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A report from the Merial - Performance Horse CPD and Raceday at Gowran Park

VETERINARYWeb Master
Performance Horse CPD, Gowran Park Racecourse Vets from all over Ireland congregated at Gowran Park racecourse in July for a continuing professional development event on the Performance Horse. The event, organised by European Trainer Magazine and Merial Animal Health, was the second in a series of veterinary CPD events for 2017 and featured a panel of expert speakers. The event was co-sponsored by Haygain and Connolly’s RED MILLS. Becky James BSc, MSc attended the seminar and reports on the key messages. Managing Inflammatory Airway Disease – Dr Emmanuelle Van Erck-Westergren   The first speaker Dr Van Erck-Westergren was due to fly in from Brussels on the morning of the event, so when her flight was cancelled at the last minute there was a moment of concern for the organisers but they arranged to bring her into the room via a video link so all was not lost!   Using her experience in practice at the Equine Sports Medicine Practice in Belgium, Dr Van Erck explained the importance of vets helping clients to manage the environment of the horses to prevent and manage Inflammatory Airway Disease (IAD). She described managing the horse’s environment to reduce exposure to noxious inhalable particles and improve hygiene and ventilation in the stable as the cornerstone to the success of treating IAD.   Important considerations for the environment include building design, bedding, stable activities and most critically, the forage, as this is in the horse’s breathing zone. Dr Van Erck explained that hay remains an important source of forage for horses but it is also a major source of dust and contaminants. Soaking hay is a cheap way of reducing airborne dust but it promotes bacterial proliferation and leaches out the nutritional value so well-made haylage or preferably steamed hay should only be fed to horses with IAD.   The hygienic and nutritional quality of haylage produced by local farmers can be irregular. Some horses’ digestive systems do not tolerate it well and horses can get gases or diarrhoea. Commercially-available haylage usually undergoes quality control but is expensive and although lower in airborne dust, is never “dust-free”.   Hay steamers are a promising alternative, reducing the airborne respirable dust by 98% and the wet heat of the steam killing the bacteria and moulds in the hay without altering the nutritional quality. In comparison to all other hay sources, steamed hay has been shown as the optimal solution to significantly reduce IAD in affected horses [1]. It must be noted that some homemade hay steamers do not allow homogenous circulation of the steam and improper temperatures at the core of the hay results in microbial incubation rather than elimination.   [1] Dauvillier J. & Van Erck-Westergren E. Prevalence of fungi in respiratory samples of horses with Inflammatory Airway Disease. In Proceedings of the 2016 ACVIM Forum, Denver, USA.   Assessment of a novel antioxidant supplement for TB horses in training – Maureen Dowling   Maureen Dowling was next up to speak and presented the results of a study which tested the effects of a novel supplement on markers of antioxidant status and muscle cell physiology on thoroughbred horses during and following a moderate training programme.   It is known that the increased utilisation of oxygen during exercise can have detrimental effects on equine muscle cells. The production of such reactive oxygen species can outweigh the ability of the horses to detoxify these molecules which disrupts the antioxidant-oxidant equilibrium causing oxidative stress. This can lead to muscle cell necrosis resulting in muscle tissue damage, which in turn, can affect performance.   The research found that horses supplemented for a period of 12 weeks have significantly less oxidation levels in their blood 24 hours after strenuous exercise and immediately following a maximal intensity trial, than horses not supplemented.   Sweet is the sound of silence – respiratory obstruction in the performance horse – Claire Hawkes MRCVS DipECVS   Claire Hawkes set the scene explaining that a resting horse has a respiratory rate of 12 breaths per minute and breathes a total of 60 litres of air per minute. Compare this to a racehorse under race conditions - the respiratory rate increases to 120 breaths per minute and exchanges up to 1800 litres per minute. She went on to describe the structure and function of the respiratory tract describing the larynx and soft palate as weak points in the upper respiratory tract. These weak points can become sites of airway obstruction when under the extreme fluctuations of air pressure experienced during intense exercise.   Upper airway obstructions result in reduced airflow leading to reduced oxygen intake which, in turn reduces ventilation and impaired oxygen perfusion of the muscles, ultimately resulting in reduced performance.   Overground endoscopy has allowed us to assess horses during experience making accurate diagnoses readily accessible. These systems can be used in conjunction with GPS and ECG monitoring to give a more thorough investigation.   There are three common airway obstructions seen: vocal fold prolapse, arytenoid collapse (roarer) and axial deviation of the aryepiglottic folds, Table 1 below describes their severity and treatment.   INSERT Table 1: Common airway obstructions and their treatment (P15 of the speaker notes)   How equine influenza and equine rhinopneumonitis viruses impact performance horses – Professor Ann Cullinane   Professor Cullinane has been Head of Virology at the Irish Equine Centre since 1987 and Head of World Organisation for Animal Health (OIE) reference laboratory for equine influenza since 2009.   “The most common viruses encountered in racehorses in Ireland are equine influenza and equine herpesvirus 1 and 4.” Professor Cullinane stated. She went on to explain that in a naïve population, equine influenza spreads rapidly. For example, in an unvaccinated population stabled at a racecourse in Australia it was reported that over 700 horses showed clinical signs within five days. However, in a partially immune population clinical signs may be subtle or absent, and viruses spread at a considerably slower rate.   Real-time PCR has revolutionised the diagnosis and management of these viruses. They can be identified in nasal swabs or other samples on the day of submission. In addition, it is relatively simple to screen all horses in a yard repeatedly, allowing the veterinarian and trainer to monitor both the spread of virus and the extent of the virus shedding by infected horses. Equine herpesviruses may take several weeks to spread through a yard, causing significant frustration to the trainer.   