New Standards for Global Pain Management and Nutrition Launched by WSAVA at BSAVA Congress

During this year’s BSAVA Congress, the WSAVA  announced global initiatives aimed at improving the standard of pain management provided to companion animals globally and at enhancing understanding of the importance of nutrition in health and welfare.

Global Pain Treatise – a downloadable, practical resource providing pain management protocols for a wide range of conditions and drug availability, designed to assist practitioners around the world.  It has been researched by the WSAVA’s Global Pain Committee (GPC) which will implement a regional CE program based around its recommendations during the second half of 2013.

Global Nutrition Toolkit – a suite of nutrition tools developed by the WSAVA’s Global Nutrition Council following the launch of its Global Nutrition Guidelines in 2011.  They include practical aids for the veterinary healthcare team and a range of educational materials for pet owners.

The initiatives were first unveiled at WSAVA World Congress in early March.  The World Small Animal Veterinary Association (WSAVA)  is an umbrella organization representing 180,000 veterinarians globally through 93 member associations.

Immune-modulators can reduce severity of respiratory disease

Immune-modulators may provide a valuable contribution to the reduction of some respiratory diseases, concludes a new review published in Veterinary Immunology and Immunopathology recently. The study reviewed the immune-modulators Parapoxvirus ovis and Propionbacterium acnes for the prevention of respiratory disease and other infections in the horse.

Parapoxvirus ovis (iPPVO) and Propionibacterium acnes (P.acnes) are currently used in equine medicine as immune-modulators for prophylactic treatment or adjunct to conventional therapy in order to improve immune defences, to prevent or treat infectious diseases. Their mode of action relies on a non-antigen-specific interaction with the innate and/or adaptive immune responses. iPPVO stimulates and regulates cytokine secretion by a number of leucocytes, while P. acnes acts primarily through activation of macrophages.

The review, conducted by Romain Paillot of the Animal Health Trust, Centre for Preventive Medicine, Newmarket, examined current scientific literature and reports on the use of immune-modulators in horses, particularly for the prevention or treatment of equine respiratory disease.

Stress factors such as weaning, transport and co-mingling predispose horses to infection and increase susceptibility to respiratory pathogens such as Streptococcus zoopidemicus and EHV-1/4. In the past 15 years iPPVO has been tested against several equine infectious respiratory diseases.

The review examined the results of studies on the beneficial use of iPPVO to limit the severity of respiratory infectious diseases in young horses, one of which evaluated the use of iPPVO for protection in yearlings exposed by contact challenge to EHV-1 or EHV-4^2,3,4. Yearlings treated with iPPVO were co-mingled with horses experimentally infected with EHV-1 and the trial was repeated with horses infected with EHV-4.  Horses treated with iPPVO showed a 40% reduction in disease severity in the EHV-1 study and a 61% reduction in the EHV-4 study.

Further studies showed significantly increased frequency of recovery in horses with clinical signs of respiratory disease that had been treated with P. acnes. The decrease in disease severity was also significantly improved in the treated groups^5,6.

Romain Palliot concludes: “Non-specific immune-modulators such as iPPVO or P. acnes may not provide protection against direct infection or transmission of respiratory pathogens but they seem to contribute to the reduction of the disease severity, subsequently reducing the frequency of complications and improving the rate of recovery.”

References

1. Palliot R, 2013. A systematic review of the immune-modulators Parapoxvirus and Propionibacterium acnes for the prevention of respiratory disease and other infections in the horse. Veterinary Immunology and Immunopathology
2. Lindner, A., von Wittke, P., Thein, P., Strube, W., 1993. Effect of a paramunity inducer on the incidence of diseases and the plasma cortisol content in Thoroughbred foals before and after weaning. Tierarztl. Prax. 21, 47–50.
3. Ziebell, K.L., Kretzdorn, D., Auer, S., Failing, K., Schmeer, N., 1997. The use of baypamun N in crowding-associated infectious respiratory disease: efficacy of baypamun N (freeze dried product) in 2-week-old veal calves. Zentralbl Veterinarmed B 44, 415–424.
4. Donecker,JM & Holland Re. Efficacy of the immunomodulator Zylexis in horses challenged with equine herpes virus 2005. Pfizer Zylexis Technical Bulletin V3
5. Evans, D.R., Brent Rollins, J., Huff, G.K., Hartgrove, T.B., Van Kampen, K.R., 1988. Inactivated Propionibacterium acnes (immunoregulin) as adjunct to conventional therapy in the treatment of equine respiratory diseases. Equine Pract. 10, 17–21.
6. Vail, C.D., Nestved, A., Brent Rollins, J., Huff, G.K., Hartgrove, T.B., Evans, D.R., Clapper, J.J., Van Kampen, K.R., Peters, B.A., Hay, C.A., 1990. Adjunct treatment of equne respiratory disease complex (ERDC) with the Propionibacterium acnes, immunostimulant, EqStim. Equine Vet. Sci. 10, 399–403.

