The Modern Equine Vet - October 2022

LEGAL

AAEP Releases Equine Cutaneous Leishmaniasis Guidelines

The American Association of Equine Practitioners (AAEP) published comprehensive guidelines for managing equine cutaneous leishmaniasis, a nonfatal infection that causes cutaneous lesions usually appearing as nodules on the head, pinnae, scrotum, legs and neck.

Although rare in the United States, equine cutane ous leishmaniasis is endemic in tropical and subtrop ical regions of the world, including South America, western and central Europe, and the Middle East. The most common mode of transmission is through bites of the sandfly.

Most U.S. cases have occurred in horses with in ternational travel history or those recently imported from endemic areas. However, cases have been docu mented in horses that have never left the United States, according to the AAEP. As an OIE-reportable disease; suspect or confirmed cases should be reported to the U.S. Department of Agriculture and state animal health officials.

The infection is not directly contagious; however, confirmed diagnosis in 1 horse may suggest the pres ence of infected vectors in the area and the need to implement vector-control measures. Most clinical

Cowtribe First Investment of BI Social Engagements

Cowtribe is the first recipient of investment and nonfinancial support from the Boehringer Ingelheim So cial Engagement (BI SE) initiative, a program which aims to close a critical financing gap for businesses in vulnerable communities. Cowtribe, a last-mile veterinary delivery company from Ghana, leverages technology to help coordinate deliveries of veterinary vaccines and other animal health products to rural and underserved communities, where many farmers depend on just a few animals.

With innovative solutions, such as software sup ported demand and supply matching, as well as a part nership for drone delivery, Cowtribe bridges the final, critical last mile to get animal medication and veteri nary vaccines to smallholder farmers in remote areas.

BI SE was launched in 2021 to provide investment and non-financial support, together with comple mentary partners and by engaging Boehringer Ingel heim’s employees to help scale up solutions to create systemic change.

“Every year, smallholder farmers lose about 25% of their livestock, due to preventable diseases.,” said Ilka Wicke, global head of Making More Health at BI. MeV

cases in horses spontaneously resolve within 3 to 6 months, although therapeutic intervention may be performed for persistent or recurrent cases.

“While cutaneous leishmaniasis in horses is fortu nately not fatal, Leishmania organisms in people and dogs can result in systemic and fatal syndromes. So horses may serve as sentinels of infection,” said guide lines co-author Sarah Reuss, VMD, DACVIM, equine technical manager with Boehringer Ingelheim. MeV

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IS FROZENTHAWED SEMEN

as Viable as Fresh, Cooled?

By Marie Rosenthal MS

Many horse breeders resort to shipping frozenthawed semen when fresh, cooled is not available, but is it a viable alternative?

It just might be, according to Peter Daels, DVM, PhD, ECAR, DACT, a professor of veterinary medi cine, at the University of Ghent, in Belgium, who pre sented a small study at the annual British Equine Vet erinary Association Congress where he and his 2 PhD students, Margo Verstraete and Machteld van Heule, looked at the differences between fresh, cooled semen and frozen-thawed semen.

“People don't talk about this because they don't like to tell the client that, ‘Hey, I just pulled some frozen se men out the freezer, and I'm sending you this instead of the real fresh, cooled semen,’” he said. “Nobody really mentions it. But if you start asking around, it turns out that, it's not infrequently used.”

He said he began the study because “we noticed that for more and more stallion stations and veterinarians that deal with a lot of fresh and frozen semen, when the stallion is not available to ship out fresh, cooled semen, they often resort to frozen-thawed semen that is then repackaged as a cooled liquid semen,” he explained.

“It seems that the results are actually quite accept able.”

Dr. Daels wanted to do a practical test—one that rep resented real-world conditions—to assess the motility and the viability of frozen-thawed semen and determine if it was a reasonable alternative to fresh cooled semen.

They looked at 2 separate times—8 hours and 24 hours—because the shipping courier service in Bel gium and The Netherlands allows them to ship semen out in the morning, so it can get to the mare in the after noon. This allows same-day insemination (the 8-hour

time point). For those that were further away, they also looked at the 24-hour time point.

“We had 2 cooled storage protocols and 31 stallions. In the study of all ages and of all breeds, we thawed that semen in a very classical way—by putting it in a warm water bath at 37°C for 30 seconds, and diluting it in a

common semen extender, INRA96. The samples were either placed immediately in a passive cooling box for 8 or 24 hours or placed in a refrigerator at 4°C for 30 minutes and then transferred to a passive cooling box. Finally, we checked the viability by looking at the mem brane integrity, and the total and progressive motility.”

They had 2 straws per stallion, which was divided over 5 aliquots for a final dilution of 1:5. The first ali quot was the quality control for the batch of frozen se men, warming it up for 5 minutes at 37°C and checking the concentration, motility and viability as a baseline.

Then 2 aliquots stayed in the cooling box for 8 or 24 hours and were removed and submitted to the same warming protocol as the control. The 2 final aliquots were put in the refrigerator for 30 minutes and then moved into the cooling box for 8 or 24 hours, which he said was an error by one of the students, who thought it should go in the refrigerator while she did other prepa rations. They decided to check its characteristics, too.

“There is a little story behind [the fourth and fifth aliquot],” he admitted.

“The student that did the preliminary experiments for the present study thought it was convenient to put the first batch of straws that she had thawed in the refrigerator, while she prepared a second batch. And then when she was all done, she put all the outputs in the cooling boxes. And lo and behold, when we looked at the data, it turned out that there might be a slight difference between the 2.

“So, we integrated those 2 groups in the final ex periment and then analyzed the 2 storage-protocols separately,” he said.

