Southeast Asia Blog: Vaccinating the Horses

This is the last in a series of travelogues that jockey-veterinarian Ferrin Peterson has written for the TDN about her charitable mission to Southeast Asia to bring much-needed veterinary care to the population's animals. To read the prior installments, click here, here or here.

The trials of the jungle are ever-changing. We had started vaccinating the horses one evening when suddenly the sky opened and a downpour came. We returned the vaccines to the refrigerator and ran for shelter. In the evenings, I always read my book, “Where There Is No Animal Doctor,” to look for answers from my cases that day. I used my headlamp to read, but that night the rain brought swarms of small moths which were attracted to the light. I tried to wrap myself in a tarp so they could not fly in my face, but they managed to find an opening and fly right into my eye. I finally gave up and went to sleep early. The villagers said those moths come out during storms, and the next morning everything was covered in dead moths. Usually the bugs are not that bad this time of year with it being the dry season. Next trip, I am bringing a mosquito net! Bathing in a cold river used to be tough for me, but between the humidity, long hikes with the herd, and looking at parasites, I was always grateful to jump in that river at the end of the day. Lacking the vet supplies I need happen on a case-by-case basis, and I will never be able to pack enough to cover all my bases. It makes me appreciate the convenience of working in a fully-equipped hospital and having pharmacies readily available.

The vaccines stayed properly temperature-regulated this time. Other than the rain storm delaying our vaccine clinic and working with half-feral mules and ponies, the mule men successfully vaccinated the entire herd. I told the men the amount of vaccine to draw up according the animal's size and the area on the neck to administer the vaccine, but I left the hands-on work up to them. One of the men was missing most of his fingers; but despite his birth defect, he was able to figure out how to connect a syringe and needle, which requires a fair amount of dexterity.

I conducted a fecal test to get an idea of the types of parasites infecting the herd. I went to the human medical clinic to use their microscope and met some of the medics and students working there. They were very interested in what I was doing with horse stool, so it was easy to strike up a conversation in broken English. I learned one of the medics, named Naytaw, had recently graduated with a Masters in Public Health. He spoke English well, and he told me there are university programs for refugees, and that he had interacted with Harvard Medical School through the program. After graduating, he chose to return to his village to help his own people.

After finishing my parasitology observation at the clinic, I headed back to meet with the mule handlers. The tubes of horse dewormer had taken up a lot of space in my pack, but it was a high priority, especially in a tropical environment. The ponies and mules demonstrated again that they are only half broke, but the men did a great job of working together. It was humorous to see such a small pony take advantage of four of us trying to hold them down, but we did succeed in the end.

I had a friend donate dog and cat dewormer for my trip, which had not been on my radar until she reached out about the idea. There had only been one dog in that village the last time I visited. His name was Freddy, and Freddy has since passed but left behind a bunch of Freddy juniors. I watched the village kids running around carrying puppies, and I envisioned the canine parasites that can be passed to humans. I observed the dogs scratching often, and I wondered which external parasites they could be passing on, too.

Deworming the dogs one time would not make much of an impact, so I packed in a surplus of dewormers but needed to find someone who would maintain a regular deworming schedule. I remembered Naytaw with his MPH, which focuses on the interaction of animals and humans. I hoped he might see the importance in what I wanted to implement.

I found Naytaw at his house, and he happily accepted the assignment. He went into his house and grabbed a list of the homes in the village that had dogs or cats and how many. I was surprised and asked him why he had this list. He said they had told him a veterinarian was coming to visit, and he hoped he might be able to work with her. He had been too reserved to ask to me when we had met before. That was an encouraging coincidence. Naytaw's list guided our house visits, and he dewormed all the pets in his village. I wrote out instructions so he could remember the dosages, and he thanked me for teaching him a new skill.

The following day, I hiked with a few of the mule men, Poh, and a mule to a village who had questions regarding their water buffalo. I brought along a tube to teach them how to relieve bloat and a wound insecticide to prevent screw worms. When we arrived at the village after our long hike, I did not see any water buffalo. Apparently the message had not been relayed that a water buffalo needed to be present for the clinic. It was another good reminder of patience and flexibility when working in a foreign culture. We waited over an hour in a bamboo hut while they said they had someone trying to find a buffalo. A sack of rice on a bamboo floor was comfortable enough, and I took a nap while I waited for the buffalo round-up.

