The Process and Challenges of Importing Horses for the Pan- Am Games

quarantineI read with great interest last week the uproar over Johnny Depp bringing his two dogs into Australia without putting them into quarantine. It reminded of the efforts the veterinary team is doing to prevent the importation of foreign horse diseases into Canada. It seems that a large part of the preparation for the equine events  at the Pan Am Games is co-ordinating the import of foreign horses to Canada for the Pan Am Games. For those who travel to the USA with their horses it isn’t a big deal, but when we are bringing horses in from the Caribbean, Central and South America and Europe there are many more restrictions in place. The veterinary organizing team has been working closely with the Canadian Food Inspection Agency (CFIA) on the import and quarantine regulations for visiting horses. You might wonder what a food inspection agency as to do with horse importation, but the name is misleading since the CFIA is responsible for regulating the import and export of all agricultural products into Canada.

The challenge we face is that the USA and Canada share similar regulations for the importation of horses. Both countries are free of two disease in particular that some horses that will be competing might have. The first is Contagious Equine Metritis, a reproductive disease that causes fertility issues, and the second is Piroplasmosis, a tick borne disease that is prevalent in some part of Central and South America. Piroplasmosis can be life threatening to an acutely infected horse, but if they can survive the initial signs of infection they carry the disease but don’t show any signs of it. Like the border officials in Australia we don’t want to introduce foreign diseases into our country. Fortunately, both diseases only affect specific parts of horses, so there ability to exert themselves in competition is not putting the horse at risk health wise.

As a result of all of this the transport team that co-ordinates all of the arriving teams has been working with visiting teams to make sure arriving horses will be quarantined in the USA before arriving in Canada, or have a quarantine arranged in Canada to accommodate their arrival. On top of this the veterinary team has been working on a biosecurity manual that will instruct us on how to house the Piroplasmosis horses, how to inspect for ticks, and how to stable CEM horses so there is no risk of infecting other horses. Thankfully, these diseases are not easily transmissible to other horses,  nonetheless there are processes in place to keep these diseases out of Canada.

This whole process has been a great reminder of how integral veterinarians are involved in agricultural safety in Canada. It also shows how collaboration between different stakeholders is helping making these Games run as smooth as possible. Finally, it demonstrates that the global movement of horses brings manageable risks and that it is imperative that we remain vigilant to prevent the spread of foreign diseases into Canada. Johnny Depp bringing his dogs into Australia  might have seemed a trivial matter, but there is much more going on than meets the eye.

 

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Preparing For the Games at Rolex Three Day Event in Kentucky

Dr. Mike Pownall spent last week visiting the Rolex Three Day Event in Kentucky. Here he is sharing his experience in words, photos and videos as we prepare for the Pan Am Games.

In preparation for the Pan Am Games I spent last week in Lexington at the Rolex Three Day Event. I was particularly interested in seeing how Cross Country was run from the perspectives of general organization, and the care of the horses before, during and after the event.

I was overwhelmed by the generosities of the organizing and treating vets in allowing me to shadow them as they went about their duties. The scope of the veterinary care was incredible with 3 supervising FEI vets, 2 official treating vets, various competitor vets, and 17 vets with numerous students helping out on the Cross Country course. It takes a team for this type of event to work well and seamless communication was key to their success.

It has been awhile since I was up close to a 3 Day Cross Country course and my respect and admiration for the horses and riders grew as I walked the course Friday morning. I was exhausted after walking the 6 km course. Imagine galloping this while navigating the challenging jumps? Incredible.

Cross Country day featured torrential rain, which added another layer of complexity for horse and rider safety. Again, I was impressed by how well riders navigated the slick course. The event was overshadowed by the euthanasia of one of the horses because of an injury suffered at the end of Cross Country, but every other horse I saw in D Box following the course was sound and recovered well. As the day progresses you could see the care the riders took on course to minimize the risk to their horses. It was a display of phenomenal horsemanship.

One of our goals during the Games is to offer the best veterinary care to our equine competitors. After seeing the veterinary excellence offered at Rolex I am confident our team of vets, technicians and students will meet the challenge. Currently, we have 23 vets, 17 techs and 9 students who are volunteering their time to help!!

It is almost 2 months until the first horses arrive at the Caledon Equestrian Park. I’m looking forward to sharing more of our experiences as we prepare for the Pan Am Games. Let us know if there is anything in particular you are interested in learning about so we can share with everyone.

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Veterinary Care Well in Hand for Equine Pan-Am Games

The upcoming Pan Am Games are going to see some of the top equine athletes in the world in these parts, and they’re going to have to be cared for.

Dr. Mike Pownall, of McKee-Pownall Equine Services, has been named veterinary services manager for the equestrian events at the Games.

Excerpt from the Caledon Citizen, See full article here: Veterinary care well in hand for equine Pan Am Games

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Equine SOS

The phone rings. We have just finished laughing about the squirrel outside our window that we have named “Nutty,” guarding his tree from fellow wildlife. We answer. On the other end of the receiver is a teary voice, indicating that there is an emergency that is going to have to take priority over anything else at the moment.

Suddenly, Nutty’s antics aren’t so funny. We stay calm, collect the information and contact a veterinarian to get them out to see the horse ASAP.  You may not be able to hear it, but we are having an emotional reaction too. Our mouths feel pasty, our hearts race, our hands get sweaty and we get a pit in our stomach. We page the vet. Why are they taking so long to answer?  It has really only been 30 seconds, but feels much longer.