They noticed that the ones that were put in the re frigerator first had a slower cooling rate than the ones that went into the cooling boxes immediately, which he called “counterintuitive.”

“By looking at that, we also realized that we were cooling this semen at a rate that was too high,” he said.

The optimal cooling curve should be 0.3°C per minute, he explained. The samples that were put in the refrigerator for 30 minutes first had a slightly slower cooling rate compared with the ones that went into the cooling boxes immediately, but was still too high he said.

Study design

Thawing (37 5°C, 30 sec) 1 2mL

refrigerator

Cooling box:

hr

hr

Refrigerator

hr

30 min in REF

5 min at 37 5°C

hr

min in REF

Quality

min at 37 5°C

semen:

cooling box

30 min at 37 5°C motility

T8.5 CB: viability concentration Minitube Neopor Box

8 hr in CB

T8 CB: motility

5 min at 37 5°C

T24 CB: motility 30 min at 37 5°C motility

T24.5 CB: viability concentration Minitube Neopor Box

hr in CB

min at 37 5°C

30 min at 37 5°C motility

T8.5 REF: viability concentration Minitube Neopor Box

5 hr in CB

T8 REF: motility

T24 REF: motility 30 min at 37 5°C motility T24 5 REF: viability concentration Minitube Neopor Box

5 hr in CB

min at 37 5°C

30 min at 37 5°C motility

5: viability concentration

There’s nothing else like it.

For more than 30 years, Adequan® i.m. (polysulfated glycosaminoglycan) has been administered millions of times1 to treat degenerative joint disease, and with good reason. From day one, it’s been the only FDA-Approved equine PSGAG joint treatment available, and the only one proven to.2, 3

Reduce inflammation

Restore synovial joint lubrication

joint cartilage

Reverse the disease cycle

When you start with it early and stay with it as needed, horses may enjoy greater mobility over a lifetime.2, 4, 5 Discover if Adequan is the right choice. Visit adequan.com/Ordering-Information to find a distributor and place an order today.

BRIEF SUMMARY: Prior to use please consult the product insert, a summary of which follows: CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian. INDICATIONS: Adequan® i.m. is recommended for the intramuscular treatment of non-infectious degenerative and/or traumatic joint dysfunction and associated lameness of the carpal and hock joints in horses.

CONTRAINDICATIONS: There are no known contraindications to the use of intramuscular Polysulfated Glycosaminoglycan. WARNINGS: Do not use in horses intended for human consumption. Not for use in humans. Keep this and all medications out of the reach of children. PRECAUTIONS: The safe use of Adequan® i.m. in horses used for breeding purposes, during pregnancy, or in lactating mares has not been evaluated. For customer care, or to obtain product information, visit www.adequan.com. To report an adverse event please contact American Regent, Inc. at 1-888-354-4857 or email pv@americanregent.com. Please see Full Prescribing Information at www.adequan.com.

www.adequan.com

1 Data on file.

2 Adequan® i.m. Package Insert, Rev 1/19.

3 Burba DJ, Collier MA, DeBault LE, Hanson-Painton O, Thompson HC, Holder CL: In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondral defect model. J Equine Vet Sci 1993; 13: 696-703.

4 Kim DY, Taylor HW, Moore RM, Paulsen DB, Cho DY. Articular chondrocyte apoptosis in equine osteoarthritis. The Veterinary Journal 2003; 166: 52-57.

5 McIlwraith CW, Frisbie DD, Kawcak CE, van Weeren PR. Joint Disease in the Horse.St. Louis, MO: Elsevier, 2016; 33-48. All trademarks are the property of American Regent, Inc. © 2021, American Regent, Inc.

PP-AI-US-0629 05/2021

When they analyzed samples af ter 8 hours of storage, they found a 10% drop in viability and another 10% drop after 24 hours for both storage protocols, but that was not statistically significant, he said.

“In the end, at 8 hours of stor age and at 24 hours of storage [the semen] was still within a range of percentages that is quite acceptable for insemination. We were between 55% or 50% for the total, some where between 40% or 45% for the progressive motility,” Dr. Daels said.

“Based on what we've seen, I think we can conclude that we can obtain acceptable motility and viability or integrity after 8 and 24 hours of cooled storage in INRA96,” he said. “The cooling rate may have an im pact; however, we don't really have significant data to make that a hard rule.”

Supporting Data

Two earlier studies lend support to his findings, Dr. Daels said. One done in 2018 by a group in Hanover, Germany, looked at the quality parameters after 24 hours of cooled storage using several different extend ers. The semen was frozen, thawed and put into cooled storage for 24 hours. They found the membrane integ rity for the viability of the spermatozoa only dropped by 4%, and the percentage of motile sperm was similar, it dropped about 3% to 8%.

They also did the sperm oocyte binding test, which gives an idea of the fertilizing capacity, and that was un changed in frozen-thawed semen that was stored for 24 hours. They also inseminated 18 mares with that stored semen and 10 or 55% became pregnant. The control group had 6 mares, and 4 or 66% became pregnant, which was not statistically significant.

In 2020, a group from Colorado looked at the motil

ity and the fertility of frozen-thawed semen that was stored for 24 or 48 hours, which they compared with fresh semen stored for 24 or 48 hours. In this study, the extender was INRA96, which is the same ex tender used by Dael’s group.

They found that the total motil ity was 77% after 24 hours for the fresh semen and 50% for the fro zen thawed. By 48 hours, however, the total and progressive motility was basically the same, he said.

“So that was in my book, very encouraging,” he said.

