The Modern
Equine Vet www.modernequinevet.com
Vol 6 Issue 3 2016
Staying Alive
Delivering CPR to Foals Supporting foals in respiratory distress Surgery probably best for ulnar fractures Prednisolone may not increase laminitis risk
Table of Contents
Cover story:
alive: 4 Staying Delivering CPR to foals Cover photo Shutterstock/smereka
Respiratory
Supporting foals with CPAP .................................................................................................9 Orthopedics
Surgery probably best for ulnar fractures.....................................................................12 Prednisolone may not increase laminitis risk..............................................................14 News
Dexamethasone during pregnancy does not affect foal growth..........................................................................3 Zoetis launches guess-the-weight contest.............................11 Julie Dechant wins teaching award ..............................................15 Steve Kraus joins International Horseshoeing Hall of Fame ...........................................................................................16 Patterson wins the BOLD ..................................................................17
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Issue 3/2016 | ModernEquineVet.com
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news notes
Maternal treatment with dexamethasone during pregnancy affects glucose and insulin regulation in the mare, results in lower placental size but does not significantly alter foal growth after birth, according to a recent study. In addition, researchers from the University of Cambridge in the United Kingdom found that dexamethasone exposure in utero does not significantly alter glucose and insulin metabolism in the foal after birth but does reduce amino acid uptake. The researchers wanted to know how dexamethasone affected the metabolism (in particular glucose regulation) of pregnant mares and their offspring. They administered intramuscular dexamethasone (200 µg/kg) to six pregnant mares on three occasions at 48-hour intervals. Five pregnant mares received placebo injections. Serial IV glucose tolerance tests were performed on all the horses 48 hours before the first dexamethasone or placebo treatment, 24 hours after the second treatment and 72 hours after the final treatment. Baseline plasma concentrations of glucose, insulin and lactate were similar in both treatment and control groups. Within three days of commencing treatment, concentrations were significantly higher in the dexamethasone group than in the control group. Posttreatment, there was no difference in glucose or lactate concentrations but plasma insulin remained significantly higher in the treated group. The maximal glucose concentrations following dexamethasone treatment were not significantly different between the two groups; however, the magnitude of the insulin response to glucose was significantly higher in the dexamethasonetreated group and the insulin response was more prolonged, indicating a greater pancreatic β-cell response to exogenous glucose. All foals were delivered uneventfully. They were followed after birth and for 12 weeks. At birth, the placental area and femur length were significantly lower in the dexamethasone group compared with the control group. However, there was no difference in growth rate of foals up to 12 weeks or plasma cortisol concentrations between groups. The foals’ pancreatic β-cell response to glucose was unaffected by maternal dexamethasone treatment with
For more information: Valenzuela OA, Jellyman JK, Allen VL, et al. Effects of maternal dexamethasone treatment on pancreatic β cell function in the pregnant mare and post natal foal. Equine Vet J 2016 Feb. 15 [Epub ahead of print]. http://onlinelibrary.wiley.com/doi/10.1111/evj.12560/abstract
Shutterstock/Andrew Lever
Dexamethasone during pregnancy does not affect foal growth
no difference between groups; however, there was a difference in the response to arginine, with a significantly lower insulin response in the dexamethasone group foals compared with the control group at 12 weeks old. This suggests maternal dexamethasone treatment suppresses the ability of insulin to stimulate uptake of amino acids, they said. MeV
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cover story
Staying alive:
Delivering CPR to foals
Shutterstock/Christopher Gardiner
B y
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M a r i e
You know that “earworm” song, “Staying Alive,” the one that just can’t get out of your head after you hear it? It could just be a life saver, SallyAnne L. Ness, DVM, DACVIM, said at the 61st Annual Convention of the American Association of Equine Practitioners in Las Vegas. When delivering cardiopulmonary resuscitation (CPR), compression to the beat of a song like “Staying Alive” can help you deliver the correct number of compressions per minute, said Dr. Ness, who is an instructor of Large Animal Medicine in the Department
Issue 3/2016 | ModernEquineVet.com
R o s e n t h a l , of Clinical Sciences at Cornell University College of Veterinary Medicine in New York. “Birth is an emergency, particularly for those who fail to choose life when coming into this world, and foals that fail to spontaneously breathe at birth are ones that require immediate intervention for any chance of a positive outcome,” Dr. Ness explained. Acting quickly means being prepared, she said. If possible, leave a portable neonatal crash kit at the stall with all the equipment that might be needed if CPR is indicated, she said.
