www.southernequineservice.com/doctors-say/2020/1/6/understanding-equine-cushings

Spotting Lameness: The Game Plan
— Read on horsenetwork.com/2018/10/spotting-lameness-game-plan/
Learn about the diseases veterinarians recommend protecting your horse against and how vaccination could save your horse’s life.
— Read on thehorse.com/features/core-vaccination-protecting-horses-from-5-deadly-diseases/
Ask TheHorse Archives – The Horse
— Read on thehorse.com/topics/podcasts/ask-thehorse/
What should you do (or not do) if your horse shows signs of colic? And how do you prevent colic in the first place? Find out from our veterinary experts.
— Read on thehorse.com/features/dealing-with-equine-colic/
Equine Vaccination Cheat Sheet – The Horse
— Read on thehorse.com/137994/equine-vaccination-cheat-sheet/
Chance began another round of Excede to get his scratches under control- it is a never ending battle. A while back, I had a skin scrape of Chance’s scratches due to their chronic nature. The scrape results showed a number of bacteria, all commonly seen with this type of infection, that were resistant to most antibiotics. Thus why we decided to try Excede.
Administering Excede is pretty straight forward- 1 shot IM every 4 days for about a month. Easy enough….or so I thought. The first shot was administered by the vet when I was not present. The second shot the vet also administered while I was there. Thirty minutes after the shot was given to Chance I noticed he seemed off but not in his “normal” post-acupuncture relaxed state. He suddenly became lethargic, he wouldn’t eat his dinner, and the gut noises became almost nonexistent. I commented to the vet my concerns and she came over and reexamined him. Sure enough something was wrong. She proceeded to administer 10cc of Banamine (just in case it was colic) and told me to walk him around outside for about 20-30 minutes. Then see if he would eat 2 cups of feed only. We walked and Chance began to act like his normal happy go lucky self. Once inside he started to eat!
Part of me felt that his reaction was a fluke. However, the third dose proved me wrong. Four days later, Chance received his shot and went outside to enjoy the first beautiful, warm day. I sat in the field watching him. He was sluggish, lethargic, stiff..he looked 10 years older and barely moved from one spot under a tree. He wasn’t eating grass nor did he run around and play- he didn’t even run up to me like he normally would. I decided to bring him inside and give him a warm bath since it was in the high 70’s. He was non responsive to his bath- no playing with the hose or even accepting peppermints. I placed a cooler on him to ensure he stayed warm until he was out in the sunshine. I figured after a bath he would perk up- again, I was wrong. At dinner time I went to bring him in and typically I will open up the gait and he will canter into his stall- he slowly walked instead. He wouldn’t eat his feed (he normally whinnies and makes a fuss until he gets his feed and devours it) or his hay…I stayed and watched him for a while and he just slept. I spoke to John, the guy who helps me with Chance and Lucky, and he confirmed that Chance hadn’t been finishing his feed and wasn’t running when he brought him in for dinner.
My concerns grew and I decided to do some research on Excede. That strange thing is I usually do extensive research before changing or administering anything with my animals. But, for some reason I did not do so this time and I wish I had.
According to a number of reputable websites, Excede can cause significant and dangerous side-effects such as; diarrhea, severe acid reflux, blood coming from mouth, loss of appetite, lethargy, muscle and gait stiffness, and more.
The most troubling of everything that I read wasn’t what was posted on the Pfizer (the manufacturer) website but from the countless statements given by horse owners and the studies done by outside companies.
According to drugs.com, “in the PK study, several horses developed clinical signs consistent with foot pain (stiff in the front limbs when turned in tight circles, and increased pulses and heat to the front feet). One horse in the NAXCEL group and one horse in the 6.0 mg/lb (2X) EXCEDE group were euthanized due to laminitis. Clinical signs of foot pain (stiff front limbs and increased heat and pulses in feet) affected more horses, for a longer period of time, in all EXCEDE-treated groups as compared to the NAXCEL-treated group. The study housing (multi-horse pens on concrete slabs) and diet (free choice alfalfa/grass mix and once a day pellets) may have contributed to the development of foot pain. The prevalence and severity of injection site reactions in EXCEDE-treated horses may also have contributed to the development of a stiff gait. A causal relationship between ceftiofur and foot pain could not be definitively determined.”