They did a very limited fertility study in which they had 8 mares without really any breeding history. They bred those mares on 2 subse quent cycles. First cycle they had a pregnancy rate of 50%, second cycle, they had 62%.

More study is needed, he said, to answer questions, such as how long frozen-thawed semen is viable or are there significant differences among semen from differ ent stallions, but they are unlikely to be done because it’s an “orphan topic” with little interest in funding this research. It would behoove practitioners to get together and pool the data, he suggested in hopes of better an swering these questions.

Some semen from stallions you can freeze and oth ers you cannot, he admitted. “I'm sure there are stal lions that do very well and stallions that are going to do very badly, but the only way to have better insight into that is to get together with a couple of stations and then pool data,” he said.

Although there are advantages to working with fro zen semen, it does cost more, so it is important to make sure that the stallion’s sperm is suitable for freezing. If in doubt, he suggested doing a test in the lab and look ing at the motility after freezing a sample, and if it is still viable, then that is a case where one can use frozenthawed semen.

MeV

Ask the

Financial Expert

This column is brought to you by AAEP Educational Partner Synchrony, provider of the CareCredit financing solution.

BY KYLE PALMER, CVT

First off, congratulations on asking the question. Most equine practitioners would rather float teeth on Clydesdales with hand tools all day than work on the business side of their practice. But without revenue there is no practice, which means collecting has to be a top priority. Here are a few strategies for shrinking that pile of accounts receivable.

1. CHANGE YOUR MINDSET.

Squeamishness about asking for payment or discounting fees when clients push back stems from misunderstanding your worth. You bring tremendous value to clients and horses, and it’s time to recognize that. Your fees reflect your value, so there’s no need to apologize when it’s time for clients to pay.

2. CREATE A FINANCIAL POLICY AND STICK TO IT.

If you don’t have a written policy, create one that states payment is expected at the time of service. Proactively communicate your policy to every client. Post it in your reception area, on your website and at the bottom of

estimates. Make your policy clear to begin with, then stand by it without exception

3. ADDRESS COST UP FRONT. Speaking of estimates, make sure to provide treatment plans with costs listed out, especially for routine care. When horse owners understand your fees from the outset and have a chance to ask questions, there’s less friction when it’s time for payment.

4. PLAN AHEAD FOR ABSENTEE OWNERS. When you work with large boarding or training operations, the owner may be in another location. Find out who’s financially responsible when scheduling the appointment. Set up a payment method in advance, such as the CareCredit credit card, and confirm you’ll text a link once services are rendered so the client can pay using their mobile device.

5. GET COMFORTABLE WITH TECHNOLOGY. The last few years have seen phenomenal advances in mobile and contactless payment solutions. Once your clients are

set up, collecting becomes as easy as a scan of a QR code and a few clicks on a smart device. A mobile payment method cuts down on the number of times you hear, “Gosh, I left my checkbook in the house.”

6. OFFER OPTIONS FOR CARE AND PAYMENT. It happens: Sometimes clients can’t afford your full recommendation. Instead of waiving or discounting your fees or opting for deferred billing, talk through financially feasible treatment options. This might mean providing some care now and some later, or offering a third-party payment option that lets the client accept the full plan now and spread the cost out in a budget-friendly way.

No matter how long you’ve sent invoices, you can make a change that improves your practice health. Diligence and communication about your financial policies can strengthen client relationships. Fewer accounts receivable, stronger client bonds, and better care for horses—who wouldn’t want that?

To discover more about how veterinary financing can help you, your patients, your clients and your practice, visit CareCredit’s Equine Insights page

Kyle Palmer, CVT, manages VCA Salem Animal Hospital in Oregon. During his 30 years in the veterinary field he has been manager of a mixed equine and companion animal practice, executive director of Northwest Equine Practitioners Association, a consultant, and an author in veterinary management magazines.

Disclaimer from sponsor: This content is subject to change without notice and is offered for informational use only. Synchrony and its affiliates, including CareCredit, make no representations or warranties regarding the content. You are urged to consult with your individual advisors with respect to any information presented.

I’m sick of not getting paid on time—or at all. How can I get better at collecting and improve my cash flow?

What role does insulin sensitivity

PLAY IN CARDIAC FUNCTION?

By Paul Basilio

During the past several years, interest in equine metabolic syndrome (EMS) appears to have outpaced the clinical understanding of the condition. In humans, metabolic syndrome is defined as a collection of risk fac tors that develop in genetically susceptible people as a result of chronic, inappropriate dietary intake and insuf ficient activity.

Although they share many similarities, EMS di verges from the human form of the disease in several important ways.

“In horses, EMS is a collection of risk factors for endocrinopathic laminitis,” said Natasha J. Williams, BVSc (Hons), MS, MANZCVS, from the Department

of Clinical Sciences, Oklahoma State University, College of Veterinary Medicine, in Stillwater. “The central find ing of EMS is insulin dysregulation, which is defined as a disturbance of the balanced interrelationship among plasma concentrations of insulin, glucose and lipids.”

Insulin dysregulation can be manifested by basal hyper insulinemia, excessive or prolonged hyperin sulinemic response to oral or IV carbohydrate chal lenges, excessive or prolonged hyperglycemia, or tis sue insulin resistance.

“Given that EMS and human metabolic syndrome share several features—including insulin dysregulation, cardiac hypertrophy, and hypertension—it is plausible that the systolic and diastolic dysfunction seen in hu mans with metabolic syndrome may be a heretofore un recognized feature of EMS,” Dr. Williams said in a pre sentation at the 2022 ACVIM Forum in Austin, Texas.

She and her colleagues set out to investigate the re lationship between the magnitude of insulin resistance and the degree of myocardial dysfunction in horses, the

hypothesis that insulin sensitivity would not be correlated with chang es in cardiac function.