Riders needed for important research project

Equine vets at the Animal Health Trust are appealing to horse riders to help with an important research project, to assess the interaction between horse, saddle and rider. Participants simply need to complete an anonymous online questionnaire. In so doing they will be helping to protect and improve the future health, welfare and longevity of the ridden horse.

Dr Sue Dyson, Head of Clinical Orthopaedics at the Centre for Equine Studies at the Animal Health Trust and Line Greve, PhD Student, are conducting the detailed study to find out how the horse, rider and saddle can influence each other. They are particularly trying to understand better why a saddle may persistently slip to one side in some horses.

“Saddle slip is a problem seen in all sorts of horses and ponies and can contribute to back pain and thus impaired performance,” explains Line Greve. “Research suggests that 25% of British dressage horses have a history of back-related problems and subsequent reduced performance. Our preliminary studies involve just over 700 riders but for a more accurate picture we would like to bump this figure up to 1000 plus. We are urging all riders, whatever their level or ability, to help by completing the questionnaire.”

The online questionnaire should take no more than 15 minutes to complete and all answers remain anonymous. The questions cover saddle types, fitting, use and maintenance; rider experience, training and ‘handedness’; as well as horse type, use and any previous lameness or back-related problems. Please follow the link to the questionnaire http://www.aht.org.uk/cms-display/premise_questionnaire.html.

The results will be presented at the ground-breaking Saddle Research Trust Conference in 2014.

New study links sycamore tree to Atypical Myopathy

Toxins from the seeds of the tree Acer pseudoplatanus are the likely cause of Atypical Myopathy (AM) in Europe, concludes a new study published this month in the Equine Veterinary Journal (EVJ)¹. The common name for this tree is sycamore in the UK but it is also known as the sycamore maple in some other countries. There is further potential for confusion because a completely different tree, Platanus occidentalis, is known as the sycamore or American Sycamore in the USA. The new research follows hot on the heels of a study in the USA earlier this year that has linked toxins from the box elder tree (Acer negundo) with Seasonal Pasture Myopathy (SPM), the US equivalent of AM². The discovery marks an important step for the future prevention of this fatal disease.

Atypical Myopathy is a highly fatal muscle disease in the UK and Northern Europe. In ten years, approximately twenty European countries have reported the disease. Incidences tend to occur repeatedly in the autumn and in the spring following large autumnal outbreaks. Horses that develop AM are usually kept in sparse pastures with an accumulation of dead leaves, dead wood and trees in or around the pasture and are often not fed any supplementary hay or feed. SPM is a very similar disorder, prevalent in Midwestern USA and Eastern Canada that is now known to be caused by the ingestion of hypoglycin A, contained in seeds from the box elder tree.

The new European research¹ was conducted by an international team led by Dominic Votion, University of Liege and involved 17 horses from Belgium, Germany and The Netherlands, suffering from Atypical Myopathy. High concentrations of a toxic metabolite of hypoglycin A, were identified in the serum of all of the horses. The pastures of 12 of the horses were visited by experienced botanists and the Acer pseudoplatanus, the sycamore maple, was found to be present in every case. This was the only tree common to all visited pastures.

Researchers believe hypoglycin A is the likely cause of both AM in Europe and SPM in North America. The sycamore and the box elder are known to produce seeds containing hypoglycin A and the pastures of the afflicted horses in Europe and the USA were surrounded by these trees.

Hypoglycin-A is found in various levels in the seeds of plants in the genus Acer as well as in various other genera in the family Sapindaceae such as ackee (Blighia sapida).  In ackee, hypoglycin-A levels do vary with ripeness of the fruit and, if the fruit is eaten before it is mature, it causes hypoglycaemia to different degrees including a condition called “Jamaican vomiting sickness” (because of ackee’s use in Jamaican cooking) and occasionally death in humans.