The research has revealed that Excede should be used with caution and the horse receiving the medication must be monitored. Make sure to weigh the benefits and risks before starting Excede. This drug can be lifesaving for many horses but for others, it can be life-threatening.
Excede Resources
Straight from the Horse’s Mouth: Antibiotics, Antifungals, Antivirals
Equine Product Catalog: In depth understanding of equine medications
FINALNewMexicoEIBPetitionExhibits2908-1407_pdf
The vet came out to give Chance and Lucky their fall shots and do some follow up acupuncture on Chance. The vet said that Chance has increased flexibility especially in his cervical spine and has gained weight and muscle mass!!!!!!
His feeding regiment is as follows:
AM:
PM:
He is out all day when it is cool and all night when it is hot during the day. So he has tons of green grass to eat. He walks constantly- up and down the hills- and runs around with Lucky. We also walk ground poles and do stretches and massage every time I come out to the barn.
We still need to continue upping his weight and muscle mass preferably before winter. Fingers crossed.
Today was not the greatest of days….but I will say that we had the luckiest unlucky day ever! And, of course, it was a full moon tonight which means I should just stay inside.
Today we met with a new farrier. I have been doing some research on shoes that provide comfort, support, and do not mess up Chance’s hooves like nails tend to especially when a horse is on rockier terrain. I spoke with my vet who suggested to, “put shoes on all 4 hooves with a 1 degree wedge pad on both hind shoes. Set all 4 shoes back from the toe of the foot by at least a 1/4th an inch.”
I went to the farm a bit early and gave Chance a bath, some Equinox for pain, and got ready for the farrier. The farrier arrived and Chance was great! He stood on the cross ties and ate hay like a champ. For some reason I decided to lengthen the cross ties. I am not sure why exactly but thank God I did.
My dad and the farrier were with Chance while I went to feed Lucky his dinner. Well, after I fed Luck, I turned the corner and saw that Chance was on the ground! Yes, you read correctly, he was on the freaking ground…all 17.1 hands of him! The moment I saw him our eyes met- I know it sounds like the beginning of a love story- and he immediately took a deep breath and calmed down. I walked up to him and he slowly got up and stood there right in front of me with his head resting under my arm- breathing heavily and he had the beginnings of sweat covering his body.
I stood there and just spoke to him- calmly- telling him he was okay. Once a few minutes had passed, and he was calm, I walked him forward to make sure he was okay. Sure enough, he was fine…aside from some surface scrapes. I cleaned his scrapes up and walked him outside to eat some grass. After about ten minutes, I walked him back into the aisle for the farrier to finish up.
According to both my dad and the farrier, Chance was having his back left shoe nailed in when the nail hit a nerve and he flinched. I guess the farrier didn’t realize this because he hit the nail once more. That was when Chance reacted and went down. Thankfully, the farrier got out of the way & removed the nail midair (so that Chance wouldn’t go down on the foot with the nail and drive it deeper). Think of a splinter going under your nail…and then hitting it again, deeper under your nail….ouch!
However, he landed somewhat gracefully, but due to the cross ties not being break away and the concrete not allowing Chance to gain any “grip” with his newly shod feet, he began to panic. Upon seeing me, he calmed down, and he was able to get back up. I can’t help but thank my lucky stars that I had lengthened the cross ties so that he had some slack, and that I came back inside when I did…had I not, he would have kept flailing. Had I been in there when the nail hit the nerve it may not have happened because I would have said something to the farrier. However, had I been in there when it occurred, things may have also been far worse…since my dog, Sadie, is always right by Chance’s or my side at all times.