The study

The investigators purchased 11 horses from a dealer based on the horses’ metabolic phenotypes. However, 5 horses were excluded for various reasons, including colic, severe underlying cardiac disease, respiratory disease and pregnancy. After borrowing 2 horses of the Oklahoma State Uni versity research herd, they ended up with 7 horses (5 mares, 2 geldings) of different breeds in the study.

Insulin sensitivity may be correlated with cardiac disfunction.

“Based on previously suggested cutoffs for insulin sensitivity, only 1 horse would have been classified as insulin resistant,” Dr. Williams said “However, using fasting insu lin as a cutoff meant that 2 horses would have met the criteria for in sulin resistance.”

The results did not show any correlation between insulin sensitivity and blood pressure, nor was there correlation between mean or relative wall thickness, which are measures of ven tricular hypertrophy.

Each horse was scored on body condition and degree of cresty neck. They were weighed, aged based on denti tion, and underwent basic physical examinations. Com plete blood count, serum biochemistry and echocardiog raphy were also performed.

The horses underwent insulin-modified, frequently sampled IV glucose tolerance testing to determine insulin sensitivity. Horses were stabled in pairs to minimize stress, and they were fasted for 10 hours before testing began.

All horses underwent complete 2-dimensional (2D) and M-mode echocardiographic examination, as well as tissue Doppler analysis and analysis via 2D speckle tracking.

“Standard 2D echo and M-mode were used for anatomic assessment and fractional shortening, and tissue Doppler imaging was used for measurement of myocardial velocities and systolic time intervals,” Dr. Williams said. “The strain rate was calculated using 2D speckle tracking.”

IV dextrose 20% solution 100 mg/kg was admin istered, and blood samples were collected at multiple predetermined times. Twenty minutes after dextrose ad ministration, a blood glucose sample was obtained and regular insulin at 20 mU/kg IV was administered imme diately.

Blood pressure was measured noninvasively at the coccygeal artery.

Results

Mean insulin sensitivity in the study horses was 2.21±0.03 × 10-4 L/min/mU, and the median basal fasting insulin was 7.44 microU/mL. Median cresty neck score was 2/5.

“We did find that insulin sensitivity was positively correlated with peak velocity of the myocardium during the period of diastole, corresponding with active atrial contraction and with isovolumic relaxation time—both indicate diastolic dysfunction,” Dr. Williams reported.

Insulin sensitivity was also correlated with the ratio between peak myocardial velocity in early and late diastole.

“The more the horses trended toward insulin resis tance, the greater the decrease in myocardial velocity during late diastole, and the longer the isovolumic relax ation time,” she added.

Using Spearman correlation, insulin sensitivity was correlated with the cresty neck score and with both isovolumic contraction and relaxation times. Increasing insulin resistance was also correlated with longer periods of isovolumic contraction, indicating systolic dysfunction.

“It’s difficult to draw conclusions about whether the values found in our study fit previously published refer ence ranges, as those have typically been reported for Warmbloods, Standardbreds and Thoroughbreds,” Dr. Williams explained.

Moving forward

Dr. Williams noted that the study was small, which lim ited its power. Future work in this area should expand to include a larger sample size that includes horses with a wider range of metabolic scores.

“These preliminary data suggest that decreased insu lin sensitivity is correlated with alterations in both sys tolic and diastolic function, but this relationship needs further investigation,” she said. MeV

Williams NJ, Furr M, Navas de

C,

sensitivity in horse: a pilot study.

The link between RAPID ONSET and LONG-ACTING RELIEF of pain & inflammation

BetaVet® (betamethasone sodium phosphate and betamethasone acetate

is indicated for the control of pain and inflammation associated with osteoarthritis in horses. Learn more at www.betavetequine.com or call 1-800-458-0163. Please see

of

Prescribing

on the

INDICATION BetaVet® (betamethasone sodium phosphate and betamethasone acetate injectable suspension) is indicated for the control of pain and inflammation associated with osteoarthritis in horses.

For Intra-articular (I.A.) use in Horses. CONTRAINDICATIONS BetaVet® is contraindicated in horses with hypersensitivity to betamethasone. Intra-articular injection of corticosteroids for local effect is contraindicated in the presence of septic arthritis.

WARNINGS: Do not use in horses intended for human consumption. Clinical and experimental data have demonstrated that corticosteroids administered orally or parenterally to animals may induce the first stage of parturition when administered during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in congenital anomalies. Before use of corticosteroids in pregnant animals, the possible benefits should be weighed against potential hazards. Human Warnings: Not for use in humans. Keep this and all medications out of the reach of children. PRECAUTIONS: Corticosteroids, including BetaVet,® administered intra-articularly are systemically absorbed. Do not use in horses with acute infections. Acute moderate to severe exacerbation of pain, further loss of joint motion, fever, or malaise within several days following intra-articular injection may indicate a septic process. Because of the anti-inflammatory action of corticosteroids, signs of infection in the treated joint may be masked. Due to the potential for exacerbation of clinical signs of laminitis, glucocorticoids should be used with caution in horses with a history of laminitis, or horses

otherwise at a higher risk for laminitis. Use with caution in horses with chronic nephritis, equine pituitary pars intermedia dysfunction (PPID), and congestive heart failure. Concurrent use of other anti-inflammatory drugs, should be approached with caution. Consider appropriate wash out times prior to administering additional NSAIDs or corticosteroids.