M S Use a tackle box to organize drugs and syringes for easy access, and make sure to restock any used items after each use, because there will be no time to run for extra supplies in the event of an emergency. A premade CPR emergency drugs dosage chart can also be extremely helpful in CPR scenarios. Not having to do calculations in an emergency can prevent many errors, she explained. “Try to be as prepared as possible,” she said. “At any high-risk birth, have all of your tools out. Check your ET tube cuffs, Ambubag seal, and pre-load any syringes with medications you think you
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Consult your veterinarian for assistance in the diagnosis, treatment and control of parasitism. Do not use in horses intended for human consumption. When using PANACUR® (fenbendazole) Paste 10% concomitantly with trichlorfon, refer to the manufacturers labels for use and cautions for trichlorfon. 1
PANACUR® (fenbendazole) POWERPAC Equine Dewormer product label.
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Images courtesy of Dr. Ness.
cover story
Compressing to the tune of "Staying Alive" helps you deliver the correct number of compressions. From left: Intubating the foal, giving it air, the correct position for delivering CPR. Finally, if there are two people, one can deliver CPR, while the other applies ventilation.
may need.” In foals that are slow to breathe upon birth, sometimes tactile stimulation is enough to get the foal going. Place the foal in sternal recumbency, rub it with towels, tickle the insides of the ears and nose. These sensations may be enough to initiate respiration. For those that are still unresponsive, clear the airway either manually or with a bulb syringe. Listen to the heart and lungs, and concurrently palpate for any pulses. Get a heart and respiratory rate. At birth, a normal heart rate (HR) should be more than 60 beats per minute (bpm), but usually it is up close to 80 bpm or 100 bpm. Identify any rib fractures or congenital deformities. “These are important because they are com6
Issue 3/2016 | ModernEquineVet.com
Sometimes tactile stimulation is enough to get a newborn breathing, but others will require CPR. mon in dystocias, which are often the foals that need CPR. And they will affect your ability to do CPR,” Dr. Ness said. “Rib fractures are
clearly not very conducive to chest compression.” The goal is to do this initial exam in less than 1 minute. “If you have the luxury of having students or helpers around, sometimes giving everyone a job can be quite helpful. We often assign someone to the heart, someone to the lungs and then a leader to orchestrate the resuscitation efforts,” she said. If the foal is still unresponsive after a fairly short time—about 10 to 15 seconds—then initiate ventilation. There are several options for ventilating a foal; Dr. Ness said that intubation is probably the easiest option. Put the foal in lateral or sternal recumbency and extend the head as much as possible to make it eas-
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cover story
ier to pass the endotracheal (ET) tube ventral medially into the trachea through the nose or mouth with the neck extended and the larynx stabilized. After placing the tube, secure it with tape, inflate the cuff, connect the bag and give a test breath, she said. “Palpate the ventral neck and feel the tubes. You should feel one. If you feel two, you are probably in the esophagus,” she explained. An abdominal bloat with your test breath confirms the misplacement of the tube, she said. Remove the tube and try again. “Don’t forget to inflate the cup. It is easy in all the chaos to forget, but you won’t be able to inflate the lungs without it,” she warned. If for some reason the foal cannot be adequately intubated, there are other ways to ventilate the foal, she said. One option is mouth-to-nose resuscitation, which Dr. Ness said can be effective. Occlude the lower nostril with your hand and blow into the upper nostril, she said. Another is to use a face mask made for foals and a self-inflating pump. Hold that first inspiration for three to five seconds to help inflate the lungs and clear the fetal fluids. Then provide quick short breaths thereafter. The goal is to give the foal about 10 breaths per minute. “All of the oxygen in the world to the lungs will not help the body if there is no blood circulation,” she said. So, reassess every 30 to 60 seconds to look for worsening bradycardia and a lower HR. An HR of <40 bpm would indicate it’s time to initiate chest compressions and consider drug therapy. To do the chest compressions, Dr. Ness prefers to be behind the foal, bracing the head with her knee, to apply compressions. Good compression technique is important, she said. Keep your 8
Issue 3/2016 | ModernEquineVet.com