We ended up deciding to forgo putting hind shoes on until later (a few weeks) and the farrier removed the one evil hind shoe and trimmed up the other hoof. Chance stood quietly and allowed him to complete his job. I was so impressed with my old guy!
I have emailed my vet to see if she is able to come check on Chance tomorrow just in case…hopefully, Chance will just be a bit sore in the morning and nothing worse….:(
Chance is continuing to gain weight, although as I said in the previous post, he still needs to put on a good 50-75 lbs. As the days continue to get warmer, Chance’s arthritis seems to become more manageable for him; his stride is longer and he runs around (mostly after Lucky) more frequently.
Unfortunately, when the farrier came out about two weeks ago Chance was too stiff to get his back right shoe on. The farrier decided to come back out to try and re-shoe him and, during that time in between, Chance must have tweaked it…AGAIN!
While Chance did not have a shoe on his back right I kept it wrapped to provide some protection and also even out all of his hooves. However, when I arrived I noticed that Chance was significantly twisting his back right leg inward at the walk & it had some swelling. The swelling was not horrible but it was noticeable. I cold hosed his leg for about 45 minutes while I groomed him & gave him a dose of Equinox (pain medication) and Ulcer Guard. I put on his back leg wrap to help with reducing the swelling and provide some extra support. Chance did his neck stretches effortlessly and was baring weight on his back hind.
But as I was grooming him I noticed, on the left side his chest, he had patches of hair loss and dandruff. The area did not look red or inflamed, nor did it seem itchy or painful. So I continued grooming him and decided to put a call into the vet to come and check his leg and the hair loss.
Of course, I turned to Google to try and find out what exactly could be the cause of the patches of hair loss.
According to a handful of sources, there are a few possibilities for hair loss- mites or Lice, a vitamin deficiency, rain rot or crud, or even just his natural shedding tendency. A skin scrape would help to confirm what may be the cause.
As for the swelling of Chance’s back right leg, I decided to call our previous vet who collected and injected Chance’s DDFT with stem cells to heal the hole in his tendon. We have some stem cells left over and I wanted to see if injecting his leg again would be of any benefit. I also would like to get an ultrasound recheck to ensure that there is not another injury to his DDFT tendon sheath again.
The twisting of his back hind leg is worrisome as well.
Everything I have read about EPM states that horses can have a relapse in symptoms after treatment is complete. My concern is that the twisting are due to the neurological symptoms coming back since Chance’s EPM treatment has been finished for a little over two weeks….
Our current vet believes that Chance’s ataxia and twisting is not due to EPM but his cervical spine instead. Could the twisting be worse due to the swelling of his hind leg? Or is the swelling and the twisting two separate issues all together?
If you compete in rated shows, here’s what you need to know to keep your horse healthy and maintain a level playing field.
If you’re like 99 percent of horse-show competitors, you don’t dope your horse. But you can’t help gulping when you hear those words?it’s like being called to the principal’s office in junior high. Did you or your trainer make a mistake? Are you in trouble?
The USEF regulations for drugs and medications can seem complicated, and changes this year may affect you. In this article Stephen Schumacher, DVM, chief administrator of the USEF Equine Drugs and Medications Program, explains the changes and tells you how to make sure you stay on the right side of the rules.
The goal of the USEF program is to protect horses from abuse and maintain a level playing field, so no competitor gains an unfair advantage through chemistry. And it’s working, Dr. Schumacher says. Of the 10,000 to 12,000 horses that the USEF tests annually (not a huge number, considering how often horses compete and the number of disciplines that the federation oversees), anywhere from 50 to 100 may test positive in a given year?1 percent or less.
“The low rate of positives doesn’t mean the program isn’t needed,” Dr. Schumacher says. “The numbers are low because the program is there?deterrence is its main effect. We would rather educate than adjudicate.”
Education starts with understanding what is and isn’t legal. It’s all spelled out in the USEF Rule Book.
