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Grant Miller, DVM Vet Check
by Grant Miller, DVM
Grant Miller is a Veterinary Editor for the Horse Journal and currently practices in Northern California. His areas of interest include acupuncture, chiropractics, performance horse medicine, geriatric horse care, and forensics. He grew up riding in the Pony Club and studied dressage until he attended veterinary school at UC Davis. In 2007 he founded The Sonoma County CHANGE Program to assist his local animal control department with equine humane cases. View more blogs

Not Enough Vets in Your Area?

By Grant Miller, DVM, November 10, 2014

Thinkstock Photo
Credit: Thinkstock Photo
Finding a veterinarian in some rural areas can be difficult, but Congress has a plan - one that needs some tweaking.
Last year, we posted an article that generated a lot of chatter among our loyal HJ readers - it discussed the debate over the supply of veterinarians in the United States. To summarize the article, some people contend that there is or will be a shortage of veterinarians while others think that there are/will be too many vets due to several foreign schools now being “viewed” by accreditation powers as U.S. equivalent institutions.  This has caused concern. A key point overlooked by many, however, is this: While the overall number of veterinarians in the United States is excessive, the distribution of those veterinarians is imbalanced. And that imbalance causes service shortages in many parts of the country.

 The American Veterinary Medical Association (AVMA) conducted an extensive study last year to look into the supply and demand issue in greater detail.  The study, called the AVMA Workforce Report, concluded:

 “We estimated that the supply for veterinarians (90,200) in the U.S. in 2012 exceeded demand for veterinarians (78,950) by approximately 11,250 (or excess capacity of 12.5%) at the current levels of prices for services. Between 2012 and 2025, under a baseline scenario we projected that both supply and demand would grow by about 11% (reaching demand of 88,100 and supply of 100,400 by 2025).”

 In other words, we have too many veterinarians. 

However, horse owners in several parts of the country report that veterinarians are scarce in their area.  

How do we solve this problem?  

Congress has attempted to fix the problem by dangling a carrot in front of qualifying veterinarians (thanks to heavy lobbying efforts by the AVMA).  About six years ago, the United States Department of Food and Agriculture (USDA) was given the authority to administer the Veterinary Medicine Loan Repayment Program (VMLRP), which would  pay up to $25,000 per year towards qualified educational loans of eligible veterinarians who agree to serve in underserved areas, with payments up to three years. 

That sounds good, but there are two problems:

 1.The overall amount of funding Congress provides for the program is only enough to enroll a handful of veterinarians each year, if at all and,

2.  Every veterinarian who enrolls for the program is taxed at a 39% rate for the money awarded to them. 

Double take!  The government takes 39 cents out of every dollar that it gives to veterinarians who enroll in the program!  Do you think this is ridiculous?  Ludicrous? Sensible? Logical?

 The AVMA is leaning toward ridiculous. They have introduced new legislation that will remove the 39% tax liability for veterinarians participating in the VMLRP.  The new legislation is called the Veterinary Medicine Loan Repayment Program Enhancement Act of 2013 (S.553 / H.R. 1125).  You can find more information here.  Now is a crucial time for the bill since it is moving its way through Congressional committee review. 

If you feel that you need more veterinarians in your area, and you think that it is just flat-out wrong for the government to take back 39% of money that it is supposed to be giving out on behalf of tax payers to ensure that our animals get access to the veterinary skill they need, then make your voice heard by sending a message to your Congressmen, women, and representatives.

Time is of the essence here.


John Strassburger The Equine Things That Matter Most
by John Strassburger

John Strassburger, Horse Journal’s Performance Editor, is a graduate A Pony Clubber. He currently competes in eventing at the Intermediate level. As editor of The Chronicle of the Horse for 20 years, he covered six Olympics and thousands of competitions. With his wife, he operates Phoenix Farm (phoenixsporthorses.com), a breeding/training facility in California.

Email John

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The Elusive Mind of a Horse

By John Strassburger, November 08, 2014


We bred Amani, so I'm very glad that, so far, she's shown a great love of solving the puzzles of cross-country jumps.
When you're trying to pick a horse for a particular sport, it's easy to select for particular physical characteristics—the quickness to cut cows, the scope for 1.60-meter fences, the speed of racehorse, the gaits for international dressage, and the gaits, bravery, and jump for top-level eventing. But selecting the right mind to go along with all those physical gifts can be quite a bit more challenging.

Animal-rights types often like to decry horse sports as cruel endeavors, in which horses are forced in to activities by aggressive and uncaring riders. But anyone who knows much about actual riding and training horses knows that their attitude is a pile of horse manure, to put it in a politically correct way.