For CPR, keep your back straight, elbows locked and put one hand over the other. Use the back and core muscles to apply pressure. back straight, lock your elbows, put one hand over the other and use the back and core muscles to apply pressure. Your goal is 100 to 120 chest compressions per minute, she said. “Push hard, push fast and aim for one-third compression of the chest wall. Some people advocate singing the tune ‘Staying Alive’ in your head and compressing to the beat and that will put you right in the 10–120 range,” she suggested. She said that the song, “Another One Bites the Dust” also works very well. “So, it will be up to you to decide your CPR mantra,” she said. Don’t pause once compressions start. “In other species it has been found that it takes one to two minutes to circulate one full passage of blood through the peripheral circulation, and every time you stop compressions, you lose that headway,” she said. “Use the back and core muscles instead of the arm muscles to avoid fatigue,” she said. “If there are several individuals present, they can switch off to avoid fatigue and ineffective compressions,” she said. An intubated foal will not need coordinated compressions. How-
ever, if the foal is not intubated, pause every 30 compressions to administer two breaths and then resume compression. The overall CPR protocol with concurrent ventilations is 30 compressions for every two breaths, according to Dr. Ness. Every two minutes, do a quick vital check looking for spontaneous circulation, heartbeat, a palpable pulse and spontaneous breathing. Continue CPR until spontaneous breathing and HR is >60 bpm. “If neither of those has occurred by 15 minutes, then success is highly unlikely. Foals that do respond to CPR are considered high-risk neonates and should be referred to a hospital for further treatment and monitoring,” she said. In some cases, medications that increase blood pressure and stimulate the heart and lungs can be administered to aid in the physical resuscitation procedure. “If the foal has been dead for any length of time, he is unlikely to respond to any CPR. However, acute cardiopulmonary arrest at the time of delivery can respond favorably to immediate CPR. At the time of birth, we rarely have that information available to us, so you have nothing to lose in doing CPR on a dead foal. In the owner’s eyes, it is usually better to do anything you can rather than nothing at all.” she said. Owners usually look on the effort favorably, and if the cardiopulmonary arrest is acute at the time of delivery, some foals respond and do well. Dr. Ness said that a free online app is available with more information at Veterinary Advances (https://appsto.re/ie/lZ0iG.i.) “CPR is a rewarding and lifesaving procedure that can result in a positive outcome when delivered quickly and with proper training,” MeV she said.
Respiratory
Supporting foals with
CPAP
Stabilizing a foal with respi-
Images courtesy of Dr. McKean
ratory disease in the field can be tricky, because access to proper ventilator-assisted respiratory support can be limited by space, ex-
Equipment needed for continuous positive airway pressure
pense and operator expertise. Continuous positive airway pressure (CPAP) therapy is being investigated as a possible stopgap to provide an inexpensive, non-
Could someday be a simpler way to stabilize foal in respiratory distress B y
P a u l
B a s i l i o
invasive method to stabilize foals during transport to a facility that offers more invasive ventilator interventions. “CPAP is the treatment of choice in human neonates,” said Rosemary McKean, BVetBio/BVSc (Hons. 1), a veterinarian at Moorong Veterinary Clinic, in Wagga Wagga, New South Wales, Australia. “Human neonates have stiff lungs, floppy chests and higher oxygen requirements—all similar characteristics to foals and their ventilatory requirements.” CPAP therapy can decrease the work of breathing by providing a pneumatic splint to reduce airway collapse, which optimizes functional residual capacity and pulmonary compliance. It also acts to increase airway diameter and reduce the pressure needed to generate flow. In addition, CPAP increases alveolar recruitment and perfusion, which improves oxygenation and, in some cases, CO2 removal. Lung inflammation is also reduced by minimizing the shear forces generated by repeatedly opening and closing the alveoli. Permissive hypercapnia associated with CPAP is thought to reduce pulmonary inflammation, but there is no consensus for this effect in human medicine. ModernEquineVet.com | Issue 3/2016
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Images courtesy of Dr. McKean
Respiratory
Delivering CPAP to a foal in respiratory distress
The setup
“Most ventilators have a CPAP function, but most ventilators are [used] on the surgery side,” Dr. McKean said at the 61st Annual Convention of the AAEP. “Those of us on the medicine side sometimes have trouble gaining access to them for long enough periods.” Dr. McKean and colleagues wanted to test the effects of CPAP on foals to see if it could deliver the same positive effect for horses that it provides infants. They devised a cost-effective CPAP pro-
Whither O2 insufflation?
