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Ask Your Veterinarian Presented By Kentucky Performance Products: What We Know About This Year’s Placentitis Cases

Veterinarians at Rood and Riddle Equine Hospital answer your questions about sales and healthcare of Thoroughbred auction yearlings, weanlings, 2-year-olds and breeding stock. If you have a question for a veterinarian, email us info at paulickreport.com .

QUESTION: We saw an increased number of nocardioform placentitis in the 2020 foaling season. Why are some years worse for placentitis than others?

DR. MARIA SCHNOBRICH: In the 2020 foaling season in Central Kentucky saw an increase in the incidence of Nocardioform placentitis. The University of Kentucky Veterinary Diagnostic Laboratory reported that this was the second worst year for Nocardioform placentitis behind 2011, when they had 328 confirmed cases. In 2020 there were 207 cases confirmed. Likely these numbers represent an underrepresentation, as not all cases are submitted for evaluation.

Nocardioform placentitis is a type of placentitis that is associated with isolation of a slow-growing, gram-positive family of bacteria that are found in the placenta after delivery or abortion. These bacteria (Crosiella, Amycolytopsis, Actinomycetes) are thought to originate from the soil, but frustratingly we do not know at this time how the disease process starts or what is the reason it develops in some mares and not others. This type of placentitis usually causes well-demarcated lesions in the placenta where a mucoid plaque develops and causes the placenta to be disrupted, and may limit or severely compromise fetal development. The outcome of mares affected with this type of placentitis can range from abortion to normal foals and does not always correlate to the severity of the lesions.

Due to the increased incidence of this disease last year, many involved with the broodmare management, including veterinarians, farm managers, owners and researchers worked together to collect and compare data. The UK Gluck Equine Research Center's Dr. Barry Ball is currently compiling data from this past year and will be making his team's findings available to the public.

Dr. Maria Schnobrich

Frustratingly, despite many attempts to reproduce the disease, we do not know what causes or initiates Nocardioform placentitis in the mare. While researchers continue to work on this, we have learned several things which I will summarize below.

The incidence of Nocardioform placentitis seems to be associated with weather. When conditions are hot and dry (as they were in the late summer and early fall of 2019), there is an increase in disease. When conditions are wet and cold, we see a decrease in this type of placentitis, while other diseases like leptospirosis may increase.
Evaluations of soil samples from 2019 are pending and may help give us insight on whether this bacteria was more common. Previously the bacteria found in affected placentas could not be found in the soil from the affected farms when the soil was cultured much later in the year. The new data from 2019-20, when the soil was cultured closer to the time of possible infection, may be helpful in identifying why we had an increase.

Nocardioform placentitis does not occur only in Kentucky, as might have been previously thought. There are cases reported and diagnosed in animals that have never been in Kentucky, though we in Kentucky at the moment seem to have the highest incidence.
Natural cover is not required to produce the disease. Confirmed cases of Nocardioform placentitis occurred in mares bred by artificial insemination and even embryo transfer recipients.
Screening for the disease remains problematic as we have no sure way of identifying the issue. Diagnostic tools that may aid the owner and veterinarian in identifying affected patients include:

Clinical signs such as premature udder development, and rarely vulvar discharge.
Transabdominal and transrectal ultrasound which may identify lesions before they become advanced. The downside of ultrasound in the pregnant mare is that the entire placenta can't be visualized, so some cases may be missed. The advantage is this may allow you to identify an issue earlier in the course of the disease and implement treatment then.
Evaluation of hormones to assess pregnancy (estrogens and progesterone). Screening may result in identifying cases with significant pathology or compromise. In cases that were presented to a referral clinic, all animals had abnormalities in these values, though this needs further research to determine how useful a screening tool it may be.

This image shows the ultrasound image generated from a transabdominal screen of a pregnant mare. The blue arrow is pointing to an area where the uterus has separated from the fetal membranes and placental disruption is caused by a dense fluid. This area correlates to our findings of thick mucoid debris caused in areas affected by Nocardioform placentitis.

There seems to be little resistance to commonly used antibiotics when isolates from the disease were tested for susceptibility in vitro. Doxycycline (81-96% sensitivity) and TMS/SMZ (80%-95%) were incredibly effective when isolates from 2020 placentitis cases were tested in the lab.
The data regarding which treatment for this type of placentitis is most effective is confusing. Research by Gluck's Dr. Carleigh Fedorka demonstrated that cases that were treated actually had a worse outcome than untreated cases. Additionally, the only treatment which seemed to have a positive effect on pregnancy outcome was Firocoxib (Equioxx), an anti-inflammatory. We have to remember though that this data reflects animals that were treated because they were identified as having an issue, and so likely had more severe disease than those untreated animals. There are few situations in which an animal identified with disease would have been left untreated, as this usually results in a poor outcome.

