How One Thoroughbred Horse Show May Be Helping The Equine Veterinary Shortage

As a shortage of equine veterinarians grows, everyone from universities to veterinary hospitals to farm managers have been brainstorming how they can help inspire young people to take up the profession, or keep young vets from switching to small animal practice. You might not think of the upcoming Thoroughbred Makeover as a pivotal event in this area, but thanks to the efforts of Dr. Shannon Kelly Reed, clinical associate professor of large animal surgery at Texas A&M University, it has become that for some students.

The Thoroughbred Makeover is a training competition hosted by the Retired Racehorse Project and is designed to showcase the significant progress an ex-racehorse can make with just 10 months of training in a new career. The event evolved from a demonstration to a small competition between professional trainers to a giant event with cash prizes which draws hundreds of Thoroughbreds and people to the Kentucky Horse Park each year.

Reed is a longtime advocate of off-track Thoroughbreds, having competed in the Makeover event herself in 2017 and 2018 and aimed some of her academic research at better understanding the demographics of horses leaving the track for new careers.

While trainers must apply and be approved to enter the Makeover, many of them are amateurs who don't ride or train as their full-time job. For some of them, their Makeover horse may be one of their first Thoroughbreds. As she watched the event grow from a competitor's perspective, Reed saw an opportunity for continuing education.

“I heard a lot of people saying, 'You can't put weight on Thoroughbreds' or 'They're always footsore' and I wanted to say no – you just have to change the standard, or help people reach it,” she said.

Reed suggested to event organizers that this could be accomplished by a mandatory veterinary exam on arrival, and they suggested she launch a program to make it happen. The arrival exam, which horses must pass in order to compete, includes evaluation of the horse's body condition score, soundness, heart rhythms and lung sounds, and basic vitals before they're cleared to compete.

Dr. Reed helps conduct an arrival exam ahead of the 2022 Thoroughbred Makeover

Reed said it's rare for a horse to fail the arrival exam, but the goal isn't to weed out potential competitors – it's to help Makeover hopefuls anticipate what Thoroughbreds need that other breeds may not. The exam process is explained thoroughly to competitors during the year as they're training their horses, giving them the chance to anticipate and troubleshoot some common challenges with horses transitioning from racetrack to show ring. Reed and the RRP staff make themselves available for continuing education webinars and troubleshooting, all with the knowledge that the let down period between track and new career can be a learning process not just for the horse, but also for the owner.

The prospect of examining every horse in a field that this year includes 404 horses is a daunting one, however. Reed knew from the first year of the procedure in 2019 she was going to need some help.

“The first year we started it was me and multiple veterinarians from Hagyard and Boehringer-Ingelheim because they were co-sponsors of RRP,” she said. “It was seven veterinarians getting through well over 300 horses. That was the first year I put out a call for vet students. I had a whole bunch show up and at the end of the day they said this was the best experience they'd ever had.”

The next year, Reed created a formal program and asked interested students to apply for a spot on the examinations team. She got 350 applications for 30 spots, well beyond anything she could have expected, and several years in, there are still ten or more applications for every one spot on the examination team. The response has been so encouraging that practicing veterinarians have pulled together stipend money to help students who don't live locally to afford the trip to Kentucky.

Small teams of veterinary students are matched with veterinarians and each other based on their equine experience level, pairing more experienced students with those with less handling experience. They work 30 hours in the course of three days, which is a real crash course in the type of working conditions that can be part of a working equine vet's day.

Reed said most of the applicants already have an equine interest, but she gets many who are on the fence about whether they want to go into a horse-oriented practice – and who may not have been sure whether their non-riding backgrounds would dampen the industry's welcome.

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“The AAEP helps us out a lot, but I don't limit it to student AAEP chapter members. We want to open it up to students who think they might be interested,” said Reed. “There's no pre-requisite that you have worked with horses before you get there. We try to keep it inclusive, and I randomize how I choose the students. Then, a lot of them leave there saying, 'You know, I think I could do horses.'

“It's unique in the hands-on part of it because nowhere else can you say we're going to examine 400 horses. They're all going to have lumps and bumps on them because they raced, but we can talk about those, we can look at radiographs, we can do soundness checks. They get a huge experience seeing horses, some of which are normal, some of which are rehabbed. I don't think there's many experiences that allow them that much repetitive, rapid, learning to assess a horse which is the baseline for all of their physical exams when they go out for their career.”

The students get a great experience interacting with horse owners, because Reed points out the culture of the Makeover is the “happiest horse show on earth” wherein most competitors are just thrilled to have made it to their season-end goal. Owners in this setting are much more cheerful than the typical show barn, where a lot of money is on the line and everyone's attentions are divided and strained.