totype system that could deliver a specified level of therapy to a foal and tested it. The therapy was then evaluated by measuring the cardiorespiratory response following pharmacologic induction of respiratory insufficiency. The prototype was built using a human CPAP machine connected to a veterinary anesthesia mask with an added rubber diaphragm. A positive end-expiratory pressure (PEEP) valve was fitted and set to 10 cm H2O. Oxygen supply tubing and a rudimentary air res-
ervoir helped to dampen the large expiratory excursions. The team’s main question was whether CPAP therapy administered at 10 cm H2O with 5 L/min of oxygen could provide effective respiratory support in sedated juvenile foals when compared with masked or nasal insufflation of oxygen at 5 L/min.
The results
The CPAP setup showed reduced respiratory rate, increased oxygen usage and CO2 production, and
Nasal insufflation is cheap, easy, and it increases the partial pressure of oxygen (PO2), so why fix what isn’t broken? “Nasal insufflation of oxygen is not ideal,” Dr. McKean said. “It can cause alveolar collapse due to nitrogen washout. This is more of a problem in sick, recumbent foals with positional atelectasis and suspected lung pathology. Hyperoxia also decreases the hypoxic vasoconstriction, causing increased perfusion to an area of poor ventilation. The hyperoxia can actually reduce oxygen loading in the tissues by causing vasoconstriction in vital organs.” Dr. McKean also noted that prolonged administration of a high fraction of inspired oxygen is a major risk factor for acute lung injury. 10
Issue 3/2016 | ModernEquineVet.com
physiologically acceptable pressure of oxygen (PO2, PCO2 and pH) levels when compared with mask or nasal insufflation of oxygen. “The CPAP system provided an improvement in clinical respiratory support in foals without ventilator-assisted respiratory therapy,” Dr. McKean explained. Following sedation, a decrease in the tidal volume and the minute alveolar ventilation was noted. CPAP and mask oxygen resulted in a significantly greater tidal volume versus nasal insufflation. CPAP slowed the respiratory rate by increasing the expiratory time relative to inspiratory time. Even with the changes in respiratory rate and tidal volume, peak inspiratory and expiratory air flows
did not change meaningfully with treatment. “Changes in heart rate or mean arterial pressure were not observed in this study,” Dr. McKean noted. “This suggests that CPAP at 10 cm H2O was not associated with cardiovascular changes attributable to increased thoracic pressure. Other complications that have been observed in human patients, such as valve occlusion, barotrauma and aerophagia, were not observed in the horses.” CPAP was superior to mask delivery of oxygen in the reduction of respiratory rate while producing the same tidal volumes. CPAP also enhanced oxygen uptake and CO2 removal versus delivering oxygen through a mask.