ADVERSE REACTIONS: Adverse reactions reported during a field study of 239 horses of various breeds which had been administered either BetaVet® (n=119) or a saline control (n=120) at five percent (5%) and above were: acute joint effusion and/ or local injection site swelling (within 2 days of injection), 15% BetaVet® and 13% saline control; increased lameness (within the first 5 days), 6.7% BetaVet® and 8.3% saline control; loose stool, 5.9% BetaVet® and 8.3% saline control; increased heat in joint, 2.5% BetaVet® and 5% saline control; and depression, 5.9% BetaVet® and 1.6% saline control. SHAKE WELL IMMEDIATELY BEFORE USE. For additional safety information, please see full prescribing information. CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.

The only dual ingredient injectable corticosteroid approved by the FDA for use in horses

References: 1. Trotter GW. Intra-articular corticosteroids. In: McIlwraith CW, Trotter GW, eds. Joint Disease in the Horse. Philadelphia: W.B. Saunders; 1996; 237–256.

BRIEF SUMMARY OF PRESCRIBING INFORMATION (Betamethasone Sodium Phosphate and Betamethasone Acetate Injectable Suspension) 6 mg betamethasone per mL For Intra-Articular (I.A.) Use in Horses

CAUTION: Federal law restricts this drug to use by or on the order of a licensed veterinarian.

INDICATION: BetaVet® is indicated for the control of pain and inflammation associated with osteoarthritis in horses.

DOSAGE AND ADMINISTRATION: Shake well immediately before use.

CONTRAINDICATIONS: BetaVet® is contraindicated in horses with hypersensitivity to betamethasone. Intra-articular injection of corticosteroids for local effect is contraindicated in the presence of septic arthritis.

WARNINGS: Do not use in horses intended for human consumption. Clinical and experimental data have demonstrated that corticosteroids administered orally or parenterally to animals may induce the first stage of parturition when administered during the last trimester of pregnancy and may precipitate premature parturition followed by dystocia, fetal death, retained placenta, and metritis. Additionally, corticosteroids administered to dogs, rabbits and rodents during pregnancy have resulted in cleft palate in offspring. Corticosteroids administered to dogs during pregnancy have also resulted in other congenital anomalies including deformed forelegs, phocomelia and anasarca. Therefore, before use of corticosteroids in pregnant animals, the possible benefits to the pregnant animal should be weighed against potential hazards to its developing embryo or fetus. Human Warnings: Not for use in humans. For use in animals only. Keep this and all medications out of the reach of children. Consult a physician in the case of accidental human exposure.

PRECAUTIONS: Corticosteroids, including BetaVet®, administered intra-articularly are systemically absorbed. Do not use in horses with acute infections. Acute moderate to severe exacerbation of pain, further loss of joint motion, fever, or malaise within several days following intra-articular injection may indicate a septic process. Because of the anti-inflammatory action of corticosteroids, signs of infection in the treated joint may be masked. Appropriate examination of joint fluid is necessary to exclude a septic process. If a bacterial infection is present, appropriate antibacterial therapy should be instituted immediately. Additional doses of corticosteroids should not be administered until joint sepsis has been definitively ruled out. Due to the potential for exacerbation of clinical signs of laminitis, glucocorticoids should be used with caution in horses with a history of laminitis, or horses otherwise at a higher risk for laminitis. Use with caution in horses with chronic nephritis, equine pituitary pars intermedia dysfunction (PPID), and congestive heart failure. Concurrent use of other anti-inflammatory drugs, such as NSAIDs or other corticosteroids, should be approached with caution. Due to the potential for systemic exposure, concomitant use of NSAIDs and corticosteroids may increase the risk of gastrointestinal, renal, and other toxicity. Consider appropriate wash out times prior to administering additional NSAIDs or corticosteroids.

ADVERSE REACTIONS: Adverse reactions reported during a field study of 239 horses of various breeds which had been administered either BetaVet® (n=119) or a saline control (n=120) were: acute joint effusion and/or local injection site swelling (within 2 days of injection), 15% BetaVet® and 13% saline control; increased lameness (within the first 5 days), 6.7% BetaVet® and 8.3% saline control; loose stool, 5.9% BetaVet® and 8.3% saline control; increased heat in joint, 2.5% BetaVet® and 5% saline control; depression, 5.9% BetaVet® and 1.6% saline control; agitation/anxiety, 4.2% BetaVet® and 2.5% saline control; delayed swelling of treated joint (5 or more days after injection), 2.5% BetaVet® and 3.3% saline control; inappetance, 3.4% BetaVet® and 2.5% saline control; dry stool, 1.7% BetaVet® and 0% saline control; excessive sweating, 0.8% BetaVet® and 0% saline control; acute non-weight bearing lameness, 0.8% BetaVet®and 0% saline control; and laminitis, 0.8% BetaVet® and 0% saline control.

CLINICAL PHARMACOLOGY: Betamethasone is a potent glucocorticoid steroid with anti-inflammatory and immunosuppressive properties. Depending upon their physico-chemical properties, drugs administered intra-articularly may enter the general circulation because the synovial joint cavity is in direct equilibrium with the surrounding blood supply. After the intra-articular administration of 9 mg BetaVet® in horses, there were quantifiable concentrations of betamethasone (above 1.0 ng/mL) in the plasma.

EFFECTIVENESS: A negative control, randomized, masked field study provided data to evaluate the effectiveness of BetaVet® administered at 1.5 mL (9 mg betamethasone) once intra-articularly for the control of pain and inflammation associated with osteoarthritis in horses. Clinical success was defined as improvement in one lameness grade according to the AAEP lameness scoring system on Day 5 following treatment. The success rate for horses in the BetaVet® group was statistically significantly different (p=0.0061) than that in the saline group, with success rates of 75.73% and 52.52%, respectively (back-transformed from the logistic regression).