Poh woke me up, telling me there were two very sick teenage boys that would be passing by from another village who were trying to reach the medical clinic. I offered them the mule we had brought in with us and wondered if he was broke to ride. They nearly took me up on the offer, but instead the people from the village appeared with a hammock strung on bamboo and carried the boys themselves through the mountainous terrain to the clinic. I watched them head out–working together to carry the boys and was once again blown away by the way they care for each other.
After they left with the boys, we returned our focus to the water buffalo clinic. It was another reminder to me of the importance of being patient and flexible with my planning. If we had not had to wait so long, I would have missed out on an amazing demonstration of selflessness.

The villagers were unable to find where the buffalo had gone, so I decided we could just have a sit-down meeting where I would do my best to answer their questions. Sitting on a hard bamboo floor for hours is another jungle challenge I am learning to appreciate.

I had been refreshing my knowledge of common cattle pathologies in preparation for the trip, and I was able to answer more questions than I expected. The most peculiar question was that some buffalo had eaten their clothes which were hanging to dry, and the clothes became trapped in their stomach. Even Poh laughed while translating that one. They wanted to know if there was something they could give to break down the fabric. When I worked as a small animal vet, I was shocked by the items we scoped out of dogs' stomachs; things which they had spontaneously decided looked appetizing. I never knew water buffalo had some much in common with golden retrievers.

My time in the jungle ran out, but I believe that important nutritional changes had been made which, in time, would do a lot to improve the herd's overall health. Several days after my departure, one of the volunteers still at the village reached out to assure me that the mule handlers were still turning the herd out to pasture and still cutting down banana leaves for them to eat with their increased portion of grain.

When I made it back into town, I returned to the vet shop with a translator to find medications that I had promised to send back to the village for their water buffalo. One of those items was dewormer. After witnessing how little the buffalo from that village are handled, I realized it was important to find a topical solution rather than an injection, as it is far easier to pour liquid on their back than inject them with a needle. It took a lot of translating and charades to identify what I was looking for, but we found the medications and the buffalo will be receiving their first dewormer treatment any day now.

My last stop in town was to visit ECHO, a nonprofit farm that carried a copy of the book, “Where There Is No Animal Doctor.” I wanted another copy to send back to the mule handlers in a second language (theirs is in English). Most of the mule handlers are illiterate, but they told me if they have the book in two languages they can show it to other villagers who can read it to them. Thankfully there are illustrations on every page, too.

When I went to ECHO and told the staff that I was a veterinarian, they asked me to come look at three of their sick calves. I assessed the young calves and gave their intern, Christina, a basic treatment plan. Christina and I discovered we were from the same hometown, Sacramento, CA, and now here we were both using our unique interests to serve on the other side of the globe. It really is a small world.

Christina gave me a tour of the rest of the farm, which had livestock that they were using for nutritional assessment. She taught me which plants are hardy and easy to propagate in the jungle and which ones have higher protein content. I took a special interest in that, as I want to continue building the herd's nutritional plan even as I return to the U.S.

That concludes this journey. It was a special time to foster new and old relationships, teach and learn from the local villagers, and do my part to make a small difference in the lives of animals and the people connected to them.

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Double Down: Traditional Deworming Increases Drug Resistance At Alarming Rate 

Traditional deworming methods dictate that all horses on a farm be dewormed with moxidectin or ivermectin at specific intervals, usually every other month or quarterly. Though significantly easier on farm managers, this method increases anthelmintic resistance two to three times more rapidly than other deworming programs, reports The Horse.

Dr. Thomas Geruden, with Zoetis in Belgium, said these results are not surprising as the worm population is continuously pressured for selection of survivable genes in the calendar-based deworming routine.

Geurden and other researchers in Belgium, along with scientists at the Gluck Equine Research Center in Lexington, Ky., studied two farms that utilized the standard deworming protocol on their Belgian draft horses.

