Archive | March 2014

AERC March 8: Kira Epstein–> Colic in Endurance horses, or…?

Disclaimer that goes for ALL my blog entries, but especially when I am reporting on what others said: I can be wrong, I welcome corrections and comments, and I will remove any spam, flame, or non-productive comments. Let’s stay CIVIL and show respect; 3 R’s: respect the post, respect each other, and respect this place. Thank you.
In addition, I am thinking of myself as a *connector*, So, if you have questions about the content, do contact the person who did the presentation. I will provide as much information about contact info as I can.

Presenter: Kira Epstein, Works in the Equine Emergency Clinic at University of Georgia ( 6 years, I think?)
DVM Dr of Veterinary Medicine
DACVS Diplomate, American College of Veterinary Surgeon
DACVECC Diplomate, American College of Veterinary Emergency and Critical Care

I am hoping that you, reader, as I did, find this information educational and helpful because I can now be a much better advocate and helper for my veterinarian if this happens to my horses. I find information calming and soothing.

Dr. Epstein, Kira, she said…. *Horses will Colic, they are just made badly* and then she started out asking the audience how many people had a horse that had colicked– 90% of the people in the room ( I think the room holds 150-200 people and it was fairly full at this session).
then, she asked how many people had had horses colic as a result of an endurance ride, less people raised their hands but maybe about half of the 90% who initially raised their hands at the starting question.

Then she said that at this time, there is not much information on colics in endurance horses so she was going to give us the basics of colic then talk a bit about colic in endurance horses. She mentioned she sees 5-6 colics per week present at the clinic where she works and she wanted to educate us a bit about colic so we all have the same language as well as a basic understanding of how she deals with colic cases and makes decisions about colic cases.

This was an extremely helpful session in colic education.

Kira started with the basics of Colic, that Colic is abdominal pain in the horse. What causes the pain? Stretch receptors and chemical receptors in the peritoneum ( lining of the abdominal wall). Stretch receptors in the mesentery ( double lining in the GI tract) that sense distention. and Chemical receptors that sense products o inflammation and anaerobic metabolism. These receptors are in the whole lining of the peritoneum so the pain in the abdomen is not as localized as you might think so finding where the pain is actually coming from can be difficult.

Symptoms of colic are variable and include: off feed, changes in manure, pawing, looking at or kicking at abdomen, posturing, stretching to urinate, laying down, quietly laying down to rolling convulsively; there are breed and sex differences in symptoms as well. You, the owner know your horses the best so PAY ATTENTION.

The Dr. Kira Epstein decision tree: you may assume my notes above and below are my renditions of Dr. K’s presentation.

Anatomy of Colic: Is the colic in the GI tract or not or localized elsewhere?
GI tract is where almost all colics are, there are a few cases when the colic is not in the GI tract.
GI tract is stomach, small intestine( duodenum and jejunem and ileum— **** Most colics happen in the Ileum****), and large intestine ( cecum, lg colon,transverse colon, small colon). A question that popped into my mind as Dr. K was talking was that I have heard the phrases Hind Gut and Fore Gut used, so I was wondering how the two anatomy languages match up. So when I had a chance I looked it up and logically it works out, see here

Other stuff that is in the equine abdomen are reproductive organs, spleen, urinary tract, lover, kidney ( Colics rarely happen in these areas and organs)

There are diseases that present like colic and need to be ruled out: Typing up– muscuoloskeletal system, Unable to get up=neurological, *shipping fever= lung or pleural infection*= respiratory, and cardianc failure.

Ok, Back to GI Colic: There are three mechanisms of colic: non strangulating, strangulating, and inflammatory.
Non Strangulating colics impact the aforementioned stretch receptors via impaction, displacement, ileus ( intestine stops oand ingesta cannot move– **** 80% of colics are ileus of the large intestine***

Strangulating colics impact the stretch and chemical receptors hence the purple colors of organis due to strangulating obstructions.

Inflammatory Colics impact the chemical receptors resulting in diahrrea if in small intestine and fluid in stomach if small intestine not working.

Treatment plans for colics in the Field: treat or refer and/or in the hospital medical or surgical
First, a colic exam is done: Physical exam, Nasogastric tube and Rectal Exam plus in lessening order of getting good information back: bloodwork, ultrasound, abdominocentesis, radiographs, fecal testing and gastroscopy.
Physical exam determines level pain : mild– pawing, stretching; moderate–wanting to lay down w or w/o rolling
and severe–constantly wanting to roll and roll onto their back. ****Strangulating colics result in sicker horses with typically more pain.**** Then, Triage exam: Cardiovascular stats: HR, pulse, mucous membrane color and cap refill, jug refill, leg and ear temperature. **** Strangulating and Inflammatory Colics present as much sicker horses than non strangulating colics). Then, yep! GUT SOUNDS– all quadrants, both sides, and a ping test ( this was interesting– hold stethoscope on gut in different quadrants and flick the skin, results in a different sound if there is a gas bubble trapped in the gut — wow. The veterinarians call it simultaneous auscultation ( listening) and percussion– which is self explanatory); then take temperature; a fever is more associated with the inflammatory colic. Then, rule out other diseases/causes of the colic symptoms in other body symptom such as concurrent illness, look for self- traumatization and injury and any other look-alike diseases.

