The practice of veterinary medicine has changed dramatically in the 35 years since I graduated from veterinary school. Today, clients seek information from all kinds of sources — the internet, their extension agents, or even worse, chain farm supply store sales agents and promotional signage. In this climate, we veterinarians need to use our unique knowledge to stand back and get the big picture on equine health. And we need to be proactive in promoting and “selling” this service. Below are a few areas equine veterinarians can consider.
1. Vaccines and antibiotics
Vaccinations and antibiotics are available at every farm store, even though recent regulations require a prescription for stores to dispense antibiotics, which implies a valid CPV relationship. As equine veterinarians, we need to learn how to advise our clients on the proper time to vaccinate for each disease, and which vaccines are necessary, based on the susceptibility of each horse. Not every horse needs every vaccine. Holistic veterinarians are aware of the problems associated with over-vaccination. Even though there are multiple holistic treatments for these ailments (vaccinosis), the horse is often left more susceptible. Careful vaccine recommendations can improve longevity and health.
2. Emerging diseases
Get current on emerging infectious diseases, and re-learn obscure diseases. The relocation of animals after the recent spate of natural disasters will result in previously unseen diseases in your area due to transfer by animals or fomites, or by insect vectors. Climate change has also resulted in shifts in insect populations and the timing of their lifecycles. We may see Tabenid flies and noseeums earlier; or cayenne ticks, which transmit spiroplasmosis, farther north.
In the past, equine practitioners in Lexington, Kentucky would deworm 250 head of horses before lunch. Today, tube deworming has been largely replaced with paste deworming done by the owner, often too frequently and with limited efficacy. We need to help our clients develop strategic deworming protocols because many of the anthelmintics are no longer effective (see sidebar on page xx). Even the need for anthelmintics can be questioned. A herd of horses on the research farm at the University of Kentucky in Lexington, for instance, has not been dewormed in 35 years. They provide untreated helminthes for research. The horses maintain good weight and show no external signs of parasitism.
Colic is a big issue today, mainly because of parasitism and incorrect feeds. Every horse and owner combination should learn and be comfortable with proper handling so that in a colic crisis, a veterinarian can easily and safely pass a nasogastric tube. Show the owner how to auscult normal gut sounds. Owners can also be trained in acute TCVM and homeopathic treatments, which may quickly resolve most colics.
5. Farm visits
Equine veterinarians should schedule twice-yearly farm visits to review management, and perform wellness exams. These farm visits, which are billed for based on time, give the practitioner the opportunity to review the housing situation, including companionship for each horse, and the horse’s level of boredom or over-stimulation. Natural light exposure and potential EMF or microcurrent exposures should be evaluated.
It is important to do a pasture walk with the owners to assess safety factors such as inadequate fencing or proximity of toxic plants. These pasture walks should be repeated at different seasons because there are different toxic plants present at different times of the year. Most horses will avoid toxic plants if there is good forage present, so the forage should also be evaluated. It is important that the pasture not be a monoculture; it should include trees and shrubs for browse as well as forbs, which have deeper root systems and may bring nutrients to the surface.
While at the farm, veterinarians should also inspect the feed room. Open the feed bins and see if there is contamination with rodent feces, especially opossums (whose feces may have protozoa for EPM). Look for ventilation to help assess the potential for mold in the feed. Find out how often the owner buys feed and how long it is stored on site. This gives the veterinarian a chance to discuss the ration formulation as well as make recommendations on feeding whole grains. Highly processed grains are digested too quickly and can change the population of gut bacteria. Horses need to be able to munch on forage all day long to decrease acid production in the stomach and to relieve boredom. Horses with a tendency to gain weight can wear a muzzle, while those not on pasture can use slow feeders.
Remember to also inspect and discuss the mineral source at the farm. White salt blocks have a very little nutritional value for horses. Combination salt/mineral blocks force a horse to eat too much salt or too many minerals. Loose minerals are much easier for horses to lick, and different free choice minerals can allow them to self-medicate. Know the mineral deficiencies and excesses specific to your region’s soil so you know what to recommend. Establish a relationship with a PhD nutritionist in your area who can help you analyze the hay fed on a farm and match that to the correct grain and mineral combination. We must also be aware that animal feed may no longer contain all the nutrients listed in every table since so much farmland soil has been depleted.
6. Physical exams
A physical exam of each horse is important during every visit. This can be as complicated as a full physical exam or as brief as looking at the horse move in a pasture. The condition of the feet and teeth should be noted. Watch how the horses interact in the field and observe how the owners handle them, especially as they saddle and mount the animals. This is also a good time to discuss deworming and vaccination protocols.
Decreasing a horse’s parasite load
When horses are kept in rotated pastures, with ample space and access to non-grass plants, they may have few to no worms. The addition of other species, like goats or chickens, which are not hosts, will decrease egg and larval loads. We do not need to deworm unless there is a heavy parasite load. A few adult worms in the lumen prevent maturation of larvae, so this host/parasite interaction improves, rather than lessens, health.
The various pieces of the veterinary care pie are divided among many sources these days. It is important that, as veterinarians, we develop relationships with the nutritionist, farrier and “tooth fairy” so that we may work with them to develop a treatment plan for a horse or for a farm. Learn equine massage, chiropractic, osteopathy or other modalities so you can add to your bottom line, or partner with other practitioners for modalities you do not want to learn. Stay current on infectious diseases. Understand the effects of feed on the gut microbiome. Do regular proactive farm visits. Gain knowledge so you can be a more effective leader in the health care of your equine patients.