Last week, at the Galway Downs International Three-Day Event, international eventer Boyd Martin was faced by such a conundrum with his horse Trading Aces. This handsome bay gelding has been a part of Martin’s program for several years, and he was purchased because of his copious physical gifts—the horse is a great mover, scopey jumper, and a ground-covering gallop.

But his first time around a CCI4*, the horse tired and stopped out a few fences from home. Martin chalked it up to some physical issues and the need for increased fitness. He worked very hard on both things, and it appeared to be working. This spring, Martin was seriously injured on a different horse, and his friend and mentor Phillip Dutton took over the reins and had a top-10 finish at the Rolex Kentucky CCI4*. Dutton was then selected for the World Equestrian Games team on the horse, but about two-thirds of the way around the course, the horse simply stopped.

Martin took the ride back, and brought him to the Galway Downs CCI3*, hoping a less-testing course and terrain might get Trading Ace’s career back on track. But yet again, at around the seven-minute mark, the horse just stopped.

Martin’s frustration and heartbreak have been apparent in his statements since this happened, and what’s been clear through his statements is his belief that at this point the issue is more mental than physical. He's seeing that, while the horse is an incredibly gifted athlete, he simply can’t put the mental pieces together to perform at the highest level.

During my years in the horse world, I’ve seen this phenomenon before. I remember a dressage horse who was unbeatable in the small tour, but whose brain short-circuited when it came time to learn to one-tempi changes required for Grand Prix. Many times, I've seen winning CCI2* and CCI3* horses who couldn’t, or wouldn't, step up to the next level, the show jumper who was great over big outdoor courses but who panicked during indoor season.

And the hardest thing, of course, is that the mind is the hardest thing to assess. Conformation, movement, scope—identifying these things can be learned with a small amount of effort. However, watching 3- or 4-year-olds go and trying to decide how mentally tough they are is a far, far trickier thing.

Jack Le Goff, the legendary coach of the U.S. three-day team from 1970 to 1984, used to talk about not judging a horse’s greatness until he’d “looked in to his heart,” which usually meant that he'd fought his way to the end of a tough course.

When I’m looking at youngsters for my sport of eventing, I try to observe how the horse thinks and how they react to a bit of pressure. I give them a puzzle, and see if they can figure it out. But there is no perfect formula, and every trainer ends up with a few horses that simply reach an unexpected ceiling in their progress, one you can’t move past.

The hard part is that usually by the time you hit that ceiling, there’s been many years, and many dollars, invested in that horse, (especially in the case of international competitors, who are often owned by syndicates), so you don't want to just give up and sell or give away the horse. You try different veterinary options, you change up your program—and sometimes it works, and, sometimes, the horse simply doesn’t want the job you’re offering.

This is the crossroads where Martin finds himself at right now, and I certainly don’t envy him. His affection for the horse is obvious, but he’s enough a realist to know that Trading Aces' career as a team candidate horse is over (he said at Galway Downs, even before he stopped on course), and his future career as an event horse is certainly up in the air. Perhaps the horse will happily step down to be a young rider horse—or perhaps he’s just done with the whole thing. Time will tell.


Grant Miller, DVM Vet Check
by Grant Miller, DVM
Grant Miller is a Veterinary Editor for the Horse Journal and currently practices in Northern California. His areas of interest include acupuncture, chiropractics, performance horse medicine, geriatric horse care, and forensics. He grew up riding in the Pony Club and studied dressage until he attended veterinary school at UC Davis. In 2007 he founded The Sonoma County CHANGE Program to assist his local animal control department with equine humane cases. View more blogs

Bipartite Navicular Bones

By Grant Miller, DVM, November 03, 2014


A bipartitie navicular bone with the fibrous junction between the two ossification centers indicated by a red arrow.
Every once in a while a veterinarian will come across a peculiar navicular bone abnormality when radiographing a horse’s foot. Most of the time this occurs because the horse has presented for front limb lameness. But sometimes, the horse isn’t lame at all - the problem is coincidently identified when radiographs are being taken for a prepurchase exam. The condition is called bipartite navicular bone(s.) 

 

When forming in utero, all bones begin as cartilaginous structures. Special stem cells in the bone begin to collect minerals and ossify the bones. In the vast majority of bones, the ossification process begins in one location and emanates outward until the complete bone is formed.  But in the case of bipartite navicular bones, there are two centers of ossification that form the bone. Unfortunately, the result is essentially two bones where there is only supposed to be one. Bipartite navicular bone is a congenital problem - meaning that it occurs when the fetus is developing in utero and the foal is born with it. 