Researchers at the Universities of Minnesota² and Liege are continuing their work to try to uncover exactly how the equine disease occurs. Discussing the on-going research there, Dr Adrian Hegeman and Dr Jeff Gillman of University of Minnesota point out, “It is likely that the most important contributing factors to horses becoming poisoned by hypoglycin-A are the availability of seed in the field combined with lack of other feeding options. The seeds from two species of maples (box elder and sycamore maples) that we have tested include significant quantities of hypoglycin-A.  We know that seeds contain highly variable quantities from seed to seed, even within a single tree.  We do not know yet how hypoglycin-A levels vary seasonally, nor do we know how its abundance varies with different levels of stress to the plant, though this may well explain seasonal variability in the occurrence of the malady. It is possible that conditions that stress the plants may contribute to significant seasonal changes in hypoglycin-A levels.  At this point we just don’t know.  It is common held knowledge that trees under stress usually produce more seed.”

Jeff went on to comment “Without question, further analysis of the seeds and other tissues from Acer species needs to be performed along with sampling of plant materials over multiple seasons and at various stress levels.   Additionally, one cannot rule out more complex explanations for the seasonality of disease occurrence such as: animals may begin feeding on seed materials in response to depletion of more palatable choices under drought conditions; or simple explanations such as high wind events driving seeds into fields.  These sorts of explanations for the occurrence of the disease do not depend on botanical variations in toxicity across seasons, sites or stress levels, yet also require consideration.

Although limited examples are available, the experience of animals at a pasture site might also confer some degree of behavioral resistance to poisoning due to exposure at sub-lethal levels with prior exposure to seeds in the pasture.

Professor Celia Marr, Editor of Equine Veterinary Journal said: “This is an important advancement in our understanding of what causes AM and how it can be prevented. In immediate practical terms owners can take prompt measures to avoid exposing their horses to sycamore seeds this autumn. Where horses are grazing in the vicinity of sycamore trees, it is imperative that they are provided with sufficient supplementary feed as this will minimise the risk that horses might be tempted to ingest seeds containing this toxin. This must be done carefully and leaving wet hay on the ground should be avoided so providing extra carbohydrate feeds may be more practical.”

“Too many horse vets and not enough jobs,” says BEVA survey

The British Equine Veterinary Association (BEVA) says that there may be up to five times as many veterinary graduates wishing to work in equine practice as there are jobs available. This alarming mismatch, which has been of growing concern to the Association, was highlighted in a survey of BEVA members’ practices conducted earlier this year.

BEVA represents 2,500 vets and vet students who work with horses in the UK and overseas. The survey was carried out amongst members in the spring of this year to ascertain manpower requirements of equine practices in the UK.

Of the 819 new veterinary graduates in the UK in 2012, it is conservatively estimated that between 10 and 15 per cent intend to work in equine practice. The extrapolated results of the survey suggest that in 2012 there was less than 1% growth in full time equine vet positions and as few as 24 new permanent jobs available in the UK.

In line with the survey’s suggestion of restricted opportunities, some BEVA members are also finding that internships, commonly the domain of new graduates to gain paid, supervised experience in practice, are now often taken by vets with some post-graduate experience. Furthermore, unpaid externships, which traditionally gave vet students valuable work experience, appear to be being filled by unemployed veterinary graduates wanting to gain experience in order to improve their chances of securing a job in equine practice.

“Earlier this year we had more than 80 applications for just one internship,” said Tim Mair, a partner at Bell Equine Veterinary Clinic in Kent. “Several years ago we would expect 50 or so applications for an advertised intern post but now, without advertising at all, we are constantly receiving applications, not just from new graduates but also from those who have been qualified for a year or more.”

On the subject of externships Charlie Schreiber, a partner at Donnington Grove Veterinary Surgery in Berkshire, commented: “We take on an average of two externs a month and over the past four years have had more than 350 applicants but their calibre is noticeably changing. We used to hear primarily from students but now it tends to be recent graduates or those who have already done a job in mixed practice and are keen to move into equine but can’t find an internship.”

Andrew Harrison, a partner at Three Counties Equine Hospital in Gloucestershire, continued, “In addition to the numerous applications we received for our recently advertised internship position, we are inundated with unsolicited enquiries about job opportunities from recent veterinary graduates from across the globe.  Our most recent advertisement for an equine veterinary nurse has attracted interest from a handful of recently qualified vets desperate to find work. This employment problem is not confined to internships; some of our recent interns have found it very difficult, if not impossible to find a job in horse practice, once they’ve completed their internship.”

Amanda Piggot, a recent graduate, has first hand experience of the challenge of finding a suitable placement. She said: “I have always wanted to work in equine practice and my approach has been very strategic. It took me five months to find my current position at Kessock Equine Vets in Inverness, which necessitated moving 500 miles further north than I ideally wanted. For my next position I applied to Liphook twice and had no luck but I have now been accepted by Rossdales for a two year internship.”

According to the British Veterinary Association (BVA) the problem isn’t confined to equine practice. The Association’s President Peter Jones commented: “The findings of the BEVA survey make sober reading and reflect the growing concerns in the wider veterinary profession about opportunities for new graduates in all types of veterinary practice.