ANIMAL SAFETY: A 3-week target animal safety (TAS) study was conducted to evaluate the safety of BetaVet® in mature, healthy horses. Treatment groups included a control (isotonic saline at a volume equivalent to the 4x group); 1X (0.0225 mg betamethasone per pound bodyweight; BetaVet®); 2X (0.045 mg betamethasone per pound bodyweight; BetaVet®) and 4X (0.09 mg betamethasone per pound bodyweight; BetaVet®). Treatments were administered by intra-articular injection into the left middle carpal joint once every 5-days for 3 treatments. Injection site reactions were the most common observations in all treatment groups. Injection site reactions were observed within 1 hour of dosing and included swelling at the injection site, lameness/stiffness of the left front limb, and flexing the left front knee at rest. The injection site reactions ranged from slight swelling (in many horses on multiple days in all treatment groups) to excessive fluid with swelling, pain, and lameness (4x group only). Injection site reactions were observed most commonly on treatment days, and generally decreased in number and severity over subsequent days. The incidence of injection site reactions increased after the second and third injection (number of abnormalities noted on day 10 > day 5 > day 0). In the BetaVet® treated groups the number and severity of the injection site reactions were dose dependent. The 4X BetaVet® group had the highest overall incidence of and severity of injection site reactions, which included heat, swelling, pain, bleeding, and holding the limb up at rest. The control group and 4X group (which received similar injection volumes) had a similar incidence of injection site reactions; however, the severity of reactions was greater in the 4X group. Absolute neutrophils were statistically significantly higher in the BetaVet® treated groups as compared to the control group. Trends toward a decrease in lymphocytes and eosinophils, and an increase in monocytes were identified in the BetaVet® treated groups after the initial dose of BetaVet®. Individual animal values for white blood cells generally remained within the reference range. BetaVet® treated horses also had a trend toward increased blood glucose after the initial dose. Some individual animals showed mild increases in blood glucose above the reference range.

SHAKE WELL BEFORE USING NADA 141-418, Approved by FDA

For customer care or to obtain product information visit www.betavetequine.com or call 1-800-458-0163.

For customer care or to obtain product information visit www.betavetequine.com or call 1-800-458-0163.

To report an adverse event please contact American Regent Animal Health at (800) 734-9236 or email pv@americanregent.com.

To report an adverse event please contact American Regent Animal Health at 1-888-354-4857 or email pv@americanregent.com.

A Division of American Regent, Inc. 5 Ramsey Rd. | Shirley, NY 11967

Biodiversity of

May Reduce the Risk for Various Diseases in Young Foals Microbiome

A study looking at the microbiome of young horses found that those with higher bacterial di versity in the gut at 1 month old had a reduced risk for various diseases, particularly respiratory and soft tissue diseases, according to Chris Proudman, MA, VetMB, PhD, CertEO, FRCVS, who presented his data at the annual congress of the British Equine Veterinary Association.

Prof. Proudman and his colleagues looked at the changes to the bacterial diversity and bacterial fam ily quantity in the early life of horses to see if they could determine whether there is an association be tween the bacterial composition of the gut in early life with the health of that foal later.

Studies in human medicine are finding that a va riety of diseases from cancer to cardiovascular dis ease may be affected by the gut microbiome.

“These are all increasingly being linked to what happens in our gut bacteria. Now, I find that mindblowing, and I also see no reason why the same thing should not be happening in the horse,” said Dr. Proudman, who is the Foundation Head of the new School of Veterinary Medicine at the Univer sity of Surrey.

By Marie Rosenthal MS

Bacterial Diversity and Abundance

As part of the 5-year Alborada Well Foal Study, they recruited 52 foals from 5 Thoroughbred stud farms in Southeast England and followed them for the first 3 years of their life, collecting 445 fecal samples and lots of details about their management.

“During the first year of life, we took repeated fecal samples, and that would allow us to measure and characterize the gut bacterial communities in the feces, which we know are not exactly the same as the hind gut, but they're a pret ty good indicator,” he said

“We collected an absolute shed load of fecal samples,” he joked.

They saw that the bacterial com munity diversity and abundance in the gut changed quickly in the very first weeks of life, Prof. Proudman explained.

Although they are still analyzing the data, he said they found that the biodiversity of the gut changes rapidly and by 3 months of age, the foal’s gut looks very similar to 1-year-old horses. While nursing, there are many bacteria that digest simple sugars, which de cline during the first few weeks of life. By a year later, when the animal is eating mainly fiber in its diet, it tends to have more fiber-degrading bacteria. “You can see the abundance of these bacterial families increases dramatically,” Prof. Proudman said.

“The bacterial composition of the fecal micro biome changes very rapidly during these first 3 months. And it seems to be quite a critical period of development in terms of influencing the subsequent risk for various health events,” he said.

“We've identified higher bacterial diversity at 1 month old is associated with the reduction in risk of various diseases, particularly respiratory and soft tissue disease. And there's some indication possibly for ortho pedic and gastrointestinal disease as well,” he said.

They were able to find families of bacteria in the gut that influenced the risk for specific diseases. Hav ing more:

• Methanomassilicoccaceae, Endomicrobia, De thiosulfovibrionaceae were linked with a reduc tion in the risk for respiratory disease;

• Weeksellaceae, Enteromicrobia, Victivallaceae, Rickettsiales and Dethiosulfovibrionacea were linked with a lower risk for gastrointestinal dis ease; and

• Weeksellaceae and Odorib actereaceae were linked with a lower risk for orthopedic disease.