“This suggests that the foals had to expend less work on breathing to maintain the same blood gas parameters,” Dr. McKean said. “This system is suitable for further prudent testing as well as optimization in well-monitored foals with spontaneous lung pathology. If veterinarians are going to try CPAP, this must be done with great care including full monitoring of clinical, blood gas and respiratory parameters.” Although more study of the equine CPAP system is needed for optimization of the settings, as well as for improvement of the fit of the equipment, this may one day be an appropriate way to help foals in respiratory distress, Dr. McKean said. MeV
Zoetis launches Guess the Weight Sweepstakes on EQStable Zoetis kicked off its Guess the Weight Sweepstakes Sweepstakes, a new online sweepstakes specially to help teach horse owners about the importance of accurate dosing of dewormers. Through March 31, 2016, Facebook users can visit the EQStable page from Zoetis, for a chance to win a VIP experience to the 2016 Rolex Kentucky Three-Day Event in Lexington. “Zoetis has taken a leadership role in customized deworming through our individualized deworming program and will have more exciting resources coming soon,” said Tracey Higgins, marketing manager, Equine Pharmaceuticals, Zoetis. “The guess-the-weight Sweepstakes allows us to bring attention to the need for accurate dewormer dosing to help prevent parasite resistance while giving one winning horse owner an opportunity to attend a top equestrian event.” To enter for a chance to win, eligible participants will be prompted to submit their best Guess the Weight Sweepstakes of five different horses based on photos that display with each entry form. A winner will be selected and notified personally on April 1, 2016, and then announced via Facebook on April 4, 2016. The winner of the guess-the-weight Sweepstakes will receive a package for four to the 2016 Rolex Kentucky Three-Day Event from April 28 through May 1, 2016, at the Kentucky Horse Park in Lexington, Kentucky. The package includes:
• Hotel accommodations for four; • Four admission tickets for all four days to the event, the International Trade Fair, the Sponsor Village and the Kentucky Horse Park; • Four tickets to the Ringside Sponsor Hospitality Tent featuring closed-circuit monitors of all the action along with a bar, beverage service and a daily lunch buffet; • Four tickets to Thursday’s and Friday’s Rolex Stadium for Dressage with headset commentary; • On‐course Hospitality in the Kentucky Club for Saturday’s Cross‐Country Day; and • Personal cross-country course walk with Rolex competitor Doug Payne, and other prizes. MeV To learn more and to enter the Guess the Weight Sweepstakes Sweepstakes, visit https://a.pgtb.me/dMS0lH. ModernEquineVet.com | Issue 3/2016
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orthopedics
Surgery probably best for ulnar fractures The injury tends to heal faster with surgery over conservative treatment.
Shutterstock/AsyaPozniak
Horses do about equally well
whether they received surgery or conservative treatment (stall rest, sling, etc.) for an ulnar fracture, but owners were dissatisfied with conservative treatment due to concerns about prolonged hospitalization and stall confinement. Because of the time it takes to heal the injury without surgery, the two treatments are fairly equal in cost, however, surgery allows faster healing resulting in a faster return to work, according to recent study results presented at the BEVA Congress, sponsored by the British Equine Veterinary Association meeting in Birmingham, United Kingdom. Therefore, the researchers came down on the side of surgery. The ulnar fracture is a relatively
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common fracture in foals and adults and is usually due to direct trauma, kick or fall injuries, according to Soren Ladefoged, MSc, DVM. They incur varying degrees of soft tissue trauma, and there is often posttrauma fragment displacement during contraction of the triceps muscle. “That they do better with surgery is really nothing new,” he said, citing several studies supporting the surgery for ulnar fractures, particularly the use of the dynamic compression plate (DCP) and locking compression plate (LCP) for fixation. “These animals are usually much more comfortable as soon as the leg is fixed in extension and they are allowed to bear weight,” he explained. To compare surgical with conservative treatment of ulnar fractures, Dr. Ladefoged and his colleagues
K a t h l e e n
reviewed medical records and radiographs over a 10-year period (2002–2010) at the Equine Clinic, University Animal Hospital, Swedish University of Agricultural Services, Uppsala. In addition, they conducted a standardized telephone follow-up questionnaire. They studied shortand long-term outcomes, costs of treatment and owner satisfaction. The surgically managed horses included 11 horses (five Icelandic horses, three Warmblood, two ponies, and one mixed breed) ranging from 4 to 23 years (mean 9 years), Dr. Ladefoged reported. There were five type 4 fractures, five type 5 fractures and one type 2 fracture, and six of the 11 fractures were open. Total hospitalization time was two to 41 days (mean 21 days). Six fractures were treated with
O g l e
