KTFMC Meeting: Equine Veterinary Changes, Implications for Farm Managers

by Sara Gordon and Katie Petrunyak

LEXINGTON, KY-The Kentucky Thoroughbred Farm Managers Club (KTFMC) held its first meeting of the year on Tuesday at Keeneland. The event was conducted jointly with the Kentucky Association of Equine Practitioners (KAEP) and the over 200 in attendance represented both organizations. Members of the Godolphin Flying Start and Kentucky Equine Management Internship programs were also on hand.

Recent changes and trends in the equine veterinary field were a focal point of the evening, along with topics including equine litigation and liability, navigating equine veterinary practice changes and the equine veterinarian shortage.

KTFMC President Gerry Duffy said their board brought up the issue of the equine veterinary shortage as a potential topic for their monthly meeting and from there, they partnered with the KAEP knowing that the subject would be relevant to both organizations.

“We know that the vet-farm manager relationship is so important and we have been hearing statistics about how they're struggling to get equine practitioners and of the ones they get, there's a high degree of partition,” Duffy explained. “We thought it would be a good topic to discuss at the meeting and when we got talking to the KAEP, they were having a meeting focused on equine veterinary litigation and liability so we thought, why not bring the two together?”

A 'Q and A' session on the Horseracing Integrity and Safety Act (HISA) was also conducted with HISA's Director of Equine Safety and Welfare Dr. Jennifer Durenberger and HISA Representative Marc Guilfoil, bringing forth a host of questions on the new responsibilities that those overseeing horses outside of the racetrack would take on if and when HISA comes into authority.

Evolving Landscape of Equine Insurance Coverage

Equine attorney Mike Casey of Casey Bailey & Maines, PLLC, based in Lexington, was the first speaker to the podium, leading a discussion on the evolving landscape of equine insurance coverage and the particulars of filing a claim under those policies.

Casey emphasized the importance of the relationship between vets and farm managers, particularly when it comes to how the vets document interactions with their patients and handle subsequent care when called out to the farms. This is all information that is not only necessary for those directly connected to the horse, but also required when it comes to instances of filing a claim, such as equine mortality, with an insurance agency.

Common issues that arise involve how often the vet visits the patient, varying whether the visits are routine or for a specific health issue, which correlates with the problematic pressure to prescribe medication without examining the patient first.

“It is critically important to make sure when you're administering medications that you have that temporal visit with the horse,” said Casey.

He also touched on the growing issue of using medication on a horse that it was not originally prescribed to.

“I probably see that more today, in the last two or three years, than the last 10 years before.”

All of these issues were weighed against what the insurance company would be looking for when handling a claim, which always leads back to the importance of maintaining precise, updated documentation. Medical records must include enough detail that anyone checking on the horse should be able to know exactly what their health status is, what treatments they have received in the past and how things should be handled for that particular patient going forward.

“Farm managers need to call the vet and make sure they see the horse the next day. It'll hopefully avoid a catastrophic outcome and it is in compliance with regulations that we know will have heightened scrutiny as we go to HISA, or as KAEP redrafts regulations,” said Casey.

When dealing with mortality insurance claims, farm managers should take the time to read through the entire policy in order to understand what is expected of them when dealing with the insurance company. In that same vein, all communication with the designated representative of the insurance company should also be documented, to avoid any issues when filing a claim down the road.

Casey explained why understanding any negating factors, such as instances of failure to provide improper care, is crucial. His example touched on use of a medication on a horse that it was not prescribed to, which could fall under the realm of an “intentional act” of improper care. In most cases, “proper care” is defined after the fact.

“We want to be able to connect the prescription to the horse, to the vet's visit, to prevent application of the unauthorized medication claim,” he said.

Communication and proper documentation are the key points when it comes to vets and farm managers abiding by regulations, maintaining the proper care for the horses in their charge, and ensuring that in the case of any insurance claims filed, everything is presented properly to guarantee a seamless process.

According to Casey, there is no such thing as too much communication, using the example of emailing the insurance agency a summary of the vet's visit for annual vaccinations to prove his point. Farm managers must also understand that a vet isn't going to report directly to the insurance agency in the case of a claim, so they must maintain their own day-to-day records as well.

