What is Equitation Science and Why Should We Care?

Equitation Science is the study of horse behaviour and welfare in an objective, science-based manner. Research spans topics from riding and competing to “the other 23 hours”.

I attended my first International Society of Equitation Sciences conference this past month and I loved it! It was such an amazing group of people, all working toward the common goal of giving our horses the best lives possible and proving what is truly ‘best’ through scientific research. The people in attendance were primarily academics and researchers, as well as trainers, riders, and a couple of veterinarians like me. They are from all over the world, with the majority of the research coming out of Europe and Australia. The society was formed in 2005 when a group of like-minded researchers gathered in Australia to begin to address the lack of research into the science of horseback riding. This has since expanded to include the entirety of horses lives as they interact with humans.

Some will argue that interacting with horses, whether it is on their back or from the ground, is more of an art form than a science. While I agree that there is art in the ability to communicate and work with a horse in a harmonious manner, I have to say that there is also a place for science to help improve our management and training methods.

As a veterinarian, I wanted to attend this conference from the viewpoint that we as vets are asked our opinion on husbandry or even training decisions fairly frequently. We also handle horses every day and if anyone can benefit from further knowledge of their behaviour, it is equine veterinarians. There is also a large body of research into horse welfare, and what qualifies as cruel treatment. The Ontario government has changed the way that it handles cruelty investigations and we are currently in a transition period, we are supposed to have a more concrete system in place this fall… what will be the role of veterinarians? We don’t know yet.

Let me take you through some of the highlights (for me) of the conference!

The pre-conference workshop with the amazing Technical Large Animal Emergency Rescue team was an important view into how we handle horses in emergency situations, how we interact with a team of first responders, and how we keep everyone safe. These are skills that you hope you never have to use, such as a horse down in a trailer that has crashed or helping horses out of a barn fire. In this early part of my career, I have already been involved in both of those situations. That is worthy of an entire blog on its own.

A large focus of the conference was teaching these scientists different techniques to help communicate their findings to horse people. If we can’t effectively pass the science from the laboratory to the stable then it isn’t benefiting the horses.    

The Change Cycle – human learning science. Before we can change, we need to become aware that there is a problem.

Looking at the correlation between rider weight and horse behaviour. Research has shown that increases in weight can lead to increased stress measurements in horses (heart rate, lactate, and respiratory rate), as well as a decrease in stride length. This study looked at sudden increases in weight using weight vests, increasing rider weight within a rider: horse ratio of 15-23%. Within this range of weight ratios, there was no significant response to increased rider weight.

Horse and rider safety in-game encounters. Did you know that you can go on an African safari on horseback?!?! I didn’t! These researchers looked at the stress levels of the horses used, specifically as they approached wild game. They found that the horses were generally alert but did not show extreme flight responses. They found significant differences in stress behaviours between the breeds used, thoroughbreds showing more stress than the local ‘Bush Pony’ breed. They also found that horses showed the most stress when approaching giraffes as opposed to other game species- who knew?

There was a large focus on equipment use in riding. We listened to presentations about the micklem bridle vs conventional bridles, effects on sub-noseband tissues with different noseband tensions, noseband design and rein tension, spur use in the UK, whip use in competition. This is the research that is changing FEI rules and will affect all of our other competition rules!

One presentation discussed the common pitfalls associated with measuring the equine stress response. What does an increased heart rate mean and how can we appropriately measure it? Do our measuring techniques themselves cause stress, like blood or saliva sampling? Are our tools giving us accurate results, particularly heart rate variability measures in horses with physiological arrhythmias? These are really important questions that will help us accurately interpret research findings.

This one was fun – looking at the impact of a companion horse during stressful situations. Researchers looked at horses’ approach to novel objects and their reaction to an unusual event (suddenly opening an umbrella) both alone and with a companion. In the test with novel objects, the companion helped to decrease reactivity. In the test with sudden stimuli, the companion improved recovery time. In a nutshell – horses do better in scary situations if they have a buddy. This makes my heart happy.