Vaccination against equine influenza is effective but vaccines should contain epidemiologically-relevant viruses. Since 2010, all outbreaks of equine influenza in Ireland have been caused by Clade 2 viruses of the Florida sub-lineage. Proteq Flu is the only vaccine available in Ireland that contains Clade 2 virus and is in compliance with OIE (World Organisation for Animal Health) recommendations for equine influenza vaccine strain composition.   Vaccination against equine herpesvirus appears to be less effective than equine influenza vaccination but may reduce virus shedding and therefore limit the recovery period.   What’s new with Gastric Ulcers? – Dr Kevin Corley   Dr Kevin Corley is a consultant in equine internal medicine and critical care at Veterinary Advances Ltd and was the penultimate speaker of the day. He started by describing the horse’s stomach, defining the two very different regions: the squamous area at the top of the stomach which is pink in colour and has the same lining as the oesophagus, and the glandular area at the bottom which is dark pink to red in colour and produces acid. The acid has two major roles, it is the first step of digestion and also acts as a barrier to reduce the number of bacteria entering the rest of the intestine.   Squamous ulcers occur from acid injury to the non-protected squamous epithelium when the horse exercises faster than a walk and acid is thrown up to the top part of the stomach. There is a very high prevalence of squamous ulcers in horses in training. 80-100% of Thoroughbreds in full training, 66-93% in Endurance horses in a competitive season. In comparison to leisure horses, kept and worked in their home environment and rarely competed, the prevalence is around 11%.   The pathogenesis of glandular ulcers are not fully understood but it is believed that ulcers occur as a result of a breakdown of the protective barrier. In humans, steroids and bacterial infection (Helicobacter pylori) are the principal cause of glandular ulcers.   Again, there is a high prevalence in horses in training with 47-65% of thoroughbreds and 33% in competing Endurance horses.   Clinical signs of ulcers are varied and not consistently present but can include: Difficulty in maintaining body condition Poor appetite Colic after feeding Poor coat condition Wind sucking and crib biting Behavioural changes – aggressive or nervous Poor performance   Dr Corley made the interesting point that the severity of clinical signs doesn’t correlate well with the severity of lesions which appear on a gastroscopy.   Nutritional factors were the highest risk for ulcers, if horses are left with no forage for more than six hours this significantly increases the risk of ulcers and if more than 2g/kg body weight of starch is fed per day. This is because food, especially forage, is a buffer to the stomach acid, and therefore prolonged periods without food promotes the formation of ulcers.   Environmental stress is also implicated in gastric ulcers. Different trainers have different incidents of ulcers in their horses, the time in training also has an effect on the percentage of horses with ulcers, the highest percentage of horses with ulcers occurs five months after starting training. Surprisingly, even playing the radio in stables is associated with ulcers. If a talk radio station is on in the stables, horses are 3.6 times more likely to have ulcers. A music radio station means horses are 2.8 times more likely to have ulcers and the longer the radio is played the more likely the horses are to have ulcers. Training at the same location where the horse is stabled is associated with increased ulcers.   The mainstay treatment of gastric ulcers is omeprazole, but Dr Corley emphasized the need for a few management practices in order to reduce the incidence of ulcers. These included keeping a calm and quiet environment for the horses, allowing constant access to forage and to feed less concentrates and to turn horses out in the field as often as possible in pairs or groups.   How to maximize the benefit of MRI and bone scanning – Warren Schofield MA, VetMB, CertES(Soft Tissue), MRCVS, Dip ECVS   The final speaker was Warren Schofield, who gave an overview of diagnostic tools for modern equine lameness investigations. Research over the last 20 years has shown that a horse lame in the foot looks the same as a lameness originating in the shoulder, so it can be difficult to accurately diagnose the problem.   There have been four main areas of development in the field of equine lameness diagnostics over the last few decades:- 1. Bone scanning or nuclear scintigraphy   This is a screening tool for the entire skeleton, the limbs, back, neck and head and is not just useful for lameness diagnosis, but for assessment of poor performance, where a specific lameness is not obvious on examination. Orthopedic pain is now recognised as the most common cause of loss of performance and non-work days in racehorses. He commented that at Troytown Grey Abbey Hospital, they scan approximately 150 horses per year. The scanning shows up regions of “hotspots” where there is any increased bone turnover. These hotspots in performance horses are regions of bone remodelling – either fractures, stress fractures, stress bone remodelling, arthritis and sometimes, though rarely, bone infections or tumours. It is a highly sensitive method and therefore extremely useful for confirmation that something isn’t there, such as a stress bone reaction. For example, when considering stress fractures in the pelvis of racehorses, the scan will identify over 98% of horses which have a fracture, compared with ultrasound scanning, which will only identify about 50% of horses with a fracture.   2. MRI Scanning   MRI scanning is used to image feet, pasterns, fetlocks, cannon bones, the ligaments, tendons up to the carpus and hock, and even carpus and hocks themselves, if the patient is cooperative. The strength of MRI is its ability to show soft tissues and bone on the same image and to have multiple directions to find the right angle to assess the structures. It gives definitive, non-invasive assessment of bone pathology.   3. Lameness Locator Device   A relatively recent innovation, developed by veterinary researchers at the University of Missouri, uses lightweight sensors on the horse’s head, pelvis and right pastern to assist clinical judgment during lameness investigations. It is good at quantifying levels of lameness and can be used to assess the response to diagnostic anaesthesia.   4. Diagnostic anaesthesia   Diagnostic anaesthesia remains an extremely important part of lameness investigations, giving an approximate guide to the region of pain. However, it should be remembered that it is approximate and just one stage of the investigation.   The talk concluded with advice on how to get the best out of MRI and bone scanning, highlighting the need for case selection and prior work-up investigations, but when used appropriately they are both powerful, accurate tools in lameness investigations.   The well-attended seminar finished with lots of stimulating discussions amongst the speakers and delegates over a late-lunch and some exciting racing on the Gowran Park track.