LCP and five with DCP, Dr. Ladefoged said, explaining that over the 10-year period of the study, the clinic changed its fracture fixation technique from the DCP to LCP. Among the surgically treated horses: • two suffered refractures during recovery from anesthesia; • o ne horse developed severe laminitis after a longer transport back to its home country against the recommendation of the veterinarian and was euthanized; • one horse came down with a surgical site infection, which healed after removal of the implant and made a full recovery; • o ne horse had a persistent lameness and suffered a fracture during recovery from anesthesia for removal of the implant at another clinic; and • o ne horse had post-surgery colic that resolved with medical treatment. Seven of the 11 horses (64%) survived more than one year, and five horses (45%) returned to their previous athletic level, Dr. Ladefoged reported. “What weighs heavily in these small case numbers is the fact that we didn’t do assisted recovery. If we want to do these types of surgeries we really should assist these horses,” he said. Assisted recovery means supporting and attempting to control the horse during recovery. This can be done in several ways. Most hospitals use head and tail rope recovery as this is the most financially feasible method of recovering horses after general anesthesia, he said. Helping the horse when it attempts to get up provides
the least traumatic recovery. Nine horses were managed conservatively, which involved stall confinement and a full limb splint, with and without a sling, he said. Six had type 4 fractures, two type 5 fractures, and one horse had a type 1b fracture. Six of the 9 fractures were open. Hospitalization time ranged from 30 to 61 days (mean 55 days). Three developed complications, two horses healed with fibrous callus resulting in non-union, and one was euthanized due to persistent lameness. Six of the nine (67%) survived more than one year, and four horses (44%) returned to previous athletic level, Dr. Ladefoged reported. “What is important is we couldn’t see any difference in survival beyond one year between these small groups and return to athletic level,” Dr. Ladefoged said. Noting that the hospitalization time is significantly longer for horses treated conservatively, Dr. Ladefoged explained that Scandinavian animal health laws prevent the transportation of severely lame animals, which often prevents the hospital from releasing a severely lame horse for transportation back home on a truck. “Many of these horses treated conservatively come in without having had a discussion of what will be required to make this horse sound again,” he said. To adjust for inflation, the investigators standardized costs to a fixed time and calculated the costs from that day. “We couldn’t see a difference between hospitalized and conservatively treated horses and horses that were treated surgically,” Dr. Ladefoged said, adding, “I think it is a valid point to men-
tion to our client in these cases.”
Owner satisfaction
In addition to similar outcomes and costs between the surgically and conservatively managed horses, the investigators found that the owners were much more satisfied when they had their horses treated surgically. “A large proportion of the owners who had their horses treated conservatively expressed welfare concerns about prolonged stall confinement, the sling and excessive splinting. Many of the owners said they would not go for conservative treatment again,” Dr. Ladefoged said. “Veterinarians recommending treatment for cases of ulnar fractures should be aware that most can be treated surgically with a good outcome,” he continued. “Owners and referring veterinarians should be advised that prolonged hospitalization of horses treated conservatively may bear the same costs as surgical treatment, which offers earlier discharge and return to function.” He specifically cautioned about the disadvantages of conservative treatment. “If you want to treat these horses conservatively and you want to do it by stall rest, cross tying will eventually result in a horse being very tired and trying to lie down,” he said. “If you want to achieve longterm resolution and a good chance of the horse returning to athletic soundness– at least as the figures are today—I think it would be wrong to recommend conservative therapy as the therapy of choice.” Dr. Ladefoged is a resident in large animal surgery at the Department of Large Animal Sciences, Medicine and Surgery, University of Copenhagen. MeV
For more information: Ladefoged S, Wallin J, Toth T, Andersen PH. Outcome and owner perception of conservative and surgical management of fracture of the ulna in 20 horses. Equine Vet J 2015;47:17–18. doi: 10.1111/evj.12486_40 ModernEquineVet.com | Issue 3/2016
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Orthopedics