Finally, one area that I found to be extremely significant was the discussion about the National Farm Animal Care Council of Canada. I am proud of the work and science that our country has put into creating Codes of Practice for the care and handling of farm animals. Do you know about these Codes of Practice? Have you read them? The codes provide minimum standards and recommendations for the welfare of animals.  These codes are due for update and revision in 3 years and the science being produced right now will impact the new codes. If you haven’t, you should have a look at the code: https://www.nfacc.ca/codes-of-practice/equine

There is so much more that I could talk about; the importance of learning theory in training across all species, the different devices being used to monitor heart rate at rest and during exercise, the perspective of Gypsy people on their horses’ welfare, different slow feeder designs, and more!

Please have a look at the website for the International Society for Equitation Sciences: https://equitationscience.com/

And if you don’t already, follow these science-based publications on social media:

Equitation Science International, Horses and People Magazine, Justine Harrison – Equine Behaviorist

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Vaccine Season – Why Am I So Scary?

Vaccine season is finally winding down as we come into the summer months. The spring months when we do our preventative health care is a busy time for us in equine medicine. It is the one time of year that we see almost all of the horses in our practice. Many of our core vaccines are seasonal here in Canada so we try to vaccinate in the spring prior to exposure to mosquitos, wildlife, and other horses.
One thought that always comes to the forefront for me during this season is, why am I so scary? Many of these horses only see me for vaccines and then have a whole year to forget about it. Somehow, as soon as I walk into the barn some will be on high alert (do I smell?), or others will be fooled up until the point that I stand beside them and face them. That’s generally when the evasive behaviours start. Trust me, I get it, I actually hate needles when they are going into me, I’m a big baby about it too. However, there is such a big difference between the horses that become panic-struck and the horses that flinch a little bit and then forgive me, I have to wonder what actually makes this difference, I act the same every time. I still don’t have an answer to this question.
I have been interested in horse behavior for a long time. I have wondered how behavior issues could become a larger focus in veterinary medicine. The difficulty is that there is a big grey area between training and behavioural therapy. When do you need a vet and when do you need a trainer? Some professionals have been able to find their space in Equine Behaviour and one day I would like to go and figure out how they draw those lines. Dr. Sue McDonnell at the University of Pennsylvania runs an equine behavior clinic at their veterinary college. Laura Fraser and Justine Harrison are equine behaviourists that I follow on social media because they practice research-based techniques. They have all found their place in the world of horse behavior.
Wildlife conservation experts have been using reward-based methods for a long time to train animals to accept and even volunteer for veterinary procedures. If we can train an elephant to offer a leg for a blood draw, surely we can teach horses to stand still for them as well.
What I am excited about is that our industry is finally drawing awareness to low-stress handling methods and training your horse to meet the vet. Standing well for veterinary procedures is generally trainable just like anything else. They had to be trained to accept a halter, accept a saddle, accept a rider, and they can be trained to accept the vet.

The other day I opened Facebook to find our national group, the American Association of Equine Practitioners (AAEP), had posted an article titled “How to Decrease Your Horse’s Stress with the Veterinarian”! We are ready to start talking about fear-based behaviour and what we can do to reduce them.
So what can we do? If you have a fearful horse then start reading articles like the one above to learn research-based methods to reduce stress and train your horse to accept veterinary care. Talk to your vet! We work with dangerous animals all day, most of us are more than happy to work with you and your horse to reduce fear and aggression because that is safer for everyone. Your veterinarian can work with you by generating positive interactions with your horse. If they are in the barn for a different horse they can take a moment to feed your horse a treat or pet his neck without injecting him. We can give you an idea of what is a trigger for your horse so you can work to train her. Whether it is the neck pinch prior to a needle, the raising of a vein, or the smell of latex gloves – the more you work on getting your horse used to these things and rewarding calm behaviour when they are introduced, the easier each vet appointment will be for them.

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Sometimes You Need All Of The Letters In The Alphabet

When making treatment or surgical plans in medicine you always have to have a contingency plan, or two, or five. I say medicine because I do not think this is exclusive to veterinarians, I am confident that human doctors experience this as well. You can have a Plan A Gold Standard, “this is what the textbooks say should work” plan but you had better have a Plan B, Plan C, and maybe a Plan D for good measure. There are few areas where this is more necessary than with dental extractions. I’m not sure if human oral surgeons experience this to the same degree that equine veterinarians do. Sometimes in equine dental planning, you need the whole alphabet of plans.

Why is that? Let us look at all of the different factors:

Horses have (mostly) hypsodont teeth that slowly erupt over their lifetime. This means that each different stage of their lives they have different amounts of tooth hiding under the gum line, into the jaw bone or sinus cavities.

