Rood & Riddle Report

News from Your Equine Health Care Provider | Vol. 1 | 2015

Rood & Riddle Named Official Equine Hospital of the Breeders’ Cup World Championships IN THIS ISSUE EQUINE HEALTH

Clinical Use of MRI-What the Client Needs to Know Exciting New Treatment for Endometritis NEWS

Thoroughbred Sport Horse

Divisional Winners Dr. Raul Bras Elected into International Equine Veterinarian Hall of Fame Rood & Riddle Receives John W. Galbreath Award

The Breeders’ Cup today announced that Rood & Riddle, one of the world’s leading equine veterinary practices, has been named Official Equine Hospital of the Breeders’ Cup World Championships and Title Sponsor of the 2015 Breeders’ Cup Post-Position Draw.

This year’s Breeders’ Cup World Championships, consisting of 13 races and $26 million in purses and awards, will be held for the first time at Keeneland Race Course in Lexington on Oct. 30-31.

The Rood & Riddle Breeders’ Cup Post-Position Draw will be held at Keeneland on Monday, October 26. The draw will be conducted in two phases. The first phase, drawing of 11 Breeders’ Cup World Championships races, will be held in the Keeneland sales pavilion at 1 p.m. ET. The Longines Breeders’ Cup Distaff and the Breeders’ Cup Classic will be drawn later that afternoon in the magnificent Bourbon Lounge chalet at the racetrack.

“Rood & Riddle has a firmly established outstanding reputation of excellence as leaders in the equine medical field, and we are very pleased that they are supporting this year’s Breeders’ Cup as an official partner and sponsor of the Post-Position Draw,” said Craig Fravel, Breeders’ Cup President and CEO. “With intense interest focused in the Bluegrass region for the first ever Breeders’ Cup at Keeneland, we are also very excited that the draw will the first gathering of horsemen and the community among the great festivities planned during Breeders’ Cup week.”

“Rood & Riddle is very pleased to partner with Breeders’ Cup as the Title Sponsor of the Post-Position Draw and as Official Equine Hospital of the Breeders’ Cup Championships,” said Dr. Tom Riddle, co-founder of Rood & Riddle. “It is especially exciting for us to join with Breeders’ Cup in its first year to be held in Lexington, our hometown.”

“The availability of magnetic resonance imaging (MRI) has increased greatly over the past ten years.”

“The ability of high-field scanners to produce higher resolution images, more images per region, larger areas that can be imaged, and faster scan times leads to a dramatic increase in the diagnostic value of the scan. “

Clinical Use of MRI – What the Client Needs to Know By: Katherine S. Garrett, DVM, Dipl. ACVS

The availability of magnetic resonance imaging (MRI) has increased greatly over the past ten years. This has led to tremendous advances in our ability to make more accurate and/or specific diagnoses in a variety of body regions. In some cases, it is required to make an accurate diagnosis. However, it is important for horse owners and Katie Garrett, D.V.M., Dipl. ACVS trainers to understand that not all MRI scanners are created equal. There are major differences between scanners that can have significant impacts on the diagnostic ability of the scan.

There are multiple types of MRI scanners on the market currently. High-field (1-1.5 Tesla) scanners were the first to come into clinical use for the horse. High-field scanners require general anesthesia. However, they allow for higher resolution images, a greater number of images of a given region, larger areas that can be imaged, and faster scan times. Low-field (typically 0.3 Tesla) scanners are available in both recumbent and standing designs. The recumbent design requires general anesthesia while the standing design can be used in the High-field MRI at standing, sedated horse or can be rotated for Rood & Riddle use on an anesthetized horse. Low-field scanners have lower-resolution images, fewer images per region, smaller areas that can be imaged, and longer scan times.

The standing design is also prone to artifacts from motion (leading to non-diagnostic images), which worsen as the scan region moves up the limb from the foot.

The ability of high-field scanners to produce higher resolution images, more images per region, larger areas that can be imaged, and faster scan times leads to a dramatic increase in the diagnostic value

of the scan. The differences between the high and low-field magnets are a result of the laws of physics, and have nothing to do with the personnel producing or interpreting the scans. A 1.5 Tesla scanner has five times the amount of information available as compared to an 0.3 Tesla scanner, which is the type used in the standing magnet design. This is entirely due to the strength of the magnet. This additional information is the factor that leads to increased diagnostic ability.