Student feedback after the event has supported Reed's impression that those three days are proving to be hugely influential in some students' career paths.

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“I do have at least two alumni from the first year that have at least discussed and negotiated with people on the racetrack to work with them there, and that's a big deal,” said Reed. “There are people out there who want to do equine medicine; we just have to catch them. It's not that they don't want to work, they just want to work with purpose.”

Anna Botiller, who is a second-year veterinary student at Mississippi State University, participated in the arrival exam program at last year's Thoroughbred Makeover. After starting a career as a veterinary technician focusing on horses in Central Kentucky, Botiller already had experience with Thoroughbreds prior to veterinary school, but found the process incredibly helpful for developing a sense for which exam findings are normal and which are less so. It also gave her the chance to see equine veterinarians at work, and to change some of the preconceptions she had about the job.

“As a first-year vet student, at the time of last year's RRP, I was sitting in classes where professional development professors told me I could expect to make half as much in salary and work over twice as many hours as my small animal counterparts,” said Botiller. “I admit, prior to RRP last year, I was a little heart-broken thinking it might be impossible to be a full-time equine vet and have any financial stability or life outside the job. Particularly concerning (then and now) were my mounting stack of student loans in contrast with the prediction of a low salary. I was seriously considering that small animal emergency work might have to become my focus, relegating equine work to on-the-side. And then I spent three days surrounded by full-time equine vets who are vivacious, laughed hard and often, supported one another, worked together like a well-oiled machine, are financially stable, and still have time to find fulfillment in family and hobbies outside of work.

“Due in large part to my experiences with the RRP vet arrival team, I'm actively looking for equine clinics where I can fulfill externship requirements that will help me continue down the path of becoming an equine veterinarian. I look back on those three days last October and realize that it's the people who put on programs like this who are reshaping equine vet med, one vet student at a time.”

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Hidden Perk: Asthmatic Horses Have Fewer Parasites

Since humans with allergic diseases often have lower gastrointestinal parasite burdens compared to healthy humans, Dr. Joana Simões, with Lusófona University in Portugal, and a team of researchers sought to determine whether severely asthmatic horses were resistant to gut-related parasites. 

The research team used 40 horses, between the ages of 9 and 16, to test their theory. There were 30 geldings, two stallions and eight mares; they were not related and had individual owners.

Twenty of the horses had diagnosed asthma and 20 did not. Each asthmatic horse was paired with a healthy control horse that was about the same age that lived on the same farm so that both horses experienced the same management. 

A fecal sample was obtained from each horse. Results from the egg count showed strongyle-type eggs and Cyathostomum sensu latum larvae to be the most abundant parasite in both the asthmatic and the control horses. 

However, there was a significant difference in the number of eggs and larvae shed. On average, the control horses shed more than nine times more eggs and 10 times more infective larva than the asthmatic horses. 

The scientists said that this may indicate that asthmatic horses may have an intrinsic resistance to parasites. Allergic diseases like equine asthma involve both genetics and exposure to allergens, as well as dysregulation of the immune response, but exact disease mechanics are not known. 

Thus far, evidence supports the idea that the genetic makeup of horses with asthma makes them more resistant to parasite infection, but also makes them more susceptible to environmental allergens. The researchers suggest that larger-scale studies are needed. 

Read more at HorseTalk. https://www.horsetalk.co.nz/2023/09/16/horses-severe-asthma-lower-gut-parasite-burden/

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How Compression Technology Can Help Horses Battling Lymphangitis

This is Part 2 in our two-part series on lymphangitis in horses. Find Part 1 here.

Veterinarians will prescribe aggressive antibiotics and anti-inflammatories to combat the underlying infection causing lymphangitis while also administering medication such as phenylbutazone and flunixin meglumine for the pain and swelling. While most swelling is addressed with cold therapy and bandaging, these treatments are often ineffective or only work for a short time before the swelling returns.

The biggest tool for treating lymphangitis and the resultant lymphedema (build-up of fluid) is movement, which is difficult when the leg is so painful.

So, what can be done?

In humans, the only way to encourage drainage for the lymphatic system is by lymphatic drainage massage. This type of massage is a gentle massage that encourages the drainage of the lymph nodes and movement of the lymph fluids around the body. Humans can utilize lymphatic drainage massage, either manually or with a device, to move the fluid to be excreted from the arms and/or legs.

So how can veterinarians accomplish the same thing in horses?

History has seen veterinarians and owners use any type of treatment to battle lymphangitis.

“It's focused a lot on bandaging, regional limb perfusion with antibiotics, and we use the saltwater spa a lot (at NC State),” said Dr. Lauren Schnabel, professor of equine orthopedic surgery at North Carolina State University and co-founder/chief medical officer of Vetletics. “But we didn't have any sort of device to provide dynamic compression to push that fluid up and out of the limb when the horse's lymphatics aren't working properly.”