I won’t get into the development of horse teeth from embryo to adult – that would take too long. You’ll just have to believe me that the teeth are made up of different materials all folded together. Sometimes during development, there can be pockets in the teeth that didn’t fill in properly – making a section of the tooth that is weaker than the rest, one that might not show up until that portion of the tooth erupts sometime during adulthood and is then at risk of fracture.

In order to keep these teeth healthy they have live pulp horns that travel the length of the tooth, from just below the grinding surface down to the roots. These pulp horns can be a highway for bacteria that would love to set up an infection in the root of the tooth.

Depending on the horse’s age that root could be anywhere from just below the gum surface (very old) to just under the skin of the jaw (very young lower jaw) or deep in the sinus cavities (very young upper jaw).

So now you have to get a tooth out – why? Is it fractured? Diseased? Infected? Did it grow in the wrong place? If it has fractured, how much tooth is actually exposed that you could potentially grab with a tool? If you can’t grab it, how are you going to pull it out? If it is fractured, it is weakened, will you be able to get all of the tooth or just parts of it? If it is infected how far has the infection spread? Into the sinus? Into the surrounding bone? You don’t want to go pulling on a tooth which then disturbs an infected jaw bone and causes a jaw fracture! If the sinus is infected it will need to be flushed and you will need to make sure that food and bacteria from the mouth can’t get up into the sinus once you take that tooth out, opening up a tunnel. What does the root look like? Sometimes even with normal development the roots splay outward and the tooth is wider at the root than at the chewing surface! It’s like the childrens matching game – the star shaped peg can’t go through the square hole!

Thankfully, we have a lot of different techniques and approaches to achieve the desired outcome. Radiographs have helped immensely in surgical planning so that we know what we are getting into before we start, for the most part. However, the reality is that sometimes you don’t know exactly what the tooth is going to do until you start and you need to have those back up plans in place in case Plans A, B, or C don’t work! I know I have overwhelmed people when discussing the plan for their horse’s dental extraction but I think it is so important for everyone to understand that if Plan A works, GREAT, if it doesn’t, we have a plan for that too!

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Is This Horse In Pain?

My winter of learning was an intense one! I am so excited to announce that I am now certified to perform veterinary spinal manipulation therapy (VSMT or animal chiropractic treatments) after over 200 hours of studying, practicing, and learning from some amazing chiropractors and veterinarians. I have also spent a lot of time learning about equine dental diseases and extractions. You may think that these two different ventures don’t really go together. I would argue that it is actually all about finding different ways to provide pain relief and improve comfort for our equine companions. It is all about PAIN.

Horses are programmed by evolution to hide their pain. If they show pain or illness, then they are most likely to be the next one on the menu of the predators in the area. As their human companions we have learned to decipher some of their subtle hints. Almost every horse person will spring into action at the first sign of a roll, belly kick, and forlorn gaze at the abdomen. We speak ‘colic’ very well indeed.

But what about pain signs that aren’t as easy to interpret? The horse that is no longer interested in the second bite of their carrot? The horse that pins its ears when the saddle is put on? Do we always notice these subtle signs? And what can we interpret from them? Pain and communication is an exciting area of equine behavior research. Recently an ethogram was presented for horses to evaluate stress and pain in riding programs. An ethogram is a catalogue of specific behaviors in a species. I might just be a behavior nerd but this is REALLY EXCITING! We can’t ask a horse if it is painful but we can learn to understand their subtle body language. Dr. Sue Dyson has put together some short videos explaining the work, I highly recommend watching them.

https://thehorse.com/110436/an-ethogram-for-ridden-horse-facial-expressions-of-pain/