Prednisolone may not increase laminitis risk Veterinarians are concerned that giving oral prednisolone to horses or ponies may increase the risk of laminitis, but a recent study has found that this is not the case. In this retrospective case-control study, researchers analyzed clinical records from ambulatory practice over a period of 13 years. Horses that had received treatment with oral prednisolone (total 416) were compared against two time-matched controls (total 814) that had not received prednisolone treatment and had been seen by the same veterinary surgeon before and after the horse which had been given prednisolone. The median age in both groups was 13 years, and there was no significant difference in breed or sex distribution between the groups. Overall laminitis incidence rate and laminitis rate during prednisolone treatment were calculated and where more than one episode of laminitis occurred in the same horse, only the first was included. There was no statistically significant difference between the prednisolone-treated and the control groups in overall incidence of laminitis or incidence during the treatment period. In total, there were 62 cases of laminitis, giving an overall incidence of laminitis of 3.19 per 100 horse years at risk. In the non-prednisolone treated group, 32 episodes of laminitis occurred over the study period, giving an incidence of 3.46 per 100 horse years at risk. In the prednisolone treated group, 16 laminitis cases occurred, giving an incidence of 2.6 per 100 horse-years at risk. Seven of these laminitis episodes occurred during the
prednisolone treatment period, giving an incidence of 20.84 per 100 horse years at risk during the period prednisolone was being given. The time at which the laminitic episode occurred in relation to prednisolone treatment varied (median 34 days after commencement of treatment), with three cases developing laminitis more than one month after the end of prednisolone treatment. The horses had been treated with prednisolone for a variety of conditions, and there was no association between reason for treatment and risk of laminitis, according to the researchers. Of the 16 cases of laminitis in the prednisolone group, six were investigated for underlying endocrine disease and all six were confirmed to have either pituitary pars intermedia dysfunction (PPID) or equine metabolic syndrome (EMS). There was no significant difference in the prevalence of these endocrine conditions between the treated and non-treated groups, but across both groups, horses with PPID or EMS had a significantly higher incidence of laminitis compared with horses without endocrine disease, although within the prednisolone group, laminitis rates during treatment were not different in those with and without endocrine disorders. Previous history of laminitis and increasing age were associated with increased risk of laminitis. Of the 15 horses euthanized because of laminitis during the study, three were from the prednisolone group and 12 from the control group, with no association between prednisolone treatment and mortality due to laminitis. MeV
For more information: Jordan VJ, Ireland JL, Rendle DI. Does oral prednisolone treatment increase the incidence of acute laminitis? Equine Vet J 2016 Feb. 15 [Epub ahead of print]. http://onlinelibrary.wiley.com/doi/10.1111/evj.12565/abstract
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Steve Kraus joins the International Horseshoeing Hall Of Fame
Click here to watch video Steve Kraus shapes the toe clip of a custom horseshoe.
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Issue 3/2016 | ModernEquineVet.com
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Cornell Head Farrier Steve Kraus was inducted into the International Horseshoeing Hall Of Fame in Louisville, Kentucky. In an interview just prior to the event, Mr. Kraus reflected on his 50 years in the business, and said he has no plans to retire. (A video overview of Kraus's career, narrated by his predecessor, Mike Wildenstein, was played during the ceremony and can be viewed on YouTube.) A fan of the TV westerns of the 1950s, he decided at about age 10 that he would be a cowboy. When his parents decided to send him to sleepaway camp for the first time, the young Kraus had one criterion: the camp had to have horses. And so he found himself in northern Pennsylvania, at a camp where the outdoor activities included horsemanship. “It was probably a life-changing experience,” said Mr. Kraus. His career aspirations
broadened that first year, from the idea of being a cowboy to discovering horsemanship as a real interest. Mr. Kraus also watched the camp horses being shod. “It fascinated me that you could do this to help a horse. I thought, ‘If I’m going to be a well-rounded horseman, I should know how to shoe’.” The camp owner’s son was also interested, so the owner hired a veterinary student from Texas A&M University for a summer to teach them both. By the time he enrolled at Cornell University in 1968, Mr. Kraus had five years of shoeing under his tool belt. It wasn’t long before Mr. Kraus turned up at the campus Farrier Shop, where he met Resident Farrier Harold Mowers, who was later inducted into the Hall of Fame. “It was another life-changing experience,” said Kraus. “The idea of therapeutic and specialty shoeing was very new to me. Now I was really seeing what horseshoeing was all about. I became fascinated all over again. I would ask Harold questions, and he was very good to me. I spent a lot of time here, and it opened my eyes to the profession of farriery.” The industry was experiencing a slump at the time, brought on by the steady replacement of horses with cars, trucks and tractors for transportation and farming. “A century before, when there were hundreds of thousands of horses working in cities, they had very good tools and shoes,” said Kraus. “When horses disappeared during the Depression and WWII, and the cavalry, which trained the best farriers, went away, it faded to a few older guys preserving the craft and trade. Harold Mowers was one of them. By this time there were very limited options in shoes and tools. I had to learn the craft of making shoes and tools—and a whole