“I think this is really quite ex citing because having this level of information allows us to think about ways that we can manipu late the horse's gut microbiome to enhance health in later life, particularly in terms of prebiot ics possibly, or probiotics,” Prof. Proudman said.

However, he cautioned, the best methods to improve the gut micro biome are not yet known. Hoping for a “quick win,” the research team reviewed the husbandry records for the foals—feed, feed supple ments, bedding, turnout, weaning, transport, farriery and medical treatments—throughout the first year of life. Initial indications are that there are no striking as sociations between foal management and gut bacterial communities but analysis of the data continues.

“We did look at management practices,” he said. “There are various management practices that were recorded for these foals throughout their first year of life. And interestingly, we found no associations between these management practices and gut micro bial populations within these horses.

“Was there something that we could do in terms of management that would enhance gut microbial profiles? Sadly, the answer seems to be no.”

More research is needed before these data can be put into practice, according to Prof. Proudman.

“We want to look at the functions of these bac teria, and we want to try to develop putative causes or pathways and understand why these associations between bacteria and disease outcomes are happen ing,” he said.

A major “take home” message is the early days of development for the microbiome of the horse seems to be a “critical period in terms of influencing the sub sequent risk for various health events,” he said.

“It’s looking quite likely that what happens in this early life period actually has a quite a profound in fluence later in the horse's life as well,” he said. And although this study does not provide any “magic bullets” that veterinarians and owners can use to improve the life of the animal or its risk for disease immediately, it provides important clues that may someday lead to health-enhancing innovations. MeV

Early development of the microbiome of foals appear to be a critical period that has a profound influence on the horse's health later in life.

Genome Testing Could Aid Lyme Diagnosis in Equids

By Adam Marcus

A modified genomic test could help equine veterinarians more rapidly and accurately diagnose certain tick-borne infections, new research suggests.

Veterinarians at Cornell Uni versity College of Veterinary Med icine and their colleagues used the method to confirm a case of neu roborreliosis caused by Borrelia burgdorferi in a horse that had previously contracted the illness.

B. burgdorferi is a common tick-borne disease in both hu mans and horses, in which it can lead to serious and occasionally life-threatening ill ness such as neuroborreliosis. However, identifying the microbe using polymerase chain reaction (PCR) testing while the animals are alive is a challenge be cause it tends not to replicate readily enough in ce rebrospinal fluid (CSF) to generate positive results on the test.

In the new study, Thomas J. Divers, DVM, the Rudolph J. and Katharine L. Steffen Professor Emer

itus of Veterinary Medicine at Cornell University College of Veterinary Medicine, in Ithaca, N.Y., and his colleagues per formed the genomic analysis on the cerebrospinal fluid (CSF) of an 11-year-old Swedish Warm blood mare in Connecticut that had fallen ill with fever, ataxia and other symptoms.

While hospitalized, clinicians tested the animal for B. Burgdor feri, the pathogen that causes Lyme disease, which is common in the area, but the PCR result was nega tive. So too were tests for West Nile virus, equine herpesvirus and oth er common infections of the central nervous system.

The capture kits can be used to quickly and effec tively isolate bacterial DNA from horse DNA, then amplify the targeted genomes of B. burgdorferi in the CSF prior to deep sequencing, thereby improving sensitivity for detection of the Lyme organism, ac cording to Dr. Divers.

“The test could be especially useful in confirm ing organisms such as B. burgdorferi that might have very low numbers in CSF or even blood,” he added, and might be able to detect other bacteria in the sample. “This might be the future for more sensitive testing for tick-borne pathogens,” he said.

Dr. Divers and his colleagues said the custom DNA test could prove a relatively inexpensive way to diagnose B. Burgdorferi infections—with a caveat.

“Although the testing could be relatively inexpen sive, diagnostic labs may not see it that way,” Dr. Div ers noted.

What’s more, turn-around time could be a lim iting factor, since labs would require a few days to process and report the test, which means treatments would likely need to be initiated before the test re sults become available.

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AVMA, USDA Offer Assistance to Hurricane Victims

Funds from the American Veterinary Medical Founda tion supported the work of the Florida Veterinary Med ical Association, the University of Florida Veterinary Emergency Treatment Service, Greater Good Charities and the Texas A&M Veterinary Emergency Team.

“Hurricane Ian caused widespread damage and suffering in Florida, and the need for relief is great,” said Jose Arce, DVM, chairman of the AVMF, the charitable arm of the American Veterinary Medical Association. “In this time of crisis, we thank every one who has stepped forward to help, and we en courage everyone who can give to please donate and help animals and the people who care for them.”

Contributions to the AVMF help provide food, medical care, disaster relief and emergency support for veterinarians providing care.

The AVMF provided $15,000 to help Puerto Rico recover from Hurricane Fiona, bringing to almost $95,000 the AVMF's donations to the US territory since Hurricane Maria in 2017.

In related news, the Department of Agriculture (USDA) staff in offices across the country are ready to respond with a variety of program flexibilities and other assistance for farmers, ranchers and residents affected by the recent hurricanes.

It is also critical that those affected keep accurate records to document damage or loss and to report losses to their local USDA Service Center as soon as possible.

Additionally, USDA’s Natural Resources Conserva tion Service (NRCS) can provide financial resources through its Environmental Quality Incentives Program to help with immediate needs and long-term support to help recover from natural disasters and conserve wa ter resources. USDA can also assist local government sponsors with the cost of recovery efforts like debris re moval and streambank stabilization to address natural resource concerns and hazards through the Emergency Watershed Protection Program.