With this research progressing we may soon be able to stop guessing at the pain level in our patients. Until then we sometimes have to use our knowledge of human medicine and apply that to horses. This isn’t a perfect system but with so much similarity in our biology and nerve pathways it seems safe to assume that the sensations that we find painful also affect our horses. For example – dental pain. Ask anyone who has suffered a tooth root abscess, a root canal, or even just had their braces tightened – dental pain is awful! It often isn’t even a sharp, specific pain, it tends to be a dull, throbbing, headache, moaning, feel sorry for yourself kind of pain. So how can horses show us this? In my experience, they don’t. They keep eating, keep working, and try their best to hide their discomfort. Sometimes there are signs: they are depressed, or the tell-tale sign for incisor pain – they happily take a bit of a carrot but refuse to go back for a second bite, the first one cost them too dearly. One of the really exciting skills that I have developed this winter is the standing procedure to extract incisors. There is a disease process called Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH) when the horse’s body starts to attack and resorb the incisor teeth (the front teeth used for grabbing grass and treats). We don’t fully understand this disease and at this time the best treatment is taking the teeth out. They can be reactive, infected, and disgusting. The first time I did this procedure each tooth that came out was shortly followed by a big buildup of pus that was sitting at the tooth route. That’s gross, I know, the people watching had to walk away. This poor little pony had been walking around with that in his head and he didn’t tell anyone! I heard from the owners shortly after the procedure that they couldn’t believe it, they had their pony back! They had thought his quiet attitude and reduced interest in feed was simply because he was getting old. As soon as those diseased teeth were out he was a new pony! I get this response frequently after taking out diseased eyes as well, and that is why it is one of my favourite procedures and I am so happy that I took the extra time to learn the technique. I can take away significant pain and give people back their happy horses!

What about the pain that isn’t quite so intense or local? The overall body discomfort that makes us as humans move a little more slowly first thing in the morning or the day after a particularly difficult workout? Is that pain? We usually give it a different name: discomfort, aching, stiffness, creaky, feeling ‘old’. Do horses experience that kind of pain? I certainly think they do. Equine athletes, pleasure horses, retired horses, whatever their job in life, they are all individuals with their own past injuries, bad posture, hard workouts, and creaky joints. As humans and caretakers we seek relief for this kind of pain – massage therapy, chiropractic treatment, acupuncture, physiotherapy, pain medication, and the other million and one ways humans have developed to decrease pain. One of the things that I absolutely love about animal chiropractic treatments is how much the animals seem to love it. They don’t have any of the internal debate going on in their brain about whether or not they “believe in chiropractic”, they either feel better or they don’t. A lot of the time they feel better and it is so exciting to have horses that like me again! The changes in their gait, their stance, and their overall comfort can be dramatic. My practice case during the course was a lovely 27 year old pony with chronic laminitis. His laminitis is under control but his overall body pain from the way he had been carrying himself during episodes of foot pain meant that we had to keep him on low dose NSAIDs to control his discomfort. Through the months of chiropractic treatments we noticed a difference in his overall body comfort coming out of the stall each morning and we were able to take him off of pain drugs completely. That is really exciting to me!! Medications have their time and place and I will never fully stop thinking like a vet but it is really exciting to be able to approach some of these issues in a different way, or to have more to offer when the medications aren’t enough.

Ultimately a huge part of our job as veterinarians is preventing and treating pain or discomfort. I am so excited that as a profession we are continuously seeking new ways to identify and treat this pain in our horses. The next step will be to take care of all of us old, stiff horse people that have bad backs from years of pushing wheelbarrows and tossing hay bales!

Resources:

https://thehorse.com/110436/an-ethogram-for-ridden-horse-facial-expressions-of-pain/

https://thehorse.com/111913/getting-to-know-eotrh/

https://horse-canada.com/magazine_articles/equine-chiropractics-coming-of-age/

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September – The Fall New Year

Most veterinarians spend the first quarter of their lives as students. High school is followed by 4 years of a university undergraduate degree, followed for some by a masters degree, others by entering directly into veterinary college, and others by taking a short break from schooling only to discover that we aren’t done with it yet. When you spend that much time in school, September starts to feel like the real “New Year”. September is when something changes, a new challenge presents itself, and we clean out the old and get ready for the new. Horse people feel this on a similar level, the end of the summer and beginning of the fall is when we start thinking about new pursuits. A new horse to train, a new level or discipline to conquer, a new area of knowledge about horses to explore. We have to do something to keep busy during those winter nights when it is too cold to ride, right?

I was one of those students that took a break after my undergraduate degree. I finished my Bachelor of Science in Animal Biology at the University of Guelph and moved to Calgary with a friend. We had lived there for 3 months of the summer when suddenly September hit and we WERENT going back to school! Something had to change! I promptly dyed my hair and for a time this satisfied a craving for change. I soon moved back to Ontario and started a new job (the next September, 2009) as a veterinary assistant, working for McKee-Pownall Equine Services. Since then I have continued to base my life around the need to change something in the transition from summer to fall. Last year I got married in late September!