Next–>Pass the Nasogastric tube look for more fluid– this can be diagnostic and treatment– because if the horse’s small intestine has stopped working and fluid is building up in the stomach, the tube can help empty the fluid and take the pressure off the stomach since horses cannot vomit. Use the tube to pass fluids, elytes, laxatives and stuff that can bind toxins. Passing the tube is followed by the rectal exam– CAUTION! a normal rectal exam does not mean nothing is wrong. Blood work is next or simultaneously looking at WBC, inflammation,elyte levels, Ultra sound cab be employed to look at displacement, distention, abdominal fluid,liver, kidney,and spleen.
Abdominocentesis the Belly Tap= can allow us a look at WBC, protein, lactate and color: RED/Oraneg is usually associated with strangulating colics, WBC, protein and lactate increase w strangulating colics. Radiographs can show us sand, enteroliths, Fecal testing can show us bacteria, parasites, sand and gastroscopy can show us ulcers and impaction or telescoping gut.

Treatment decision and comparative cost and once you have diagnosed the type and severity and location of the Colic cause:
Non strangulating in the small and large intestine usually treat medically first then consider surgery $$
Strangulating in the small and large intestine usually surgery is considered first– Cost is about the same as intense medical treatment $$$
Inflammatory in small and large intestine usually intense medical treatment. Cost is about the same as surgery $$$

If you are in the field, then it is important to decide quickly if it is strangulating or not to be able to refer faster to the hospital; once at the hospital all tests are re-run. Sometimes surgery and be exploratory.

Treatment: withhold feed, allow to nibble on grass,

Medical Treatment: pain management= antinflammatories (banamine), sedatives,, analgesics, antispasmodics. CAUTION= NO BANAMINE INTRAMUSCULARLY– FOR SOME REASON IT CARRIES A HIGH RISK OF CLOSTRIDIUM INFECTION, SO JUST DON’T EVEN IF IT SAYS YOU CAN ON THE BOTTLE. Fortunately–Banamine has good oral availability so give it orally or IV. Remember that pain can reduce gut motility. Give Fluids, orally or IV– Hydration is good, get fluids, elyltes and nutrition into the horse. Oral fluids help with impactions IV fluids don’t do that as well. Give Laxatives orally– such as mineral oil, epsom salts, psyllium, and balanced elytes. Can Give medicines orally as well– biosponges, antibiotics, laminitis prophylaxis. Trocharization is a possibility to reduce gas, usually there is limited indication for trocharization.

Surgical Treatment: Dr. K says *majority of horses do not go to surgery* Surgical procedures include: decompression, correct orientation,resection. 20% of horses coming in for colic are referred for surgery– 25% of that 20% actually GO to surgery.

Recovery from Colic Surgery is usually: in the hospital 1 week, 1 mo stall rest, 1 mo small paddock, 1 mo reg turn out. Prognosis post colic surgery: Non-strangulating colic– very good to excellent; Strangulating -variable– in the small intestine and uncomplicated surgery 80% of horses return to work; 60-80%.
Inflammatory– variable. Dr. K says, that the Majority of horses return to previous or higher level of performance; Racing and non Racing.

Dr. K did caution us that if our horse is lame prior to colic surgery that the colic surgery is not likely to cure the lameness. ***SNORT** Veterinary humor…

Ok, the Endurance connection, whew, finally! The final 10 min of an hour and a half plus talk!
Colic is one of the more common reasons for elimination from endurance competition. this is based on a paper written by Dr. Langdon Fielding–> 40% of endurance eliminations are due to colic; usually exercised induced ileus, displacements, impactions, salmonellosis, and gastric ulcerations. Ulcers are really really REALLY common in performance horses.

But, luckily,Dr. K did say that most horses can be treated in the field, medical management is the norm, and prognosis is excellent.


AERC: March 7 Friday Jeff Pauley CJF, AWCF– shoeing for endurance

Disclaimer that goes for ALL my blog entries, but especially when I am reporting on what others said: I can be wrong, I welcome corrections and comments, and I will remove any spam, flame, or non-productive comments. Let’s stay CIVIL and show respect; 3 R’s: respect the post, respect each other, and respect this place. Thank you.
In addition, I am thinking of myself as a *connector*, So, if you have questions about the content, do contact the person who did the presentation. I will provide as much information about contact info as I can.

