation with dextrose; proteins and lipids are necessary to maintain appropriate calories.

Identifying a cause of this highly contagious diarrhea proved to be challenging. Routine testing of fecal samples were either negative for common pathogens that cause foal diarrhea or positive by polymerase chain reaction (PCR) for Clostridium perfringens toxin A, which can be part of the normal flora. With the help of researchers at the University of Kentucky’s Maxwell H Gluck Equine Research Center and the Veterinary Diagnostic Laboratory a potential culprit has been identified, a novel Rotavirus Group B. These researchers have developed a PCR test to identify this novel virus from a fecal sample.

Rotavirus is one of the most common causes of infectious diarrhea in mammals. In foals it typically causes diarrhea in those less than six months of age. This viral agent causes severe diarrhea by damaging the cells which line the small intestine and serve as the site of digestion and absorption. Injury to these intestinal cells results in the loss of the ability to absorb and digest nutrients properly. Therefore, nondigested and unabsorbed food material, primarily milk, enters the large intestine where it is quickly fermented and results in diarrhea as a result of osmotic forces drawing water into the lumen as well as fermentation of the undigested material. Rotavirus is a double stranded RNA non-enveloped virus of the family Reoviridae. There are several groups of Rotavirus (A-J) based on differences in an inner capsid protein (VP6). Rotavirus A is the group commonly associated with foal diarrhea and the current Rotavirus vaccine is for group A (serovar G3). Unfortunately this vaccine does not appear to protect from group B rotavirus.

Strict biosecurity protocols and good management practice are the best strategy for prevention of rotavirus infections.

Important measures to consider are cleaning/disinfecting surfaces and equipment and using the proper disinfectant according to directions on the label. Phenolic or peroxygen disinfectants are effective against rotavirus, bleach is not. If properly maintained foot dips have been documented to reduce pathogen load from the bottom of foot ware.

Maintenance of foot dips includes replacing disinfection solution frequently to prevent inactivation of the disinfectant by organic debris. Since it is easy to spread rotavirus, people need to wear appropriate personal protective equipment when handling a sick foal. Foaling outside has helped to mitigate sickness. Because each farm’s needs are different, biosecurity protocols need to be developed with the help of a veterinarian.

Bonnie Barr VMD, DACVIM (LAIM)

“Although this disease seemed highly contagious, with proper treatment, signs occurred for approximately 3- 4 days and little mortality was reported.“ “In general the most important factor in the treatment is maintaining fluid and electrolyte balance with oral or intravenous fluids.“ “Another important aspect of treatment is providing nutritional support because these young foals have a limited amount of body reserves.“

“Identifying a cause of this highly contagious diarrhea proved to be challenging.

Kentucky’s Maxwell H Gluck Equine Research Center and the Veterinary Diagnostic Laboratory identified a potential culprit : a novel Rotavirus Group B. These researchers have developed a PCR test to identify this novel virus from a fecal sample.”

“Strict biosecurity protocols and good management practice are the best strategy for prevention of rotavirus infections. Since it is easy to spread rotavirus, people need to wear appropriate personal protective equipment when handling a sick foal.

Because each farm’s needs are different, biosecurity protocols need to be developed with the help of a veterinarian.“

www.roodandriddle.com

HERPES

by Dr. Stephen Reed Internal Medicine

Steve Reed DVM, DACVIM “The terminology used to describe the neurologic form is equine herpesvirus myeloencephalopathy which is caused by damage to the blood vessels supplying the nervous system.

However, in many, if not most cases, the clinical signs begin with fever along with ascending paralysis of the pelvic limbs, along with urine dribbling and loss of tail and anal tone.” “one’s index of suspicion is high, and can be raised even higher when several horses on the same premise present with fever, ataxia and urine dribbling. “ “If a horse develops signs of EHM, the best therapeutic strategies focus on lowering viral load in lymphocytes/ monocytes during cellassociated viremia, reducing inflammation by use of nonsteroidal anti-inflammatory medications and stabilizing the vasculature along with good nursing care to help heal damaged tissues.“

Many challenges confront owners and their veterinarians when faced with a horse showing symptoms of neurological disease; these challenges are more complicated when the signs are caused by equine herpesvirus 1 (EHV-1 or EHM). EHV-1 is quite problematic as it can affect several body systems (respiratory, reproductive and central nervous systems). The terminology used to describe the neurologic form is equine herpesvirus myeloencephalopathy and is caused by damage to the blood vessels supplying the nervous system. The clinical signs observed in horses with equine herpesvirus myeloencephalopathy are caused by multiple small vascular insults to the brain, brainstem or spinal cord; making clinical signs quite variable. However, in many, if not most cases, the clinical signs begin with fever along with ascending paralysis of the pelvic limbs, along with urine dribbling and loss of tail and anal tone. Clients should look for fever followed by neurologic signs in multiple horses on the farm.

The diagnosis of EHM begins with the neurologic examination and when the horse presents as described above, one’s index of suspicion is high, and can be raised even higher when several horses on the same premise present with fever, ataxia and urine dribbling. If there is also a history of mares having abortions on the farm, EHV-1 should be very high on the differential diagnosis list. Further diagnostic testing should include PCR testing of nasal swabs and buffy coats in blood. This should be followed up with confirmation by use of virus isolation on cell culture. Following confirmation of a diagnosis of EHM the premises should be quarantined because movement of horses off the farm places other animals at high risk for spread of the infection.

Equine herpesvirus is a member of the alpha-Herpesviridae which shares characteristics with other herpesviruses. It is an enveloped DNA virus that once infected maintains a life-long infection in the horse. The virus is capable of rapid replication which allows the virus to spread rapidly among naïve horses and causes a higher frequency of neurologic disease. The virus initially replicates in the mucosa of the upper respiratory tract and from there enters endothelial cells and eventually infects peripheral blood mononuclear cells to circulate to other sites in the body.

The disease can affect horses of all ages, though it is rarely seen in yearlings and appears to increase in frequency with advancing age. This is suspected to result from age related changes in the immune system such that older horses are more likely to become infected and to show clinical signs.

Although currently available vaccines do not reliably block infection, the development of viremia, or the establishment of latency, vaccination remains important to prevent and/or reduce the incidence of respiratory infections and abortions. Unfortunately, EHM has been observed in horses that have been regularly vaccinated against EHV-1. This lack of induction of protective immunity to EHV-1 is likely due to immunomodulatory properties of the virus.

The best strategies for prevention are for owners to keep their horses healthy and well vaccinated in attempt to prevent infection. The stress of transportation to horse shows, racetracks, and breeding farms can lead to suppression of the immune system and therefore increase the risk of infection.

If a horse develops signs of EHM, the best therapeutic strategies focus on lowering viral load in lymphocytes/monocytes during cell-associated viremia, reducing inflammation by use of non-steroidal anti-inflammatory medications and stabilizing the vasculature along with good nursing care to help heal damaged tissues.

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. He has spoken at many state, national and international meetings. His primary research interests include Equine Neurologic Diseases. He is currently an Internal Medicine Specialist and shareholder of the Practice at Rood & Riddle Equine Hospital, Emeritus Professor of The Ohio State University, an Adjunct Professor at the University of Kentucky and is currently the Chairman of the Grayson-Jockey Club Research Advisory Committee.

the EQUINE Pharmacy

Take your hoof care to the next level with NaturalHoof!

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, oversupplementing 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 www.roodandriddle.com