So what is changing this year? I’m going back to school(kind of)!! Summer is a very busy time for all horse people, see my previous post “Horse Season”. This means that it is the busiest time for horse-vets too. Therefore, we use the fall and winter to learn new things, what we call ‘Continuing Education’. This year I am lucky enough to be learning the science of veterinary spinal manipulation at the Veterinary Chiropractic Learning Centre. This course is spread over five modules, taking seven months to complete, followed by mentorship from experienced veterinarians, including my wonderful teammate Dr. Tovah Caldwell who also happens to be one of the course instructors. I am so excited!!! I’ll admit that I’m a bit of a nerd, I truly love school and learning! Veterinary spinal manipulation has shown a lot of promise in improving quality of life and athletic performance in horses and I can’t wait to learn more about it. As I write this I am surrounded by textbooks describing the history of chiropractics, the anatomy of animals, and neurology.

So what change is September bringing for the rest of you? A new horse to train? A step up in your discipline? One of the many courses available on Equine health, nutrition, or behaviour?

If you are interested in learning more about your horse this winter here are some great links:

https://campus.fei.org/

http://www.equineguelph.ca/education/indiv_courses.php

I will try to keep everyone up to date on what I learn through my studies this fall, but if you don’t hear from me it is because I’m curled up with a tea and my textbooks trying to learn the science of chiropractics.

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July Is Vet Anniversary Month

July is the time of year at McKee-Pownall where we celebrate a lot of work anniversaries for our veterinarians. We typically hire new veterinarians after they complete a one-year internship following their graduation from veterinary college. Internships in North America usually begin sometime in June and end around the same time the following year.

We prefer hiring veterinarians from an internship for several reasons. Most vet students don’t receive sufficient practical experience in vet school, so working in a busy veterinary hospital gives offers a hands on and diverse case load. Also, we appreciate the wide-ranging knowledge new vets at MPES bring to us after their internship. We are always striving to be at the cutting edge of medical knowledge so the more experiences we can bring on board the better for our clients and their horses. Our vets have come from internships across North America, so we are the beneficiaries of some of the best veterinary minds across the continent. Finally, we have hired several veterinarians that have worked with us as students and we would like them to do an internship elsewhere, so they learn new things beyond the comforts of MPES. Inevitably, they come back home with a great background and skill level that allows them to jump right in and work with you and your horses.

We are very proud of how long many of our veterinarians have been with MPES. Drs. Maggie Turner and Michelle Courtemanche were the first associates we hired 12 years ago. Dr. Kathryn Surasky joined us 10 years ago, followed 2 years later by Dr. Tovah Caldwell. In 2012 Dr. Jim Welsh came on board, followed by Dr. Andrea Dube in 2015. Drs. Samantha Molson and Marisa Markey spent a lot of time with us as vet students and we were very happy when they came back home in 2016 and 2017, respectively. Dr. Ali Miletic, who also spent time with us as a Summer Student, joined our Newmarket practice in 2017 and we welcomed Dr. Kyle Goldie this past winter. Those of you in our Caledon practice area will soon meet Dr. Taylor Mahren in a couple of short weeks as soon as she finishes up at her internship.

Having a mix of veterans and newer vets ensures that while all vets deliver the same high level of medical care and personalized experience, the influx of new ideas makes everyone a better vet.

Happy Anniversary everyone!

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Horse Season

Happy Horse Season everyone! It is that time of year again when we Canadians can fully appreciate our horse companions without freezing our toes off. I was inspired to write this blog post during a weekend at Palgrave as the vet for the horse show. Palgrave is otherwise known as the Caledon Equestrian Park, but I have been calling it Palgrave since I was 10 years old so the name has stuck.

Horse Season – it isn’t just Horse Show Season, it is everything equine, whether you ride your horse competitively, ride for fun, work with them from the ground, spend the spring greeting new foals, or simply love watching them from afar, this time of year is just the best. On my drive to the show I drove past a group of friends hacking through some fields beside the road. The day before that I had arrived at a schooling barn just in time to see a group of kids and their ponies out to graze while they dry from their baths. Everything about this weather is screaming “Be outside with your horse!” Winter here in Canada is long and cold; most of us simply bundle up and spend some time with our horses without truly enjoying it in the way that we can in the summer. There is nothing I love more than watching a content horse graze at the end of the day, something about it is just good for the soul.