The deworming schedule should have corresponded with the timeline of worm egg development, but drug resistance has caused the worm eggs to appear twice as fast as expected.

Fecal egg counts on every horse on the farm were performed every two weeks from April to September for three years. Horses that had more than 250 eggs per gram of manure were given pyrantel embonate, an alternative dewormer. All other horses were treated with standard anthelmintics in the spring and fall, reducing their deworming by half or two-thirds.

The researchers used the fecal egg counts, both before and after treatment, to create a model of worm life cycles that could predict drug resistance over the next 40 years. The team found that the alternative dewormer maintained low egg counts in all horses and slowed drug resistance in worms by 200 to 300 percent.

The scientists also found that the horses considered “high shedders” of worms were almost always under 5 years old. This knowledge might allow horse owners and caretakers to target which horses may need fecal egg counts run more often – and which may need more-frequent treatments.

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The data suggests that fecal samples should be gathered for egg counts between 42 and 56 days after the spring moxidectin/ivermectin treatment, with a second sample taken between days 98 and 112. These numbers will help determine future egg counts and reduce deworming frequency.

The ability to model the rate of anthelmintic resistance using different deworming protocols has been helpful when discussing deworming with both horse owners and vets, the researchers found. A deworming plan specifically tailored to a farm may be more expensive initially, but the less-frequent, targeted deworming will pay off financially in the long run as dewormer resistance slows.

Read more at The Horse.

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Potentially Life-Threatening COVID “Cure” Sees Dewormer Sales Surging

Though the U.S. Food and Drug Administration (FDA) and the World Health Organization (WHO) have repeatedly warned the public against using ivermectin as a COVID-19 “cure,” the United States is seeing a massive increase in dewormer purchases from livestock farm and feed stores.

Many stores that sell dewormer have added verbiage to the products that indicate that they are not safe for human consumption and are an unproven cure for COVID-19; other stores have removed ivermectin products from their shelves completely.

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Ivermectin first came on the radar as a possible “cure” for COVID in 2020, when Monash University researchers reported that the drug could kill coronavirus in 48 hours in a lab setting. Though researchers at the Australian institution stressed that further testing was needed to establish the effectiveness and dosage of the drug, the public began seeking out ivermectin.

To date, completed studies on the efficacy of ivermectin are small and not considered of sufficient quality by researchers, though there are several studies currently underway. Reliable evidence doesn't support ivermectin use as a treatment or prophylactically for COVID-19.

Human-grade ivermectin is approved by the FDA for treatment of some parasitic worms and of some external parasites. Animal-grade ivermectin is not approved or dosed for humans and should never be ingested by humans. Side effects of taking livestock-grade ivermectin include nausea, diarrhea, vomiting, skin rash, facial or limb swelling, decreased blood pressure, liver problems and neurologic issues like dizziness and seizures.

Read more at Slate.com.

Read the full study here.

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Dewormers Will Require A Prescription In 2022; Irish Horse Owners Unhappy

Horse owners in the United States, Ireland, and England have been able to purchase deworming medication without a veterinary prescription for years. In Ireland, that will change on January 28, 2022, when a veterinarian will be required to prescribe deworming medications for horse owners; they will no longer be able to order them online or purchase them at their local farm and fleet store.

Current European Union regulations require dewormers to be available only by prescription.

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The Irish Department of Agriculture and the Health Products Regulatory Authority identified conclusive evidence of widespread resistance to wormers: benzimidazole, levamisole, ivermectin and moxidectin are becoming increasingly ineffective at treating worms.

The new Irish regulatory measure is an attempt to slow drug resistance in the country by ensuring the dewormers are only being used when necessary.

There is concern among horse and farm owners that veterinarians will try to capitalize on the tightening of dewormer access as there are no mechanisms in place to remove or limit the economic incentive from medical sales. Smuggling dewormers into the country is also a concern.

Read more at AgriDirect and Westgate Labs.

The post Dewormers Will Require A Prescription In 2022; Irish Horse Owners Unhappy appeared first on Horse Racing News | Paulick Report.

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