For example, standing MRI scanners cannot detect cartilage injury where as highfield scanners can. Standing scanners can produce some types of “pretty” images, but these image types are of the lowest diagnostic value.

When considering the types of scans with the highest diagnostic value, standing scanners generally produce poor-quality images of these types of scans.

Many clients have concerns about their horse undergoing general anesthesia for an MRI procedure. The risk of general anesthesia for MRI procedures has been vastly overstated. In the most recent study of general anesthetic risk, the risk of death was found to be 1 death in 1,000 horses. This study included horses which were extremely compromised with severe diseases (colic, diarrhea, sepsis, etc). Horses undergoing elective anesthesia (such as those undergoing MRI) have a much lower risk of anesthetic complications. At our hospital, horses undergoing MRI are attended at all times during the recovery process by two experienced recovery technicians who stay with the horse in the recovery stall and assist the horse to a standing position to ensure a safe and uneventful recovery process.

An MRI scan is not a procedure to be undertaken without careful consideration and consultation with your veterinarian. However, the goal of the examination is to provide the client with the most specific and accurate diagnosis possible in order to direct treatment in the appropriate direction. High-field MRI can accomplish this goal much more effectively than can low-field standing MRI.

“Although veterinarians are frequently asked to make a diagnosis based on x-ray or ultrasound images alone, imaging abnormalities are not always correlated with a clinical manifestation of pain.”

“At our hospital, horses undergoing MRI are attended at all times during the recovery process by two experienced recovery technicians who stay with the horse in the recovery stall and assist the horse to a standing position to ensure a safe and uneventful recovery process.”

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“Once a pathogenic bacteria has been isolated from the mare’s uterus, it is important to determine the sensitivity of the bacteria to antibiotics in order to make an appropriate treatment plan.”

“Treatment of bacterial Endometritis traditionally consists of 3-5 days of antibiotics along with 1-3 days of uterine lavage to help the mare remove debris and bacteria associated with infection.”

Exciting New Treatment for Endometritis

By: Maria Schnobrich, VMD, Dipl. ACT

Maria Schnobrich, D.V.M., Dipl. ACT

Whether you are a manager of multiple broodmares, owner of a sport horse, or have a special pet from whom you want offspring, subfertility can be a cause of significant frustration. While many problems may prevent a mare from becoming pregnant and carrying successfully (ovulation failure, uterine fibrosis, chromosomal abnormalities and tumors), the most common by far is bacterial endometritis (bacterial infection of the superficial lining of the uterus).

The most common bacteria, diagnosed by recovering growth on a culture taken from the endometrium, include Streptococcus zooepidemicus, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. Each of these aerobic bacteria (those that prefer an oxygenated environment) has unique characteristics, clinical signs, and survival adaptations that make treatment a challenge; for example, S. zooepidemicus infections are often associated with a more inflammatory response by the uterus compared with infection by E. coli. Once a pathogenic bacteria has been isolated from the mare’s uterus, it is important to determine the sensitivity of the bacteria to antibiotics in order to make an appropriate treatment plan.

Treatment of bacterial endometritis traditionally consists of 3-5 days of antibiotics along with 1-3 days of uterine lavage to help the mare remove debris and bacteria associated with infection. The antibiotics, which should be appropriate with respect to the isolated bacteria’s sensitivity, can be administered systemically (by oral or intravenous route) or locally (by placing antibiotics directly into the uterus). Because intrauterine placement (uterine infusion) of antibiotics often results in higher tissue concentrations, fewer systemic adverse signs (colitis), and lower costs, it is often the preferred route of administration.

One challenge to treating an infected mare is the occasional bacteria which demonstrates “resistance” to many commonly used antibiotics. Highly “resistant” bacteria leave the veterinarian with few choices, as indicated by a recent finding that many bacteria isolated from the uterus have developed resistance to many commonly used antibiotics(1). These resistant bacteria were shown to demonstrate surprising sensitivity to enrofloxacin (a third-generation fluoroquinolone).

Although enrofloxacin therefore seems a reasonable antibiotic with which to treat susceptible endometris, unfortunately there has been very good evidence that when Baytril® (FDA approved injectable enrofloxacin) is infused into a mares uterus, a severe inflammatory reaction occurs, causing adhesions and bleeding (2) that likely would impair future fertility.