If you have never been to a large horse show or the backside at a racetrack, please go and allow yourself a moment to stand back and observe the horses and people warming up or waiting to go in the ring. This brings the most incredible collection of people who are all there because of their love for horses, their athletic ability, the freedom they give us, and their incredible hearts. You have the riders, athletes themselves, working with their horses to achieve new goals. You have the grooms, up at dawn to provide these horses with whatever they need, always ready with a towel to wipe a face or just a pat of reassurance. You have the trainers, constantly assessing what the right step is for their human and equine athletes. And you have the show parents – they may not understand their child’s love for these crazy horses but they are there, providing water and shining boots.

There is something magnetic about horses isn’t there? It is that something that makes it hard to leave the barn on a beautiful summer night, even when all of the work is done. Even though summer time brings the sweat, the flies, the impaction colics from not drinking enough, the skin hives from unknown allergies, the lameness from hard ground when it hasn’t rained, or the laminitis from fresh grass when it has – somehow all of those stresses and frustrations melt away when you make that perfect jump, perfect transition, or catch the sunset as you return from the perfect trail ride. All of the special care and extra work is worth it for those magical moments with a horse.

I am not going to use this blog as a platform to discuss deworming strategies, or making sure your horse is drinking on hot days, or protecting your horse from ticks and mosquitoes. Talk to your vet about all of those things when planning your summer.

I do want to use this blog post to encourage everyone to take as many of those magical horse season moments as they can, and to appreciate each one, because before we know it, it will be winter again!

As the saying goes, “The outside of a horse is good for the inside of a man” (or woman!)

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Vaccines, why don’t we ask?

I’ve been wondering something. Why don’t people want to ask about vaccines? Why we do them? Which ones we choose? What those diseases are? With all of the controversy surrounding vaccines in the recent past, why don’t people ask? Is it just absolute trust in their veterinarian? Is it that they worry the information is too technical? Is it that we don’t really care? I don’t think that is the answer.

I’m not sure if it is a combination of these things or if I’m missing the mark completely. What I do know is that I’m guilty of it myself. There have been a few instances that started me wondering about this gap in communication. First, I recently presented about vaccines to our team at MPES during a staff meeting. I explained the way that I think about vaccination and the immune system. The way that I found to understand immunology in vet school was to think of the immune system as an army. Each type of immune cell has its own job or rank in the army. To me, vaccines are like Mug Shots. They show the body’s army what the bad guys look like and give them a chance to figure out how to fight them. When the body’s army sees the mug shot for the first time only a few of the soldiers see it. When we complete the primary series and give the vaccination again 3-4 weeks later those soldiers realize that this is definitely a bad guy that they need to worry about and they tell everyone! So now we have a whole army ready to fight the diseases that we are the most worried about. Once or twice a year we have to revaccinate to continue to remind the body’s army the watch out for those bad guys.  After this presentation one of our staff members told me that she had never fully understood how vaccine boosters work or why we do them! Why didn’t she ask before?

Another encounter brought this back to my mind not long after that. On a routine visit to vaccinate a horse the owner had requested that the horse receive everything except for “EWT”. The veterinarian at the appointment wondered why this might be, “EWT” is one of the core vaccines that we recommend. “EWT” stands for the three pathogens (bad guys) that are combined in this one vaccine – Eastern Equine Encephalitis Virus, Western Equine Encephalitis Virus, and Tetanus toxin. The tetanus part of the vaccine is one of the most important vaccines that we give to horses. Horses shed the bacteria Clostridium tetani in their manure and it is easily found in their environments. When this bacteria gains entry to the body through a break in the skin it begins to produce a powerful toxin that affects the nervous system and causes the disease Tetanus, a disease that is usually fatal in the horse. Due to the high environmental contamination and the high incidence of wounds, horses are at a very high risk. For that same reason horse people are also at high risk of tetanus and should stay up to date on their vaccines! Eastern and Western Encephalitis are viruses that are passed to horses through mosquito bites. Although they are rare in Ontario, these viruses are 100% fatal and we generally see at least one a year, therefore we consider it worthwhile to vaccinate for them. The vaccine is protective and safe. So why did this owner not want to vaccinate with this very important vaccine? When asked her response was, “Because I don’t know what it is”. It is our job to help teach people what diseases to vaccinate against and why, we never expect anyone to just know this information, we had to learn it at veterinary school too! So once again, why didn’t she ask?