On farmers.gov, the Disaster Assistance Discov ery Tool, Disaster-at-a-Glance fact sheet (PDF, 1.4 MB) and Farm Loan Discovery Tool can help pro ducers and landowners determine program or loan options. For assistance with a crop insurance claim, producers and landowners should contact their crop insurance agent. For FSA and NRCS programs, they should contact their local USDA Service Center.

USDA’s Food and Nutrition Service (FNS) is al ready providing assistance to those communities affected in Puerto Rico through household distri bution of USDA Foods, which provides nutritious,

high-quality foods 100% grown and produced on farms in the United States. FNS is standing by to work with the Federal Emergency Management Agency (FEMA), states and local authorities, to pro vide additional emergency nutrition assistance to people in need.

Resources: To donate, please visit www.avmf.org. Here are links to resources for AVMA members who have been affected by the hurricanes or who are pro viding care:

• AVMF Disaster Grants for veterinarians im pacted by disasters www.avmf.org/for-veteri narians/disaster-relief-grant-for-veterinariansveterinary-students/ or those who are providing care to animals impacted by disasters www.avmf. org/for-veterinarians/disaster-reimbursementgrants-for-veterinary-medical-care/

• AVMA Insurance: PLIT Professional Liability, Business and Personal Insurance for Veterinar ians www.avmaplit.com

From the USDA: Livestock and perennial crop producers often have lim ited risk management options available, but there are several disaster programs for them. Key programs of fered by USDA’s Farm Service Agency (FSA) include:

• The Livestock Indemnity Program www.fsa. usda.gov/programs-and-services/disaster-as sistance-program/livestock-indemnity/index

• Emergency Assistance for Livestock, Honey bee and Farm-raised Fish Program www.fsa. usda.gov/programs-and-services/disaster-as sistance-program/emergency-assist-for-live stock-honey-bees-fish/index

• The Noninsured Crop Disaster Assistance Pro gram (NAP) www.fsa.usda.gov/programs-andservices/disaster-assistance-program/nonin sured-crop-disaster-assistance/index

• The Tree Assistance Program provides cost share assistance to rehabilitate or replant or chards and vineyards when storms kill or dam age the trees, vines or bushes. NAP or Federal Crop Insurance often only covers the crop and not the plant.

• The Emergency Conservation Program and Emergency Forest Restoration Program can as sist landowners and forest stewards with finan cial and technical assistance to restore damaged farmland or forests.

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Merck Opens Animal Health Intelligence Manufacturing Facility in Baton Rouge

Merck Animal Health announced the opening of a manufacturing facility for its animal intelligence products in Baton Rouge, La. The facility will broad en the company’s manufacturing capacity and capa bilities by establishing a printing, production and distribution facility of Allflex Livestock Intelligence identification ear tags.

This site will become another supply site for eartag production to support increased product de mand. The Baton Rouge site became operational for ear-tag production in September. At full capacity, the facility will employ 33 employees.

“Merck Animal Health continues to be a strong source of innovation and growth in Louisiana,” said Mike Strain, DVM, Louisiana Agriculture and For estry Commissioner. “The upgrades to the Baton Rouge manufacturing facility will lead to more ad

vancements in Animal Health Intelligence products and reinforce the importance of supporting biotech nology companies in the state.”

The North America livestock identification mar ket has grown rapidly over the past years, focusing on farming automation and traceability of animals, and causing an ongoing need to identify animals visually by colored and/or custom-printed ear tags. This growth in the market has caused an increased demand for ear tags.

In addition, the identification ear-tag market is seeing the adoption of radio frequency identification (RFID) for animal disease traceability (ADT) and value-added producer programs, which results in in creased customer needs for custom identification ear tags and the importance of increasing manufactur ing capacity needs. MeV

Elanco and IDEXX Making Progress on Social Initiatives

Elanco Animal Health and IDEXX recently released reports about their goals to improve the health of animals and people, and work for social equity.

“We believe our work to make life better for ani mals has the potential to make a lasting positive im pact on society and the world,” said Jeff Simmons, president and CEO at Elanco. “We are working hard around the globe to increase representation of di verse talent and reduce our own environmental foot print while supporting our customers, advancing their sustainability efforts through environmentally beneficial products, animal welfare consultation and our antimicrobial stewardship guidance.”

Among the accomplishments, both have in creased the representation of women and minorities in leadership positions.

In addition, Elanco is working to improve the health of animals around the world by promoting re sponsible use of antibiotics by transitioning antibiot ic livestock product labels to align with responsibleuse practices and introducing and expanding the use of vaccines and nutritional health products to pro vide alternatives to medically important antibiotics.

Elanco is also working to reduce its overall im pact on the environment by lowering emissions by approximately 8% compared with 2020. Elanco in troduced Experior, the first FDA approved product with an environmental benefit, labeled to reduce

ammonia gas emissions per pound of carcass weight from an animal or its waste.

“Driven by our purpose to enhance the health and well-being of pets, people and livestock, we have a responsibility and an opportunity to create a better future for animals, people and our planet,” said Jay Mazelsky, IDEXX President and CEO.

IDEXX is accelerating its scientifically directed approach to environmental sustainability through innovation, climate action and a focus on environ mental impact reduction, the company said. Key highlights include the following:

• Reduce greenhouse gas emissions by 37.8% by 2030.

• Set a new goal to source 100% renewable elec tricity by 2030.

• Transitioned to sustainable insulated packag ing for cold consumable shipments in 2021 in the U.S., which will avoid the use of approxi mately 330,000 pounds of polystyrene foam waste each year. MeV

For more information on Elanco’s sustainability jour ney, visit www.elanco.com/en-us/sustainability/esg.

For more details about IDEXX’s program: www.idexx.com/en/about-idexx/corporateresponsibility

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