In an attempt to identify an different way to use enrofloxacin, the group at Rood & Riddle, in collaboration with colleagues at Washington State University, developed a water-soluble, commercially available (3) product that allows one to

infuse enrofloxacin in the uterus. This product (a 2.5% enrofloxacin suspension) was tested in a pilot study of 8 mares, and found to cause minimal inflammation and no long-term deleterious effects. This is an exciting finding for those veterinarians treating bacterial endometritis, as it gives us another option for treatment in cases where we had been previously limited.

1. Davis HA, Stanton MB, Thungrat K, Boothe DM. Uterine bacterial isolates from mares and their resistance to antimicrobials: 8,296 cases (2003-2008).

JAVMA 2013;242:977-83.

2. Rodriguez JS, Han S, Nielsen S, Pearson LK, Gay JM, Tibary A. Consequences of intrauterine enrofloxacin infusion on mare endometrium. J Equine Vet Sci 2012;32:106-11.

3. Rood and Riddle Veterinary Pharmacy, Lexington, Kentucky, USA.

Thoroughbred Sport Horse Divisional Award Winners The Thoroughbred Sport Horse Awards, co-sponsored by Rood & Riddle, United States, Equine Federation, 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 all 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 Thoroughbred Sport Horse Awards at USEF-sanctioned events during the show season, and the open divisional 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.

2014 Rookie Winners: • Hunter Division: Pardoned (Jockey Club Name: Proud Chestnut), by Horse Chestnut, out of In by Six. Owned by Kimberly Nevitt of Pa. • Jumper Division: Counting Stars (Jockey Club Name: Cyclone Canyon), by Demidoff, out of Tokyo Spy. Owned by Kathryn Ott of Minn.

• Dressage Division: Embracing Picasso, by Fleet Foot out of Embracing Beauty. Owned

by Patricia Weston of N.J. • Eventing Division: Bayr Necessity (Jockey Club Name: Torvald), by Northern Afleet out of Blue Northern. Owned by Michelle Gauchat of Ky. 2014 Open Winners: • Hunter Division: Early Note, by Seeking Daylight out of Music Music Music. Owned by Richard Blue of Md. • Jumper Division: Panache (Jockey Club Name: Quarter Circle), by Victorious out of Sorted Change. Owned by Chris Falewitch of Neb. • Dressage Division: Mudzima, by Tralos out of Topsy. Owned by Jacqueline Greener of Pa. • Eventing Division: Mensa G (Jockey Club Name: Merisa G), by Colonial Affair out of Fire The Secretary. Owned by Carl Bouckaert, Michael and Natalie Pollar of Ga.

“This is an exciting finding for those veterinarians treating bacterial endometritis, as it gives us another option for treatment in cases where we had been previously limited.”

“The Thoroughbred Sport Horse Awards, co-sponsored

by Rood & Riddle, United States, Equine Federation, 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.”

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Dr. Raul Bras Elected into International Equine Veterinarian Hall of Fame Dr. Raul Bras, a Rood & Riddle Equine Hospital Podiatrist was elected into the International Equine Veterinarian Hall of Fame on Feb. 5.

“I cannot express with words how honored and humbled I feel to accept this award, especially when my peers are the ones who nominated me.”

Established in 1997, the International Equine Veterinarian Hall Of Fame honors veterinarians who have contributed to the knowledge and recognition of proper hoof care for horses.

Veterinarians are nominated in two classes: practicing equine vets who work closely with farriers in the field; and college and industry vets involved in teaching, research or other important aspects of hoof-care education.

Bras graduated from Ross University Veterinary School in 2005 and completed a surgery internship at Rood & Riddle where he stayed the following year as an associate veterinarian. In 2007, Bras completed the farrier program at Cornell University and in 2012 completed certification as a Certified Journeyman Farrier of the American Farriers Association. Bras became a shareholder at Rood & Riddle in 2012.

Bras said, “I cannot express with words how honored and humbled I feel to accept this award, especially when my peers are the ones who nominated me. I have tremendous respect for everybody in the industry including veterinarians and farriers, and all I wanted to do as a professional is what’s best for the horse. I never expected in a million years I would be inducted to the International Equine Veterinarian Hall of Fame. This award is a humbling achievement for me and I express my sincere gratitude to anybody and everybody that has been involved with this award, and throughout my career.”