“We've got to establish a dialogue for this industry, [when it comes to] what is reasonable, proper and the routine method of doing business. It is important that insurers play a role in this,” said Casey. “It's too easy to use the sins of others in the industry to say, 'That's why we have a heightened medication claim.'”

As he concluded his presentation, Casey reiterated the importance of ensuring all treatment decisions and medications are being administered based on the physical examination of that horse.

 

KTFMC President Gerry Duffy with former president John Williams | KTFMC

Equine Practitioners Discuss Vet Shortage

While most meeting attendees were aware of the equine veterinary shortage, the statistics shared by Hagyard's Dr. Luke Fallon were staggering.

Fallon said that according to a recent survey conducted by the American Association of Equine Practitioners, by 2030, equine medicine will need over 5,000 veterinarians to meet the growth in demand. Currently there are approximately 3,650 practicing equine veterinarians in America.

Additionally, of the 3,300 veterinary graduates each year from U.S. schools, only 1.3% will enter the equine profession directly. While 4.5% will enter an internship program, 50% will leave the equine profession within five years.

“If you do the math, the shortage of equine veterinarians is already here,” Fallon said. “Why are equine vets leaving the profession? Burnout is one of the key factors. It is a demanding job with long hours and low starting salaries compared to small animal jobs, which often include a signing bonus as high as $200,000 for new graduates.”

Fallon explained that many young students enter veterinary school with the dream of becoming an equine practitioner, but turn to small animal medicine because it is a more logical step financially. He said that equine veterinarians usually start at between a third and half of the initial salary of a small animal veterinarian.

Fellow Hagyard veterinarian Rhonda Rathgeber joined the conversation to discuss a few of the new initiatives Hagyard is working on to encourage veterinary students to consider a career in the equine industry.

Hagyard has enhanced their recruitment efforts by hosting student weekends to show how their facility operates and share details about their externship program. Although the initiative has been hurt in recent years due to the pandemic, it has led to increased numbers in their externship program.

“We are up to 150 externs this season, so if your veterinarian has an extern or a student with them, please be patient,” Rathgeber advised. “We've done a lot of work to get them to come and see what it's really like.”

Hagyard has also increased their outreach through college visits. Last year, they visited a third of the veterinary colleges in the country. Additional recruitment efforts include a podcast, their participation in the annual Opportunities in Equine Practice Seminar hosted by Rood & Riddle Equine Hospital and also hosting their own undergraduate seminars for pre-vet students.

Jim Heird, PhD, rounded out the session to discuss one promising step toward overcoming the shortage. Heird is a member of the advisory council for Lincoln Memorial University's Equine Veterinary Education Program (EVEP), which provides an accelerated, six-and-a-half year path to a Doctor of Veterinary Medicine degree. Students go through the undergraduate program at LMU and as long as they maintain a 3.35 GPA, they are automatically accepted into the school's veterinary program.

The EVEP places an emphasis on their students developing hands-on horsemanship skills. Students will work on-farm summer internships during their undergraduate years and then will intern at clinics during their summers in the veterinary program.

Heird said that LMU produces more equine veterinarians than any other school in the country.

“When I think about my career, I don't know of anything that I've done that has as much impact on the future of this industry than this program could have,” he said. “That's why I'm so passionate about it.”

 

HISA's Director of Equine Safety and Welfare Dr. Jennifer Durenberger and HISA Representative Marc Guilfoil

Concerns for Consignors and Managers Brought to Light During HISA Q and A

The evening concluded with a focus on HISA, where attendees were given the opportunity to ask Durenberger and Guilfoil questions. Pertinent to those in attendance, many questions focused on the regulations for those dealing with horses covered under HISA, outside of the track, such as consignors at the sales or farm managers handling lay-ups at the farm.

Though HISA has already released handbooks for racetracks, racetrack maintenance, regulatory veterinarians, attending veterinarians and trainers, Durenberger did say that handbooks for groups such as farm managers, consignors and off-track vets were in the works.

In the meantime, she emphasized that it would be the responsible party's job to update any records related to a “covered horse” in the HISA online portal, as those records would not be required until the horse returned to the racetrack. In those cases, the responsible party would more than likely be the trainer.