Read All About It
General rules 401 through 413 outline the procedures for testing and enforcement and explain in general what is and isn’t permitted. These rules are carefully (and sometimes densely) worded but definitely worth the read. Anyone who signs an entry form at a USEF-recognized show needs to understand them because that person (usually the trainer, acting as the agent of the owner) has the primary responsibility for making sure the rules are followed. The separate “2012 Guidelines for Drugs and Medications,” available on the USEF website or in a pamphlet from the federation, provide a roadmap for staying out of trouble.
The rules allow different breeds and divisions to adopt different standards for permitted medications; endurance horses, for example, are subject to strict “no foreign substances” requirements. Here we’ll focus on the rules and guidelines that apply to hunter, jumper, eventing and dressage ?divisions. These rules don’t give you a list of every substance that is and isn’t allowed, although they do mention some specifics. New drugs are always being developed, and there will always be a few people willing to try new ways to gain an advantage.
To cover all cases, the rules classify substances based on their actions and uses. Permitted substances, which are not regulated by USEF, include vitamins, minerals, electrolytes, dewormers and most antibiotics (except procaine penicillin?penicillin is OK, but procaine is a local anesthetic that can linger in the horse’s system). They can be given to a horse at any time, including at a competition. Other drugs are sorted into two groups, restricted and forbidden.
Restricted Substances
These drugs can be used for therapeutic reasons?that is, to treat an injury or disease?but they’re subject to strict limits on the amount of the drug or its metabolites (breakdown products) that can be in blood or urine at the time of competition, as set out in Rule 410. They include the muscle relaxant methocarbamol (Robaxin), the corticosteroid dexamethasone (Azium) and seven nonsteroidal anti-inflammatory drugs: phenylbutazone, flunixin meglumine (Banamine), ketoprofen (Ketofen), meclofenamic acid (Arquel), naproxen (Equiproxen), diclofenac (Surpass, a topical) and firocoxib (Equioxx). Theobromine, a metabolite of caffeine and related substances, is also in this category; the limit is just enough to account for any the horse might get through diet.
You should know:
New this year:
Forbidden Substances
These are drugs that can affect performance, give an unfair advantage, pose a danger to your horse or interfere with drug testing by masking the presence of other drugs. They include stimulants, ?depressants, painkillers and local anesthetics, and tranquilizers and psychotropic drugs, such as reserpine and fluphenazine. Prednisolone, bethamethasone, triamcinolone acetate (Vetalog, often used in joint injections) and other corticosteroids except dexamethasone are in this category. So are NSAIDs other than the seven listed in the restricted group. Although many of these drugs have legitimate therapeutic uses, they should not turn up in a horse-show drug test.
You should know:
New this year:
“We’ve run surveillance across the ?disciplines and never had an issue with anabolic steroids. But we’ve made them forbidden and provided withdrawal guidelines for the most commonly used ones to recognize their potential for ?unfair use and to be consistent with other groups,” he says. “We are actually the last horse-sport group to abolish their use in competition.”
Bending the Rules
The USEF rules are clear: If you give your horse something to calm him or make him less sore in competition, you’re in violation?even if the same something might be permitted for a legitimate therapeutic reason. But intent can be hard to judge, so it’s not always clear when someone steps over the line.
For example, you might see dexamethasone in horse-show medicine chests. Some competitors administer “dex” in the belief that it will calm a nervous horse, although the rules expressly forbid that use and there’s not much evidence that it works.
“Based on work done years ago, the level permitted under the rules would not be expected to sedate a horse,” Dr. Schumacher says. “Some people feel differently. I don’t think there’s any peer-reviewed scientific literature to support that, but there’s a racetrack mentality?people think it works so they use it.” The USEF Drugs and Medications committee will likely be reviewing the guidelines and recommendations for dex, he adds.