“The issue has recently been brought into sharp focus by the announcement of a new veterinary school opening at the University of Surrey in 2014, with many BVA and BEVA members worried about an oversupply of veterinary graduates into an already competitive market. We are expecting the results of the RCVS survey of recent graduates shortly and, alongside the findings of the BEVA survey, they will provide an evidence-base to build on as we continue to assess the UK veterinary manpower implications of potential new veterinary schools in the future.”

BEVA is keen to help both potential employees and employers tackle the situation as constructively as possible. BEVA President Keith Chandler explained: “BEVA is proud that equine practice is attractive to so many younger members of the profession and it can provide a rewarding and fulfilling career. However we urge all stakeholders to ensure that current and prospective veterinary students are fully aware of the very limited opportunities in equine practice. Most of all we urge the students themselves to consider carefully their career path and prospects before making their final decisions.”

Next month the RCVS will be releasing details of a survey of vets who have graduated within the past five years and how easy they have found it to find a job that meets their needs. For further information visit www.rcvs.org.uk.

Tackling the irritating problem of pinworm

With reports of persistent pinworm infection becoming more common¹, Zoetis is advising owners to remember to address this itchy issue as a part of their overall worm control programme.

Pinworm cases are now being reported more frequently in all age groups of horse rather than just youngsters². Although generally not considered to be as harmful as some other parasites, pinworm can prove to be a considerable irritation for both horse and owner as they can cause severe itching and subsequent rubbing.

Pinworm eggs are laid around the horse’s anus in a sticky substance, which is an irritant causing itching and tail rubbing. When a horse scratches itself, residue of this sticky substance can be left on surfaces such as fences or stable walls, which can lead to spread of infection. Contaminated feed and water bowls can also present a problem if they are shared around the yard.

Adult worms may be seen with the naked eye or a skin scrape or sticky tape test may be carried out by a vet in the area around the anus. Although a faecal worm egg count may show pinworm eggs it is not particularly reliable for this parasite.

It is thought that the changing behaviour of pinworm may be giving rise to increasing and more stubborn infections. Not only has a shortened time between infection and egg production been reported but the parasite also appears to be adapting immunologically. Traditionally pinworm was thought to be specific to young horses, with older horses appearing to acquire a degree of natural immunity but now infections are being seen regularly in older horses. One study reported that 4 out of 8 horses with pinworm were 17 years or older¹.

“Good stable and horse hygiene are imperative for the management of pinworm,” says Zoetis vet Wendy Talbot. “It’s crucial to break the lifecycle of the worms. Walls, fence posts and any surface that may have been contaminated should be scrubbed using a hard wire brush and a non-toxic disinfectant and feed and water sources should be thoroughly cleaned out, to prevent re-infection. In addition the area around the horses tail and anus should be washed with an appropriate cleanser to remove the eggs and soothe the area.  If you think your horse may be suffering from pinworm it’s important to talk to your vet to discuss the best worming programme.”

Stable Mate, the new App from Zoetis, makes it easy to manage your daily equine healthcare regime, including worming and it also provides handy healthcare advice. It is available from the iPhone App Store and Google Play Store: text Stable Mate to 80800 to download. To find out more visit www.wormingyourhorse.info

1 Reinemeyer, C., (2012) Anthelmintic resistance in non-strongylid parasites of horses. Veterinary Paristology; 185, 9-15

2. AAEP parasite control guidelines 2013

Vetfile – Congress reminders

Congress season is fast approaching with BSAVA Scotland starting the proceedings at the end of August. There is still plenty of time to let delegates know where you are going to be during congress. Vetfile can turn a mailing around within 24/48 hours; by Wednesday 21st August your chosen delegates can know everything about what you have to offer. That is a week before congress starts. We have 903 veterinary surgeons that see cats and dogs within Scotland.

BSAVA Scotland is followed closely by BEVA on 11th September; Vetfile has mailing addresses of 3,202 surgeons that treat horses either in equine specific hospitals or within mixed practices.

October is another busy month with two more congresses taking place. BVNA congress is on 11th October, Vetfile can mail to veterinary nurses and head nurses, reaching 8,085 veterinary nurses. Vetfile can also target the trainee nurses too. BCVA congress starts on 17th October; the Vetfile database holds information for 2,901 surgeons who treat cattle- both dairy and beef.

London Vet Show rounds of the season on 21st November, attracting delegates who treat not only small animals, but equine and cattle.

For more information about how Vetfile can help you deliver your messages, please call 01733 383537.