Becky James BSc, MSc - Haygain

 

Vets from all over Ireland congregated at Gowran Park racecourse in July for a continuing professional development event on the Performance Horse. The event, organised by European Trainer Magazine and Merial Animal Health, was the second in a series of veterinary CPD events for 2017 and featured a panel of expert speakers. The event was co-sponsored by Haygain and Connolly’s RED MILLS. 

Managing Inflammatory Airway Disease – Dr Emmanuelle Van Erck-Westergren

The first speaker Dr Van Erck-Westergren was due to fly in from Brussels on the morning of the event, so when her flight was cancelled at the last minute there was a moment of concern for the organisers but they arranged to bring her into the room via a video link so all was not lost!

Using her experience in practice at the Equine Sports Medicine Practice in Belgium, Dr Van Erck explained the importance of vets helping clients to manage the environment of the horses to prevent and manage Inflammatory Airway Disease (IAD). She described managing the horse’s environment to reduce exposure to noxious inhalable particles and improve hygiene and ventilation in the stable as the cornerstone to the success of treating IAD.

Important considerations for the environment include building design, bedding, stable activities and most critically, the forage, as this is in the horse’s breathing zone. Dr Van Erck explained that hay remains an important source of forage for horses but it is also a major source of dust and contaminants. Soaking hay is a cheap way of reducing airborne dust but it promotes bacterial proliferation and leaches out the nutritional value so well-made haylage or preferably steamed hay should only be fed to horses with IAD.

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