Finally, it was my own behaviour that really brought about this question. I am lucky enough to be travelling to the Caribbean soon for my brother’s wedding. While browsing some travel sites online an advertisement for TwinRix vaccine popped up. I asked my husband if he had ever received this vaccine and if he thought we should get one before going. He asked, “What is it for?” I replied, “I don’t know but you’re supposed to get it before travelling”. As soon as the words were out of my mouth I hung my head. I am a doctor, yes for animals, but with similar training to human doctors, and I am one of the people not asking the questions – What is that for? What do those diseases do? Is the vaccine safe? Why hadn’t I asked?

In this age of Google and quick access to information do we all feel like we should have every answer? We shouldn’t have to ask the questions and we might be judged if we do ask?  I hope that isn’t the case.  I truly believe that everyone is capable of understanding the basic principles of vaccination, the diseases that we vaccinate against, and why. I also believe that your veterinarian or doctor is the best person to teach you. We all had to be taught at some point and we have all found a way to make sense of it. If my army analogy doesn’t work for you I bet I can find 5 other ways of looking at it, just in our one clinic.

So please ask! We all love to help people understand why they vaccinate their horses each year, why we deworm the way that we do, why we choose one antibiotic instead of another, and the list goes on.

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Teaching Our Feet to Walk Away

There have been a few tough cases lately. Horses that have complicated problems and day-to-day updates can be a roller coaster. They have me checking my phone at night and on my weekends off. They have me stopping in at the barn when I drive by just to quickly see for myself how the horse is doing. They have me laying awake at night wondering what else I could be doing for them.

In this occupation we are constantly learning. Every day brings a new challenge, a new disease, a new medication or therapy to learn about. In the first few years of practice it feels like there is a mountain of learning to climb. The part that most people don’t think about is the emotional education that we go through as well. At school we are in the hospital wards constantly, and then we enter our internship where most of us eat, sleep, and breathe veterinary medicine for a year. We never leave the hospital, our patients are always just a few steps away and they are constantly monitored by either us or one of our trusted team members. Even in that time though, we have to start learning to walk away. We have such a passion for what we do and we care so much for our patients that we literally need to learn how to take care of ourselves as well as them. A frequent command heard during my internship was “Marisa, go home!”  I would skip meals and skip sleep in order to stand at my patient’s stall, hoping that the power of my gaze would fix them.

Now that I find myself working as an ambulatory equine vet, I have even more learning to do, and I’m not the only one. There are always tough cases that make it hard to go home, shower, eat a meal with loved ones, and go to bed, but we have to. These tend to be certain situations that pull at our hearts and souls more than others: laminitis, colic, colitis, pneumonia, severe lameness. The things that we can’t fix instantly and that we lose sleep over.

We have to take care of ourselves or we won’t be able to properly care for the next horse that needs us, we aren’t machines, even though we wish we were sometimes. Just recently one of my colleagues told me a story. We had a painful pony that we were helping through an episode of laminitis with multiple pain medications. This colleague stopped in late on a Saturday to administer more injectable pain medication and the pony was having a bad night. She was alone in the barn. She did an assessment, administered the medication and sat with the pony for a moment. She stood up to walk away, got half way to the door and turned around, went back and stared at him. I know exactly what she was feeling; that strong desire for the power of your stare to fix something, to take away the hurt. She stood there staring at him and then had to say to herself “turn around and walk to the truck, either to get something else to help him, or to drive away because there is nothing more that you can do while you wait for the drugs to kick in”. I’ve seen other colleagues do this as well – simply stare at the horse for a few extra seconds. I do it frequently, anyone who has ever seen me finishing up a colic exam has probably heard me say “OK, I’m just going to stare at him for a few more minutes and then I’m going to leave”. I need to see them stand there comfortably for at least a few minutes or I can’t force myself to walk away.