 

Although congenital suggests that the problem is genetic in origin (faulty DNA from the parents), this is not necessarily the case. Congenital issues can arise from environmental factors in the uterus such as toxins, hormonal influences, biochemical mediators, and others at critical times during development or throughout development.  In the case of bipartites, the veterinary community just doesn’t yet know what causes them. There is no breed or sex predilection that has been noted - they just seem to happen randomly. Fortunately, they don’t occur very often.

 

The bipartite development can occur on one, two, three or all of the navicular bones in the horse’s body. Unfortunately, most horses with bipartite navicular bones will have significant ongoing lameness. Remember - the navicular bone sits the heel region of all four feet inside the hoof capsule. Therefore, we tend to see the “classic” navicular-type symptoms: chronic heel pain in which the horse stumbles, bobs its head, lands “toe-first” and takes small steps.

 

Management strategy for bipartite navicular bones involves radiography to determine the extent of the issue (sometimes there can even be three centers of ossification in the bone!), protective shoeing, and use of medical therapy to help with caudal heel pain.  In general, veterinarians are still using antinflammatories such as bute or Previcox to manage navicular problems, +/- intermittent use of isoxuprine to help with blood flow in the foot.  Because both Tildren and OsPhos are labeled for navicular bone disease, they may also be helpful in improving the health of the bone and keeping the horse serviceably sound.  Remember - both Tildren and OsPhos are bisphosphonates which increase calcium retention in the cortex of the bone.

 

Sadly, most horses with this condition progress in severity and become too lame to ride, despite therapies.  Not exactly a motivating post to start the week, but there is so little information available about bipartite navicular bones, it seemed useful to share with HJ readers.

 


John Strassburger The Equine Things That Matter Most
by John Strassburger

John Strassburger, Horse Journal’s Performance Editor, is a graduate A Pony Clubber. He currently competes in eventing at the Intermediate level. As editor of The Chronicle of the Horse for 20 years, he covered six Olympics and thousands of competitions. With his wife, he operates Phoenix Farm (phoenixsporthorses.com), a breeding/training facility in California.

Email John

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Matchmaker, Matchmaker, Make Me A Match

By John Strassburger, October 29, 2014

Of all the skills a horse trainer must possess, the ability to play matchmaker between horse and rider is one of the most important, most challenging, and most rewarding. Part magic, part science, part luck, the perfect match is an elusive thing.

 

When horse shopping, you always start with the big basics: price range, type and experience of horse, style match with rider (quiet ones for the timid, forward ones for the quiet, etc.). But that’s just the starting point. From there it becomes an almost forensic psychology experiment, as you try to read the souls of man and beast and predict all the places they might intersect.

 

Let’s be clear about one thing: There is no such thing as the perfect horse. Every person who has ever bought a horse has given up on some aspect that their “perfect” horse possesses—size, color, age, soundness, training, something. But a deficit can be overcome if the rest of the puzzle fits together.

 

The first question is: “What does the rider really need?” Not what they want, not what would be ideal, but what is it that they absolutely have to have? (Similarly, what can they absolutely not have?) For some, it’s a level of talent that matches their ambitions; for some it’s a horse that will behave exactly the same in all circumstances; and for others, it’s a horse that can teach them a given discipline. 

 

When you have the basic ingredients—that short list of musts—then you can start evaluating prospects. We like to get on the horse first, not just to make sure it’s safe, but also so we can evaluate the horse’s personality and behavior. We know our riders well enough that we can usually figure out if we have a candidate pretty quickly, but sometimes we do get surprised.

 

Because I’m a trainer, my ride is often more demanding than what the horse is used to. So we’ve had the experience of horses that didn’t go particularly well for me, but responded positively to a less experienced riders giving them less demanding ride. Some horses are natural-born teachers, happy to show an inexperienced rider the ropes, but they get irritated by someone trying to tell them how to do their job. We usually love these types, because if the horse is good to its rider, his opinion is of us doesn’t really mater.

 

But one trick here is that you have to figure out if the horse really is a teacher or is he’s just a lazy sod who doesn’t want to work at all. We’ve tried this kind too—many times.

 

For new or timid riders, it’s often useful to buy as much experience as you can afford. But a true amateur temperament is born and not made, and for some riders a good-natured, willing young horse can be as good or better a match than a more experienced horse, provided the new owner can afford to give the horse the training that he’ll need.

 

The truth is that, a lot of times, it’s nothing so logical as a list you check off. I’ve always thought that that to properly evaluate a horse you’re thinking of buying, you have to go and see him, you have to interact with him and ride him. (That’s why I see ads and videos as just a starting point, an introduction.)

 

And I’m usually most persuaded by the feeling I get in the first few minutes: Do I feel athleticism? Do I feel comfortable and in balance with him? Do I feel him trying to understand and work with me? Do I feel magic?