This picture shows the brown discoloration caused from Nocardioform placentitis that can be found on the fetal membranes after delivery. Often there is thick, viscous debris that has been described as similar to “peanut butter” in consistency.

In summary, Nocardioform placentitis continues to be a sporadic but significant issue for the Thoroughbred industry. While it may affect us worse in certain years it has highlighted our need for vigilant monitoring of the pregnant mare and a continued effort to identify early markers of pregnancy compromise. As we now have seen trends related to weather this may give us an idea as to which years will be worse, but discussion with your veterinarian and farm manager about screening and treatment is recommended as it is a complicated issue without a clear recipe for management.

Dr. Maria Schnobrich grew up in Boston where visits to her grandparents' farm and riding lessons at a young age sparked her interest in horses and large animals. Dr. Schnobrich graduated Magna Cum Laude at Brown University followed by attending veterinary school at the University of Pennsylvania. She is a Diplomate of the American College of Theriogenology.

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Veterinarian: Well-Meaning Public Making It More Difficult And Expensive To Deal With Wild Horse Issue

The problem of what to do with thousands of wild horses and burros that roam through Western states continues to present a challenge for the Bureau of Land Management, and one veterinarian said a well-meaning public isn't helping.

“I think one of the biggest problems is the American public views horses as a symbol of the West,” said Dr. Tom Lenz at this week's American Horse Council virtual conference. “They almost have a mystic quality to people. So, most of the public's perception of how the horses should be managed is based on emotion and very little understanding of how these horses interact with the range and wildlife and other animals. They have a significant impact on Congress, which then limits the BLM.”

Lenz is a longtime veterinarian, diplomate of the American College of Theriogenologists, past president of the American Association of Equine Practitioners and has chaired the AAEP's Welfare Committee, as well as the welfare committees of the American Horse Council, Professional Rodeo Cowboys' Association, and the American Veterinary Medical Association. He provided an update to American Horse Council conference attendees in his capacity as a member of the Bureau of Land Management's Wild Horse and Burro Advisory Board.

The question of what to do with wild horses and burros has been in the headlines for years, with wild horse advocates expressing concerns about techniques the government has used to control the populations thus far and seeking to limit the number of horses that may be rounded up by the government each year. Critics of the BLM question whether the agency overestimates the number of horses on public lands and points to the large number of cattle allowed to graze on public lands, competing with the horses for resources.

Lenz said the BLM believes an appropriate number of free-ranging horses and burros would be about 27,000 animals. The government's current population estimates have 95,114 animals on the range as of March of this year. That doesn't count horses on non-BLM federal, state, or tribal lands, which could number more than another 100,000.

Critics of the BLM have also raised questions about the agency's figures on population growth, which Lenz characterized as “exponential.” Lenz presented an example — in February 2016, 2,700 horses were counted in a given herd management area. Two years later, 1,400 horses were gathered and removed from that space; the number of foals born in 2016, 2017, and 2018 completely offset the round-up, leaving the number in that herd management area at 2,700 in May 2018.

The U.S. Geological Survey indicates herd sizes for wild horses are increasing at rates of 12 to 36 percent annually, which means they're growing faster than the amount of forage and water available to them. Lenz said recent round-ups of horses have taken place because a particular herd was discovered starving in its home base. In times of drought, wild horses are known to move into towns, cities, private land, even golf courses in search of food and water — creating safety hazards for humans and for themselves.

So far, Lenz said efforts to reduce the population to manageable levels have been ineffective. The BLM does use a pelleted, feed-through form of contraceptive, but hasn't been able to get it to enough horses to produce an appreciable impact. There are contraceptive vaccines available for horses, but they have to be administered annually and while many wild horses are tolerant of people, they often won't come close enough to be vaccinated via dart more than once. Chemical or surgical vasectomies have not been effective for stallions; intrauterine devices are effective for mares, but must be inserted while the mare isn't pregnant — a challenge, as most female wild horses are pregnant by the age of two.

BLM agents have even tried removing stallions from herds, but has found that besides the potential welfare implications of disrupting a herd's social structure, mares end up being bred by stallions from other bands.

Round-ups are still the agency's primary method of population reduction. On average, Lenz said the BLM removes 6,000 animals from the range a year, though the last two years it rounded up slightly more than that. The problem comes in when those horses don't find adoptive homes after they're taken off the range. A huge chunk of the BLM's budget goes into warehousing horses in long-term holding areas if they aren't good candidates for adoption or don't attract any interest from the public. Lenz said horses in long-term holding facilities can live well past the age of 20 and end up costing the Bureau an average of $48,000 per head. A horse who is adopted within two and a half years may cost the Bureau $8,000. There are 50,020 animals in short and long-term holding pastures and corrals currently.