new world opened up for me.” Due to the lack of choice in shoes and tools, he started a second business, making, procuring and selling farrier specialty tools such as punches, hammers, tongs and selling horse shoes and nails. Among his friends at the time was Doug Butler, another eventual Hall of Fame farrier. One day Mr. Butler invited Kraus to a meeting with representatives of Mustad, a Swedish company that dominated the market for horse shoe nails everywhere in the world except the United States. Mustad hired Mr. Kraus as a consultant and began sending him to competitions and conventions to find out what American farriers were looking for in a nail. His friendly, upbeat manner again served Kraus well as he talked to the exhibitors and professionals, and he returned with ideas for new packaging as well as designs for nails that appealed to American farriers. At his urging, Mustad began sponsoring competitions and educational programs for clinicians. Eventually the company became the largest producer and marketer of horse shoes, nails and farrier tools in the U.S. In a profession that often entails a limited circuit from one barn to the next, Kraus ended up traveling all over the U.S., Canada and South America on behalf of Mustad. Mr. Kraus continues to work with Mustad to improve horse shoe nails. At the same time, they are searching together for the Holy Grail: shoes that do not have to be nailed onto hooves. He helped Mustad pioneer the use of glue-on shoes, although Kraus freely acknowledges that they are more expensive and more time-consuming than nailed-on shoes and best used for therapeutic purposes. Mr. Kraus also field tests new nail designs, tools
and hoof care products like Thrush Buster and Tuff Stuff for Mustad. As head of the Cornell Farrier Program, Mr. Kraus teaches his students the theory behind basic and corrective horseshoeing and hoof trimming, therapeutic methods, splint fabrication and more,
Julie Dechant wins teaching award
Julie Dechant, associate professor of clinical equine surgery, emergency and critical care, Department of Surgical and Radiological Sciences, School of Veterinary Medicine, at the University of California at Davis, College of Veterinary Medicine received a Distinguished Teaching Award for Graduate and Professional Studies from the university. Her faculty colleagues, residents and students regard her as an exceptional instructor with a creative and effective teaching style. Adjectives used by vet students to describe her teaching include dedicated, amazing, enthusiastic, well organized, approachable and empowering. Residents in the veterinary school appreciate her genuine contributions to their professional development and growth through her mentoring, humble demeanor, sense of humor and exceptional intellect. Her faculty peers value her leadership in redesigning curricular content and her special skills as both a didactic and MeV clinical instructor.
followed by hands-on practice under his supervision. He still travels, giving lectures about horseshoeing topics nationwide. Back at Cornell, Mr. Kraus runs an annual Farrier Conference, now in its 32nd year. His other duties include caring for the feet of patients at Cornell’s equine and farm animal hospitals. This entails trimming the hooves of a steer the size of an SUV one day and devising corrective glueon shoes for a Thoroughbred colt the next. Mr. Kraus is also the farrier for the Cornell Polo and Equestrian Teams. An avid rider and polo player himself, he owns and trains polo ponies at his farm in Truman-
sburg, NY, plays outdoor polo during the summer, and coaches and umpires for indoor polo at the Cornell Equestrian Center during the rest of the year. “All horseshoeing is about problem solving,” Kraus declared. “That’s why, even after 50 years, the profession has not lost its appeal.” Founded in 1992 and located in the Kentucky Derby Museum, the hall honors farriers around the world who have made significant contributions to the profession. Nominations are submitted by peers, trainers, veterinarians, horse owners, friends and family members, and winners are chosen by current hall members. MeV
Patterson goes for the BOLD Patterson Companies was awarded an Association for Corporate Growth (ACG) BOLD Award. Patterson Companies, nominated because of moves made to refocus its corporate strategy and scope of business, was one of three finalists in the Corporate Large category. In 2015, Patterson Companies expanded its animal health segment through the strategic acquisition of Animal Health International, while divesting its rehabilitation segment, Patterson Medical. “We are now well positioned to focus on developing our highly synergistic dental and animal health businesses, accelerating return on our investments and delivering additional shareholder value,” said Scott Anderson, Patterson Companies chairman, president and CEO. During his award acceptance, Anderson recognized the tremendous work being done by another BOLD Award recipient, Loaves and Fishes, a local nonprofit working to end hunger in Minnesota. To show support for the organization and its commitment to providing fresh, healthy produce for the underserved in Minnesota, Patterson Companies made a $25,000 donation to Loaves and Fishes. MeV
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