 

Sometimes you have to just go with a gut feeling that Horse A will fit with Rider B, even though on paper they shouldn’t be a match. Hopefully, the rider feels the connection that you see right away too. Usually, they do, but sometimes you have to go on faith that the match is right and convince the rider to give the horse a chance. This is especially true of riders who have an image of a certain type in their head, and your selection doesn’t fit their image.

 

Just being able to figure out a horse is only one half of the equation. You must also be able to delve in to the psyche of the rider. Someone who loves to groom and snuggle their horse is gong to be disappointed by a thin-skinned individual who hates being brushed or a stand-offish sort who’d like who’d really to be left alone unless you’re riding him, thank you very much. A timid person on the ground will not fit with a pushy pony type, no matter how well the riding portion fits. And a rider who loves a horse with a bit of spice and some quirks will be terminally bored with a solid citizen, no matter how “perfect” the horse is under saddle.

 

Playing matchmaker is a tricky business; one that Heather is a genius at doing. (Maybe that’s why she picked me?) But when you get it right, it’s a great feeling, for all.

 

 


Grant Miller, DVM Vet Check
by Grant Miller, DVM
Grant Miller is a Veterinary Editor for the Horse Journal and currently practices in Northern California. His areas of interest include acupuncture, chiropractics, performance horse medicine, geriatric horse care, and forensics. He grew up riding in the Pony Club and studied dressage until he attended veterinary school at UC Davis. In 2007 he founded The Sonoma County CHANGE Program to assist his local animal control department with equine humane cases. View more blogs

Equine Allergy Testing

By Grant Miller, DVM, October 27, 2014



Hives can be so severe that the horse rubs itself raw trying to get relief from the itch.

 

For those owners whose horses are plagued with allergies, few long-term options exist to effectively manage the problem. 

 

About 90% of the time, allergies manifest themselves in horses as hives.  When they flare up, the vet will often prescribe antihistamines and/or corticosteroids to combat them.  Sometimes antihistamines work to reduce the severity of the hives, yet many times cannot resolve them completely.  Corticosteroids, on the other hand, work exquisitely to make hives disappear within hours.  Cold-water therapy or ice packs can also be helpful in slowing down an allergic reaction.  The bottom line: All of these therapies really only work well for the short term. 

 

Long-term corticosteroid therapy, while possible, can be dangerous.  We know that corticosteroids can induce many metabolic changes in the horse that can result in some serious problems.  Laminitis, gastric and colonic ulcers, as well as immune suppression are on the list.  With that said, corticosteroids can be a God-send in relieving an itchy horse of his allergies.  But, are there any safer options?

 

The answer is YES.  Veterinarians have the ability to perform Serum IgE testing and hyposensitization that can provide long-term relief from allergies.  IgE is an immunoglobulin found only in mammals that plays a pivotal role in hypersensitivity (allergic) reactions. Horses plagued with hives often have elevated IgE levels to dozens of allergens prevalent in the environment.  Because of so many triggers, the horse’s immune system remains hyperactive on an ongoing basis.

 

Labs such as Spectrum Labs offer comprehensive test kits that test for common regional allergens. Testing is simple - It just involves drawing 1 blood tube sample and shipping it at room temperature to the testing facility. The Spot Platinum equine assay represents the most comprehensive allergy testing available, with a total of 86 of the most common allergens in the region that the sample is shipped from, including grasses, trees, weeds and shrubs, common barn allergens, grain mixes, foods (such as alfalfa, barley, corn, linseed, milo, oats, etc.), molds and biting insects common to horses.  Also, if you suspect that a specific trigger is causing the allergies, you may request that a test be run for it. 

 

Once testing is complete, the lab will send a report that details the allergy profile for your horse.  It will assist you in eliminating or minimizing allergens in your horse’s environment.  But what if that isn’t enough?  It just so happens that you can use your horse’s own serum to formulate a hyposensitization treatment regimen. It is actually quite simple - the lab will titrate low doses of all of the allergens that your horse is sensitive to (up to 21 standard, with additional allergens costing extra) into an injectable solution. Shots are administered over a 9-month period and administered in increasing doses as well as gradual increases in concentration. This method serves to gradually habituate the horse’s system to the presence of the allergens, thus creating a tolerance for them.  The initial 9-month period of hyposensitization is followed by monthly maintenance shots.

 

While this process does not work quickly, it may prove to be a viable option for horses and owners who are plagued with allergies year after year.  It is surprising cost effective and has either cured or reduced allergic reactions significantly in the vast majority of horses that receive it.  With adherence to the treatment schedule, one can expect an excellent chance of elimination of or reduced dependence on steroid drugs. Improvement in most cases is seen after 3-5 months of treatment, at which stage shots are given monthly.

 

To access more information about SPOT serum IgE testing, click here.


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