Magnesium is also used to quiet horses, something that Dr. Schumacher says is based on a misconception. ?”Hyperexcitability is a sign of hypomagnesia?magnesium deficiency?and giving therapeutic doses of magnesium corrects it. Based on that, some people conclude that giving any horse more magnesium will make him calmer even if he isn’t deficient, but there’s no evidence for that,” he says. Even if it were so, oral magnesium is not a concern because it’s unlikely that a horse could consume enough orally to be affected, he notes. But some competitors administer magnesium sulfate intravenously, which is dangerous. “Given this way, magnesium can affect cardiac rhythm and have a depressant effect, and it’s a horse-welfare issue,” he says.
As of this writing, USEF had no prohibition on magnesium, although the substance is on the association’s radar. One problem is that magnesium is naturally present in horses and in all animals. “To regulate it, you first have to establish a threshold level that’s acceptable. It’s a different situation with drugs like NSAIDs that aren’t naturally present,” Dr. Schumacher says. Nevertheless, he adds, injected magnesium sulfate has been added to the FEI prohibited list this year, and administration will no longer be permitted at FEI show treatment areas.
If Your Horse Is Tested
How likely is your horse to be tested? The choice is pretty much random. “We test at 20 to 25 percent of competitions each year,” Dr. Schumacher says. “There is a focus on upper levels, where more is at stake and violations may be more likely to occur, but we test lower levels as well.” He selects the shows and then asks one of the veterinarians who works with the program to test perhaps one day out of four, at his or her convenience. The odds of being tested are greater for horses who display unusual behavior or place in the top five of their classes, but anyone can be selected. For example, in a dressage class, horses are picked randomly as they leave the ring before the placings are decided.
If your horse is tapped, be polite and take him promptly to the testing area. Arguing or stalling (by cooling out, bandaging and other delays) may be considered “noncooperation,” as much a violation as a positive test. Be helpful as the veterinarian draws blood and the technician working with the vet collects a urine sample.
The samples are handled according to standards set by the World Anti-Doping Agency. Both blood and urine are separated into A and B samples; the A samples are sent to the designated USEF lab for testing, and the B samples are held. If the A samples test clean, the B samples are discarded. But if the test is positive, the trainer (or whomever is responsible) has the right to have the B sample tested to confirm or disprove the result.
A positive test leads to an investigation and a decision on whether the rules were violated. The trainer usually has the choice of accepting an administrative penalty or responding at a hearing before a USEF committee, with or without legal representation. If the committee finds a violation occurred, it will weigh several factors?the type and (for drugs covered by Rule 410) the quantity of drug found, prior violations and how similar cases have been handled. Violators forfeit winnings and any points earned, and under USEF rules they face penalties that include fines ($750 to $5,000) and suspension (one to six months). The violation and the penalty are published, in itself a strong deterrent.
There are trends in violations, Dr. Schumacher says, like a recent spike in reserpine positives. “Medications pop up, but after a few positives, word gets around and the use tails off,” he says. Still, the most common violations ?involve NSAID levels over the limits set by the rules.
“These are ?speeding ticket’ violations, not as serious as, say, doping the horse with an antipsychotic medication,” Dr. Schumacher says. “In most cases we can identify the reason for the violation, and it’s a mistake. Maybe a groom dosed the horse, and the trainer was unaware and gave a second dose.”
To guard against such mistakes, he suggests, make sure your horse’s treatment program is secure, defined and documented:
Last fall, the American Association of Equine Practitioners published a set of guidelines for veterinarians treating nonracing performance horses, and they included several tips that may also help you stay out of trouble:
Maybe some competitors will always be ready to bend the rules (or ignore accepted ethics), even when doing so puts a horse’s health at risk. But statistics suggest these folks are a very small minority. Care and common sense will keep you out of their group.
This article originally appeared in the April 2012 issue of Practical Horseman magazine.
– See more at: http://practicalhorsemanmag.com/article/understand-the-usef-equine-drug-testing-rules#sthash.NzwSH6FR.dpuf