Further concern was expressed for clarifying who the responsible party would be, depending on different situations when the horse is not at the track, and specifying the time requirements for submitting any updates to a horse's medical record. Durenberger assured those asking these questions that further details would be provided, in hopes of clearing up any misunderstanding.

 

For almost 100 years, the KTFMC has helped build community and camaraderie among farm managers while also working to find solutions for challenges that these managers face. Their current officers are President Gerry Duffy (Godolphin), Vice President Adrian Wallace (Coolmore), Treasurer Charles Hynes (Coolmore), Secretary Molly Harris (Shawhan Place) and Sergeant-At-Arms B.G. “Scooter” Hughes (Hughes Racing Stable). The club boasts over 500 members and hosts a number of annual charitable fundraisers including a golf scramble, a trail ride, a 5k run, and more. For more information on the KTFMC or to apply for membership, visit www.ktfmc.org or email info@ktfmc.org

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Letter to the Editor: Terence Collier Regarding the Passing of Dr. Billy Marrs

It seems that every tick of the clock marks the demise of another friend and colleague in my life. Word came in today of the passing on January 15th of Dr. Billy (Merritt William) Marrs, who died in Indio, California, close to his winter home in Palm Springs. Such news usually travels fast in our circles, but this veterinarian has spent more of the last few years on out-of-town golf courses than on the backside or at a horse sale. Nevertheless, there will be a few tears and many fond tales told among Thoroughbred people of this colorful and loveable character.

Billy Marrs was a Lexington native, born in 1946, a graduate of the University of Kentucky who went on to a degree in Veterinary Medicine from Ohio State in 1973. His early mentors have already left for that great clinic in the sky, but anybody around Thoroughbreds in central Kentucky from the 1980s on will remember 'Doc' Marrs pulling up in his Cadillac, enveloped in a cloud of cigar smoke. One short car ride as his passenger and you got out smelling like Winston Churchill! He eschewed the Suburbans, the Tahoes and the SUVs and worked from either the trunk or the back seat of his gray DeVille. There was much competition for space in the car and it took forever to get the ancient X-ray camera from under the sets of golf clubs. Because he was an independent veterinarian and not connected to the two or three large veterinary groups in town, I frequently put Billy on veterinary arbitration disputes at Fasig-Tipton sales. He would always be very late or very early and invariably had to ask if he could borrow a scope from one of the other panel members.

Billy and I had close mutual friends in Jack G. Jones, Jr. of Mineola Farm in Lexington and California bloodstock guru Rollin Baugh. Jack was his lawyer, golfing companion and client. In the late 1970s Billy and Jack scouted the sales together for Buckram Oak Farm's owner Mahmoud Fustok. Jack remembers with certainty that at the Saratoga Yearling Sales, both Danzig and De La Rose were passed by Billy and made Fustok's short list, only to be underbidders on both in successive years. For a few years, Rollin was accompanied by Billy at Royal Ascot. He would call me the week before the famous English racing festival and the conversation would always jokingly open, “Well, Lord Collier, where should I be dining this year in London?” or “Can I wear brown suede shoes in the Royal Enclosure?”

Without delving too deeply into Dr. Marrs's private life, in Lexington, there seem to be no close family members surviving him in his hometown. He was married twice–once, for 13 years, to the very popular and bubbly Eloise, a leading light in local banking circles. Since October last year, he was engaged to the equally attractive Karen Nielsen, to whom I extend my sincere condolences.

Dr. Marrs got out of the veterinary world before it left him behind. He was old school. And he never let an equine appointment stand in the way of a round of golf. His many friends, of which I was honored to be one, will miss a man who did it his way.

Terence Collier

PS: There will be a celebration of life in Lexington in April and details will follow.

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Blea’s Vet License Remains Suspended, Per Judge

The veterinary license of California Horse Racing Board (CHRB) equine medical director, Jeff Blea, remains suspended pending a full administrative hearing, according to a ruling by administrative law judge Nana Chin.

In a 15-page document dated Friday, Jan. 28 but posted to the Veterinary Medical Board's website Wednesday, Chin wrote that despite Blea not currently practicing veterinary medicine, this still “does not ensure” public safety.