The challenge with this approach is the way the equine leg is built. Unlike humans, horses have very little musculature on their lower legs. They are totally reliant on the pressure on their frog from walking to propel limb fluid up the leg – which is something stall-bound horses aren't experiencing.

Luckily, the same tool that humans utilize for lymphatic massage has been reimagined for the horse. The EQ PressÔ, developed and sold by Vetletics Inc., is based on human systems through efforts led by Dr. Irina Perdew. This device involves full leg sleeves that cover the horse from the hoof to the top of the leg, with straps to keep the sleeves in place. Instead of cords attached to the main device that's typically sat beside the human, the device is battery-operated and settled in a pack on the horse's back. The pumps are quieter to lessen the chance of spooking the horse.

This horse was diagnosed with lymphangitis in the right hind

“The horses are incredibly receptive to it and have done very well,” said Schnabel. “Horses that have a severely painful lymphangitis leg may need sedation for the first time, but many of them don't. Honestly, they seem to really like it. Most of them will yawn, lick and chew, and some fall asleep.”

So far, there have been great results with the lymphatic compression device.

“We've had really good success with chronic lymphangitis cases getting their legs down to normal size,” said Schnabel.

Schnabel explains that research was done to see how using the device would change the lymphatic flow for relief and repair for the legs. This was accomplished by using a tracker that follows the lymphatic system. The tracker was injected under the skin just above the coronary band, and then followed up the leg using a special camera. When being treated with the EQ PressÔ, horses had significant accelerated lymphatic flow, meaning it reached the lymph node at the top of the leg much faster than when the same horses weren't being treated with the EQ PressÔ as a control. In these control horses, the tracker actually hardly ever reached the lymph node in the time that was studied.

Dr. Schnabel and her peers are hoping that using this kind of technology can help horses in three different ways:

  • Treating horses with medical conditions like lymphangitis and cellulitis
  • Assisting horses recovering on prolonged stall rest
  • Athletic recovery

Veterinarians hope the device could also change the lives of horses who suffer from laminitis, especially contralateral limb laminitis.

“For horses, the lymphatic drainage system is the same for their blood pressure—if they're not moving, and that frog isn't getting pressure, the foot is not getting perfused with blood either,” said Schnabel. “Everything is dependent on pressure on that frog and moving to perfuse the foot properly. So, when they're stuck in a stall because they have a fracture of their left front leg for example, their right front leg is taking up all the weight and isn't moving, and the frog isn't mechanically stressed to encourage blood flow. [There have been] some great studies looking at different changes in blood flow. We'd love to see that if by having this device on, horses that cannot walk because of an injury perfuse their feet better as well as having the improved lymphatic drainage.”

The length of sessions, as well as the amount of pressure used, depends on the horse's condition. Most lymphangitis treatments last one hour at a higher pressure. Athletic recovery sessions are usually about 30 minutes at a lower pressure setting. Dr. Schnabel says that a lot of sport horses and eventers are using the lymphatic massage device for recovery from hard workouts or competitions because the massage helps accelerate the lymphatic flow, thus removing the toxic waste the tissues collect from the workouts. Clearance for its application on the track is in process with the Horseracing Integrity and Safety Authority, but some owners are utilizing the device for their horses' recovery at home—either from an injury or just as they take a break from training.

“The horses truly seem to enjoy the treatments and relax,” said Schnabel. “I'm excited to see how else we can apply this technique for the benefit of the horse. We're really excited about using [the device] to prevent laminitis. It could be a gamechanger.”

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Freedom, Friends Help Horses Recover From Exercise Exertion

New research shows that horses recover more quickly from strenuous exercise if they're turned out in a field with friends, rather than placed in a stall by themselves. 

Researchers from the Swedish University of Agricultural Sciences in Uppsala used eight trotting horses that were either kept in small herds or in box stalls for 21 days. The horses then switched to the other housing system at the conclusion of the three weeks. On days 7 and 14 of each study period, the horses completed an exercise similar to a race. 

Researchers collected blood before, during, and multiple times after the exercise, and observed the horses after their exercise. 

The scientists found that horses kept in stalls ate less than the horses living on pasture with others. They also found that horses living in groups had plasma non-esterified fatty acids that decreased more rapidly after excise than the levels of those horses living in stalls; these levels measure post-exercise recovery. 

The team determined that horses allowed to go outside after exercise exertion recovered more quickly and ate better than horses placed in stalls after exercising. This contradicts anecdotal claims that placing horses in stalls is better for them post-exercise. 

Read more at EQUUS magazine. 

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