Presenter: Jeff Pauley
Contact information:
CJF–Certified Journeyman Farrier
AWCF–Associateship of the Worshipful Company of Farriers. Yep. I looked it UP!

Jeff starts out with * I have been shoeing a long time and seen a lot*. Ok, educate us please!
I enjoy it when a speaker asks us questions to get our brains working, Jeff does that:
Q1. What is your farrier’s responsibility?
Answers from brave audience members ( AfBA) Lol.
variously: *balance your horse’s feet*, *provide balance*, *shoe my horse*, lots of quiet with thought bubbles * what is this guy’s game?*
Jeff’s answer: Stay out of your horse’s way. LOVE THAT! My farrier says much the same thing…

Q2. What is expected of your farrier?
yeah, everyone says *Miracles*– much laughter 🙂 yep
Jeff’s answer: professionalism, honesty,be forthcoming, excellent communication skills.

Q3. Whom do you ask when you have issues concerning horse’s feet?
Jeff’s answer? I was talking and did not catch this… MY answer was my farrier and veterinarian.

Jeff Says:
Farriers are after optimal performance
Identify and achieve balance for the individual horse
Minimize stress that causes injury
Buy smart ( was that shoes? farrier or the horse or all Jeff?)
OH, it was all– for Optimal performance:
Jeff Says: quote “Don’t try to make chicken salad from chicken s***” hahahahaha. oops, isn;t that what I did? sigh….. yeah, nine pages of mistakes LATER. Taking notes now.

BUY SMART: pay attention to horse conformation because Form affects Function, yep it does!
pay attention to horse posture, hoof quality, for the level of work you plan to use your horse for hoof quality is of utmost importance. He is a big believer in supplements for hoof health. Hoof quality is controlled by environment, nutrition, genetics, training and farrier/vet decisions.

Jeff Says: your farrier should shoe the horse, not a trend or philosophy; open-minded farriers tend to have the horse’s best interests in mind.Jeff went on to say the following about Static and Dynamic Balance:
Static Balance rules: evaluate the horse as they are standing square, all four feet with even weight bearing, assess each leg as an individual unit; assess growth rings– are they compressed? that means uneven stress. But, trimming one side of the hoof to tilt the hoof capsule rarely works.
Dynamic balance– arabians tend to have offset knees, toes in, flared medially which leads to paddling, landing hard on the lateral wall and breaking over the outside toe. ( You can BET I am taking this to MY awesome farrier and have him explain again and point out what this means to MY horses). Jeff continues: All horses have some hoof distortion farriers should maintain that distortion and keep the horse comfortable. He also said that *striking or forging* is a front end issue. Jeff said that quite a bit of what he has learned and read is from Simon Curtis and

Jeff went on to say, again, that function follows form; that farriers can affect foot landing, weight bearing phase and break over, but as soon as the hoof leaves the ground, conformation takes over. However, farriers should assess the horse in motion to see all phasess so they can better affect the parts they can have some affect on. Since there is tissue adaptability, from repetetive loading, ( e.g. tendons, ligament and bone) xrays are important prior to first race of the season. Farrier is looking for vertical depth, bony alignment, joint spacing, and hoof capsule in relation to P3 pre-shoeing. Wow! Xrays? by and for a farrier?

After all that, Jeff said that most injuries occur in the loading phase ( stance phase) and that uncollected horses are at more risk of injury– yep, a farrier said that! we should collect our horses, and shoe at shorter intervals [because more growth=more distortion]–>and choose our rides wisely because we don’t want to ask our horses to compete on surfaces that exceed their hoof mass. Huh? what? if a horse tends to hoof issues? pay more and closer attention to conditioning and competetive surfaces… wow… so much to think about here. Think about the different surfaces on which we compete- and the different needs of the hoof/horse ( Remember NO HOOF NO HORSE!) for the different surfaces– if we are competing in sand we want flotation conversely if we are competing in or on technical trails we want traction. Different shoes can be used to achieve these effects to minimize injury ( soft tissue injury in sand and other types of injury on technical terrain).

Jeff said we should study the terrain on which we compete— tell our farrier if we have any suspicion of injuries, try to correct defects before they become a problem so we are paying very close attention. Since shoes are an extension of the hoof capsule and that we want the shoe to dissipate the energy from the landing, that we want the lightest weight shoe possible without jeopardizing support and rigidity. Too light or too heavy of a shoe =foot soreness.

Lastly, Jeff recommended that the IDEAL shoeing schedule is 10 days prior to a ride.

Signing off now, to go REplan my ride and shoeing schedule.