Adoptions were up last year — to 7,276 horses instead of the usual 3,400 or so — thanks in part to an adoption incentive program started by the BLM which pays adopters $1,000 for taking a wild horse or burro. Half the money is paid when the horse is picked up, and the other half is paid six months later after a representative has inspected the horse in its new home and verified it is being properly cared for.

Moving forward, Lenz is hopeful the BLM can get the population of wild horses under control by making its budget more efficient. The new goal will be to gather 18,000 to 20,000 horses annually (three times more than the current average), distribute pelleted contraception to between 3,500 and 9,000 horses each year and transition 6,000 to 7,000 horses to private care. The BLM will also be looking to identify partner organizations that can house 18,000 to 20,000 for lifetime care, removing existing financial burdens from the agency's books and allowing it to focus on population control instead of caring for warehoused horses.

Ultimately, Lenz said, these initiatives will make for a better life for wild horses and burros — especially if it means fewer of them will be out on the range.

“I think the problem we have today is that the public, through Congress, is managing the horses, rather than the BLM managing them through scientists,” Lenz said. “That's what's got us to where we are today.”

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Thoroughbred Retirement Foundation Launches 2020 Hay Drive With $60,000 Matching Gift

The Thoroughbred Retirement Foundation (TRF) has received a $60,000 matching gift from the Santulli Family Foundation to launch the 2020 Hay Drive challenge–Hay, Oats and Water. The Santulli's will match every dollar donated to the TRF up to $60,000 for this campaign. The TRF's goal for the 2020 Hay Drive is $120,000 to cover the cost of hay for the hundreds of former racehorses currently in their care.

The TRF Hay Drive is one of the most important campaigns for the organization, now in its 37th year of providing sanctuary, retirement and second chances for Thoroughbreds no longer able to compete on the racetrack. The campaign will be conducted by direct mail, email and social media as well as one-on-one donation requests.

“Hay is one of our largest horse care expenses and the most important element of a horse's diet, particularly in the winter.” says Jennifer Stevens, Director of Development at the TRF.

Last year, with the help of the Santulli Family Foundation, the TRF had its most successful Hay Drive to date and the organization is hopeful that this year's response will equal or surpass last year's campaign.

“The Santulli's are longtime supporters of the TRF having funded several areas of need for the organization throughout the years. We are immensely grateful for their contributions to the TRF and the Thoroughbred aftercare effort.” said Patricia Stickney, TRF Executive Director. “Their generous gift will not only help our horses but inspire others to do the same.”

To give to the Hay Drive please visit the TRF giving page here: https://www.trfinc.org/haydrive/

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Older Horses At Higher Risk For Colic, Euthanasia

Colic is the No. 1 cause of death in horses and it disproportionately affects older horses. Surgery isn't always the best option for elderly equines because of the high cost and generally less-successful outcomes, so many older horses that colic are euthanized.

Colic, which is a catch-all term for abdominal pain, can be caused by a variety of things, including gas buildup, a blockage or twisting of the gut. Though minor colic can be handled with medical intervention and pain relievers, other episodes require surgery to resolve.

A study out of Germany looked at nearly 1,000 horses that were admitted to a veterinary clinic for symptoms of colic. The average age was 19.9 years old and the majority of the horses were treated medically; these horses had a better survival rate than those horses that underwent surgery.

The most-common type of colic for horses between 21 and 29 years old were strangulating lipomas. This occurs when a fatty tumor develops and becomes so heavy that it weighs down part of the horse's digestive tract, sometimes looping around areas and strangulating either the intestines or the blood flow to them. There is no way to prevent these types tumors.

However, there are some risk factors for colic that can be mitigated by feeding and management changes. A review of colic studies in 2019 reported that horses that crib have a higher risk of colic, specifically epiploic foramen entrapment, where part of the small intestine are strangulated. Horses that spend most of their time in a stall are at higher risk of colic episodes than those that live out or those that spend more time on pasture. Changes in stabling also increase colic risk.

Changes in hay or grain increase the risk of colic, as does feeing higher amounts of grain. The type of hay fed also increases colic risk; horses fed coastal hay and alfalfa are more likely to colic than horse fed other types of hay.

Dental issues, to which older horses are particularly susceptible, increase colic risk. It's imperative that horse owners work closely with an equine dentist and adjust the horse's diet as necessary to mitigate the risk of colic. This might include changing feed or hay options or soaking feed. The addition of a ration balancer or oil may be necessary if an older horse is struggling to maintain weight.

Colic will affect one in 10 horses during their lifetime; older horses tend to have less-favorable outcomes. Adjusting elderly horse management, feeding and care can help decrease colic risk.