Bras joins Dr. Larry Bramlage and Dr. Scott Morrison as other Rood & Riddle veterinarians previously honored with this distinction.

“We are extremely proud of Dr. Bras and his induction into the International Veterinarian Hall of Fame. Since the beginning, the shareholders at Rood & Riddle have sought to surround ourselves with the best veterinarians and staff in the world,” said Dr. Bill Rood, CEO of Rood and Riddle.

Rood & Riddle Receives John W. Galbreath Award Dr. Bill Rood and Dr. Tom Riddle were recipients of the John W. Galbreath Award. The John W. Galbreath award presented by the University of Louisville Equine Industry Program is given to those who have created and led successful equine business enterprises.

From left: Dr. Bill Rood, Dr. Tom Riddle and University of Louisville Equine Industry Program Director Tim Capps

Around the Practice...

Rood & Riddle was selected as one of one-hundred businesses across the country as part of the Small Business Revolution. The Small Business Revolution is an initiative formed to highlight small businesses and their importance in the business world.

Award winning photographer Ed Kashi who has worked for National Geographic visited Rood & Riddle to document the clinic.

This photo essay will join others at www.smallbusinessrevolution.org and will be promoted through a large media marketing effort by the company who created it.

Dr. Katie Garrett has been named to the board of directors for the American Association of Equine Practitioners.

She was appointed to a three-year term which expires in 2017.

Dr. Garrett received her bachelor’s degree magna cum laude from Dartmouth College and her DVM degree with distinction from Cornell University. She completed an internship and surgical residency at Rood and Riddle Equine Hospital where she is now the director of diagnostic imaging and is a Diplomate of the American College of Veterinary Surgeons.

The American Association of Equine Practitioners (AAEP) honored Dr. Larry Bramlage at its annual convention held in Salt Lake City, Utah. Dr. Bramlage was recognized for his position and involvement in the industry. The AAEP said, “Throughout their 23 years of On Call service, Drs. Bramlage and McIlwraith elevated the program to its current status within the racing industry and, by extension, the AAEP to its position as a respected authority on equine health and welfare. The 2014 Breeders’ Cup was the pair’s final On Call assignment. Dr. Bramlage is an internationally recognized orthopedic surgeon and a partner at Rood & Riddle Equine Hospital in Lexington, Kentucky.”

A native of Kansas, Bramlage graduated from Kansas State University and taught at Ohio State University before joining Rood & Riddle Equine Hospital, in Lexington, in 1989. He became a partner at Rood & Riddle in 1992.

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Annual Rood & Riddle Report Live Held March 10 “The Rood & Riddle Report Live is a great opportunity for people engaged in the equine industry to learn about the newest developments in veterinary care.”

The annual Rood & Riddle Report Live was held on Tuesday, March 10 at Embassy Suites in Lexington, Ky. A big thanks to the over 250 people who attended the fifth annual client education event. The Rood & Riddle Report Live featured reporting on the latest news published in veterinary journals and developments impacting equine health. A panel of veterinary specialists discussed the newest developments that affect every level of horse owner.

The news program was anchored by Dr. Peter Morresey featuring surgeon Dr. Alan Ruggles, reproduction specialist Dr. Etta Bradecamp, podiatrist Dr. Vernon Dryden, plus a special report from Dr. Bonnie Barr.

“Since our inception in 1986, Rood & Riddle has committed to offering an annual client education event. The Rood & Riddle Report Live is a great opportunity for people engaged in the equine industry to learn about the newest developments in veterinary care,” said Dr. Tom Riddle of Rood and Riddle Equine Hospital.

Sponsors for this year’s event included Boehringer Ingelheim, Hands on Originals, Kinetic Vet, Kentucky Equine Research, Rood & Riddle Veterinary Pharmacy, and Zoetis.

Rood & Riddle in Saratoga Construction Update At this time, the exterior footers and foundations have been poured to ground level.

Interior plumbing and some electrical work was performed prior to the ground freezing.

The next stage involves pouring interior footers, continuing with underground plumbing and underground electrical work. Work had been halted for the last several weeks due to the excessive cold and snowy conditions. Construction has resumed.

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