On the town in Atlanta, GA

Team member David LeBlanc recommended Imperial Fez — and now we do too!Took a cab to Buckhead to the restaurant. walked in and suddenly we are surrounded by pillows and color and music. We then were lucky enough to talk with the owner, Rafi. He regaled us with stories about the similar restaurant Kasbah in Seattle which Anne-Marie loves. This restaurant has the same menu, same art on the walls, very similar food. Rafi was cute and talkative and just a lovely conversationalist. We had a wonderful evening eating some of the best food I have ever eaten- your evening starts with a rosewater handwashing, and you drape a towel over your left shoulder, because? you eat with your fingers– awesome! Firs course is lentil soup–Harrira– lovely! followed by a plate full of 7 different salads. YUMMY! followed by B’stella—- Exquisite– pause and THEN? Belly Dancers who were very talented put on a show! followed by main entrees ( we had Cornish-hen Tagine (with Green Beans, Sweet Peas & Baby Carrots Baked in Saffron Sauce Moroccan Preserved Lemons, Garlic & Olives) and Roasted Lamb Shank (Baked in Cumin, Garlic, Paprika, Fresh Cilantro &
Fresh Herbs, Garnished with Exotic Mushrooms) which are to die for, followed by dessert, which is too much by that time. More washing in Rosewater.! FULL and satisfied. Sharing with a friend on vacation is just splendid.

See the pictures

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AERC 2014 in Atlanta, GA! Brrrrrrrrrr it’s COLD here– Day 1 Thursday March 6

We have arrived safely and uneventfully in Atlanta, GA– man it is COLD here! 39* and sleet/freezing rain and the countryside is brown. We are registered and ready to attend sessions! Anne-Marie Rousseau and I are her having some girlfriend time together, which rocks because we are able to chatter about all of the stuff we shall learn and you all know how much better that is! The weather is 39* and brrrrrr cccccold! sleet and freezing rain. The Sheraton Gateway Hotel is a 12 story brick building… BRICK! Because of my patience when booking a room way back when I was rewarded with a lovely room on the Club Floor– 12th floor with complimentary appetizers and drinks 5p-8p every day and complimentary continental brekki every day! SCORE! Anne-Marie and I are feeling pretty darn special right about now. Yay! We have a packed schedule with all kinds of stuff to learn as well as Tack Swap and Hot Topics and Social events to mingle with the locals and horsey peeps from across the nation; so exciting!

First person we met was the awesome Troy M. Smith; she is as lovely in person as she is online!


Anne-Marie attended the Board meeting, which includes our regional directors Paul Latiolais and Stephanie Teeter controversial topics are in front of the board– here is a link to the proposal

and here is a link to the other possibly controversial topic in front of the Board

I can’t wait til Anne-Marie gets home to share what she learned by attending the board meeting. While she was doing that, I was using Adobe Connect to meet with a graduate student and get some work out done — horses are resting but I need to stay in shape because HOTR is almost upon us. So, Anne-Marie was at the board meeting Friday from 8p-11p YOWZA! she stayed until the bitter end… the topics at hand were the above. It was contentious and the motion about AERC and FEI was tabled until Sunday morning. Until the study on the actual fatalities and fractures is done and everyone has read the report to inform the decision. The motion about the package of rules was sent back to committee- amidst much teeth gnashing by the committee from whence it came.

Saturday March 7th UP at 5:30a— ( 2:30a our time UGH!)we dined en suite with a lovely breakfast of egss and sausages and coffee and toast with peanut butter and jam and coffee and hit the Hot Topics seminar–FEI and AERC and USEF–> with the board members and interested attendees which numbers about everyone with few exceptions. Hot Topic was the tabled motion– refereed by John Parke— excellent moderator who asks really great questions! Such as * is there anyone who really thinks we should step away from FEI and stop co-sanctioning rides?*
Lots of people with lotsa miles spoke in favor of many things 🙂 Turns out that the fact that AERC is listening and responding has resonated with FEI which USEF appreciates because AERC is seen as the endurance *arm* of USEF and AERC’s voice is important as the endurance part of horse performance and competition here and respected worldwide.

FEI has already started making changes for the good of the horse– yes, there are problems with current rule enforcement but there is a committee committed to this and changes are being made. FEI has amde changes in the past that has profoundly affected the welfare of the horse– it is important to remember our history here; FEI enacted rules that stopped a country’s practice of *the horse only has to live 24 hours after the finish of the race to qualify for completion*. We do need to support FEI and work together with FEI and USEF. Yes, it is possible FEI says AERC is *too tough* with our rules and they might be more OK with AERC leaving than staying because AERC is annoying with all of the *welfare of the horse* stuff we are insisting on. It seems there is also a timeline, short and long for FEI to enforce the rules and agreeably our AERC-International committee will monitor and report on progress so that is how it should be, yes? There were requests for the fatalities and fractures data and that should be forthcoming soon, maybe even tomorrow morning? Very interesting and ongoing discussion shall ensue, I am sure– if you are reading this you are encouraged to read the motion in its’ entirety so you know what it says. The motion came out of a committee, it is not anyone’s motion it comes from committee.

—–discuss? yeah…..

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