“As long as Respondent's license to practice is active, he is free to return to the practice of veterinary medicine at any time. Permitting Respondent to practice and engage in veterinary medicine poses a risk of injury to the public health, safety, and welfare,” wrote Chin in the ruling.

According to a UC Davis spokesperson, Blea remains on administrative leave from his position as equine medical director.

At the start of the year, the California veterinary board announced that an emergency hearing had resulted in an interim suspension of Blea's veterinary license for a number of alleged offenses, including purportedly administering medications to racehorses without a prior examination, without forming a diagnosis and without medical necessity.

Chin presided over a formal hearing on that interim suspension on Jan. 21.

“I'm certainly disappointed,” said Blea's attorney, George Wallace. “But I don't know, given the players involved, that it really is a surprise.”

According to Wallace, the veterinary board has 30 days with which to schedule a full hearing on the merits of the case once a notice of defense has been filed, though he warned that the timeline will likely take longer.

Wallace also suggested that Blea might seek “intervention” from the Superior Court in the meantime. “Under the interim suspension statute, there is a right to seek review in the Superior Court,” Wallace said.

“I would expect that, by this time next week, we'll have a much clearer idea of where things are going to be steered,” said Wallace. “But at the moment, it's an ongoing process. There are a lot of people whose opinions get to be heard on it, on all sides.”

A timeline of events leading to the issuance of the charges against Blea can be read here.

A key wrinkle in the case concerns the question of whether or not the equine medical director position requires an active veterinary license.

The position is first appointed by the dean of UC Davis, and the university then contracts with the CHRB for the appointee's services.

Historically, the equine medical director has not required an active license.

But in its argument for an interim suspension, the veterinary board claimed that Blea presents a “danger to public health, safety and welfare,” due to his oversight as equine medical director of the high-profile investigation into the death of the Bob Baffert-trained Medina Spirit (Protonico), the Kentucky Derby winner who collapsed and died after a scheduled workout on Dec. 6 at Santa Anita.

The CHRB responded to Blea's emergency interim suspension by bringing in the executive associate dean of UC Davis's School of Veterinary Medicine, John Pascoe, to oversee the necropsy of Medina Spirit.

UC Davis subsequently placed Blea on administrative leave on Jan. 12, however.

“The UC Davis School of Veterinary Medicine is aware the interim order of suspension of Dr. Jeff Blea's veterinary license has been upheld and is monitoring the situation as the legal process moves forward,” wrote a UC Davis spokesperson, in an email.

“The School of Veterinary Medicine continues to fulfill its duties to provide equine medical director services for the CHRB,” the spokesperson added.

The CHRB has thrown its weight behind Blea, voting unanimously in closed session on Jan. 20 on their “support and confidence in Blea to continue in his role,” according to a statement issued last week.

The commissioners are “further committed to pursue appropriate legal avenues to protect the authority of the board, as well as preserve the contract with UC Davis,” the CHRB wrote, adding that “regardless of the outcome, Dr. Blea has their full support and confidence to continue in his role as EMD throughout the full adjudication process.”

The TDN reached out to the CHRB for comment on the latest ruling but didn't receive a response before deadline.

The veterinary board accuses Blea of a number of offenses, including allegedly administering drugs to racehorses without a prior examination to form a diagnosis and determine medical necessity, failing to establish “any” veterinary-client-patient relationship, and of issuing drugs that are not FDA approved for equine administration.

A subsequent TDN investigation found a broad consensus among veterinary medical experts that the infractions are largely matters of poor record-keeping which rarely, if ever, rise to the level of a suspended license.

“When it comes to rising to the level of needing an immediate suspension, in my opinion, I don't think it reaches that level,” Bryan Langlois, former president of the Pennsylvania Veterinary Medical Association, told the TDN.

In her ruling, however, Chin suggests that the defense failed to provide at the administrative hearing an adequate rebuttal to the allegations, writing that while testimony from the veterinary board's investigator, James Howard, was given “significant merit,” the affidavits submitted by the defendant were afforded “little” weight.

“Though each affiant asserts that the allegations were without merit and claims the allegations are based on a misunderstanding of racetrack practice, they provide no factual grounds for their conclusions,” Chin wrote.

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