This is what we slowly teach ourselves. We have to learn to walk away or this career will eat us alive. We all want to curl up on the hay bale and keep an eye on the colicky horse all night, and in some situations we all have. We all want to follow the horse into the hospital to make sure that they get there okay, and that the treatment is what we wanted for them. What we learn over time is to trust our colleagues, trust our referral centres, and trust the owners that take over the horse’s care when we walk out the door. We learn that when we walk away with our feet it doesn’t mean that we are walking away with our heart or our mind. We go home, we shower, we eat, and we research every new finding about the problem in question. We fight the urge to ignore all of our other patients for that one that is having the most trouble. Sometimes what they need is time and we can’t speed up time with the power of our gaze, no matter how much we want to.

So, try to remember this the next time your vet is standing there staring at your horse – they are struggling with an internal battle, and just because their feet walk away doesn’t mean their mind does. They want those updates, those pictures, and best of all, that text that says “She is so much better!”

Dr. Marisa Markey

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Why I Love Equine Dentistry

As equine veterinarians we see a large variety of horses, and we get to be involved in all aspects of horse health and wellness. An important part of that is dentistry. All vets are trained to properly and effectively perform a dental exam and float, however we all have areas of veterinary medicine that we enjoy  more than others, so not all vets enjoy dentistry like I do.  To be clear, I’m not a specialist, I am not board certified in dentistry, this is just a part of my day that I look forward to every time.

Why do I love it?

I suppose part of it is the instant results. You can take a horse with painful sharp points in its mouth and 20 minutes later they have relief! I had braces as a kid and I can tell you that sharp points cutting into your lips and the side of your mouth are awful.

Figure 1 – www.mwveterinaryservices.com/dental-abnormalities.html

They are painful when you eat and I certainly wouldn’t have been happy with someone putting a bit in my mouth and asking me to work.  Horses form sharp enamel points due to the shape of their jaw and the grinding motion they use. The lower jaw is narrower than the upper jaw, therefore the outside of the upper jaw and the inside of the lower jaw never grind against another tooth. Over time this develops into points that can rub along the sides of the tongue and against the cheeks.  Sometimes these points are sharp enough to cut the latex gloves that we wear while we exam the mouth. Ouch! When I see those points and the ulcers associated with them I actually smile – I am about to make this horse’s life so much better!  It is also an opportunity to provide education on the need for routine dentistry.  If you are present, I have a chance to let you feel what is going on inside the horse’s mouth for yourself.  Even in mild cases, when I find ulcers, or irritation within the mouth I will ask if you have had trouble with the horse on one rein, or the other and more often than not you realize that the horse has been uncomfortable in the bit on the same side as the ulcers.

Young horses losing their baby teeth are a special joy for me too. Usually these horses are chewing in a strange way, dropping feed, throwing their head – sometimes even drooling. When I get the horse in the speculum, and open the mouth – there is a loose baby tooth just asking to be pulled out! Remember being a kid, when you would spend all day wiggling a loose tooth until it came out?  The feeling of your tooth moving every time you took a bite was so annoying. Young horses experience the same thing and we can provide instant relief by playing “big-brother” and pulling that loose baby tooth.

 Another reason that I love dentistry?

The horses are usually healthy. This is a selfish one. We see sick horses frequently and it makes us sad.  I became a vet because I love horses.  Seeing them in distress can be hard for the soul, even though I am happy to have the opportunity to help. Dentistry provides a nice break from the emotional cases. The horse is happy and healthy, we sedate him, perform a dental float, and then he wakes up even happier and healthier! Everyone wins!

I’ll be honest; it isn’t all sunshine and rainbows. There are few things more disgusting than the smell of rotting tooth. When an infection takes hold of a tooth it can cause some pretty terrible nasal discharge or drainage under the jaw. It is gross and I don’t know anybody that likes that part of dentistry. When you extract those teeth in surgery you usually need to go have a shower immediately because somehow the smell just sticks to your hair and clothes.

Figure 2 slideshare.net/HorseFloss/natural-balance-or-whole-horse-dentistry

Dentistry is a fun puzzle – how does the horse chew? What is impairing normal grinding and causing any abnormalities? Could problems in the mouth relate to performance or overall health? How is it fixed without taking too much of the limited grinding surface?

Dentistry might not be everyone’s favourite part of their day, but I bet if you asked, any horse vet would admit that they do love some parts of it! All vets love how we can make such a quick and positive impact on the health of our patients.

Figure 3 – Big tongue ulcer from tooth fracture

Figure 4 – Baby teeth ready to fall out

Figure 5 – My view

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