If 30 seconds seems so long for us, the call from the client perspective must feel like an eternity – especially when the office is asking questions.  Emergencies are scary, and we recognize how traumatizing it is. Like 911 operators, we have to collect all of the right information so we can relay it to the appropriate people (in our case, it is our veterinarians) and provide you with the most efficient care we can.  We want to prevent unnecessary call backs. In these types of situations, you have enough to worry about, without us calling you back to verify something. The following, is need to know information:

  •  The issue the horse is having, and how long it has been happening.  This is important so that we can determine which vet we send, and how urgently we need to get them there.   The occasional colic has been referred to surgery without any intervention from us, due to the symptoms described over the phone and the length of time the horse had been sick.
  • The physical address of the horse – we would feel awful, if you had a sick horse and we sent the vet to the wrong location!
  • If any first aid has been administered, if so – what? Banamine can mask signs of colic, making a horse appear fine when they are really not.  Coating a laceration with product prior to an exam may affect the ability to stitch it.  Pulling a nail from a foot can cause more damage than has already been done.  We like the vet to be fully prepared, with an idea of what is going on, before stepping foot on the property.  We also, do not want to administer drugs again, if a dose has already been received.
  • A phone number that the vet can reach you at, where you will actually answer. We need to be able to get a hold of you with an ETA, or the vet needs to be able to talk to you should they get lost, or require further information.
  • Is the horse insured? This could change the options available to you.

We all have our own pets.  Most of us have horses.  We have developed relationships with clients over the years, and despite the fact that we (as office staff) may not have ever physically met your horse, we can appreciate your stories about how cute he is when he nickers for his treats, or plays with his jolly ball, or lets his friends free from their paddocks/stalls. Through interactions for routine appointments, we feel like we’ve gotten to know your horse.  When something is not quite right, we feel the anxiety it is causing you and can relate to it, because we know how much your horse means to you.

When the phone rings, we never know how the call is going to play out.  While emergency calls can cause some dread, we are glad that we are available to help treat your horse in these circumstances. It gives us a great deal of satisfaction to be able to play a role in getting a veterinarian to see your horse as fast as possible.

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Can You Hear What the Client is Saying?

Every year the Customer Service Representatives (CSR) from all of our practices get together for a CSR training day.  We discuss topics like emergency situations, how to handle different types of calls, how to respond to certain questions and how to provide the best service we can.  It is nice to get a 3rd party perspective.  This year we brought in Dr. Colleen Best as a guest speaker, to help us learn the ins and outs of communication.  Dr. Best is doing research at the Ontario Veterinary College on the impact communication has on the relationship between a client and a veterinarian – specifically in an equine setting.

Something she said, that resonated with me was, “clinical communication isn’t inherent, and needs to be taught.” To make this point hit home, she introduced some scenarios and we took turns role playing.

We are CSRs. Communication is our bread and butter.  This will be easy!

Or not…

If we talk to people all day every day, how is it possible, that we were stumbling through these scenarios?

We were thinking about our answers, and not listening to what our “client” was saying.  Instead of making a personal connection, using helpful filler/catch phrases and engaging the “client”, we were caught prefabricating responses, in an effort to show the presenter our skills.

After a pause, and some discussion about what went wrong, round 2 went much better.

The CSRs, as the initial point of contact, can’t be the advocate for the client if they don’t understand what the client needs.  We can’t really understand what the client needs without listening to what they are saying. One of our goals at McKee-Pownall Equine Services, is to be the voice of the client, and provide the best customer experience we can. To ensure this is our reality, we have to set the bar high and continue to hone our communication skills. Since our interaction is primarily over the phone, we have to understand what the voice on the other end is saying without the benefit of body language, facial expressions and other sight triggers.  Due to the technology we use, we have to solely rely on the words used and tone of voice.

What I learned about myself that day, is that I don’t do as well in the hot seat as I thought.  The veterinarians and technicians complete continuing education courses for practical skills that benefit the client and patient in the field.  We, as CSRs can do the same to benefit the client experience over the phone. By exposing our weaknesses in a group setting, we now all know what we need to work on.

Realizing that the ability to communicate is not something you should just know, made my inadequacies in the scenarios an easier pill to swallow.  I have said it before, and I’ll say it again – there is always room for improvement, and this training day has motivated me to continue to do so.

 

Laura Holmes, Office Manager

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Routine Services – Bundled in a Convenient Package

Everyone has a busy life, and smart businesses are using different methods, to offer convenience to their clients, so it is easier to deal with the business.  One of these methods is to provide packaged services. It is present in the telecommunications industry with bundles for internet/phone and television.  It is present in the auto industry with service/maintenance and warranty packages.  It even pops up in the financial industry with banks offering mortgage, credit and insurance packages.  I could provide a whole page of examples, but I want you to keep reading!

You are probably wondering what this has to do with an equine veterinary practice.

Veterinary medicine has been surviving off of an archaic business model.  Up until recently our governing body in Ontario wouldn’t allow us to offer packages or bundled services.  Things that are considered normal in other sectors of business – are practically unheard of, or cutting edge in our industry.

My horse, Rocky is treated like one of my children. My experience has been that it is much easier to book appointments, access emergency services and obtain patient history for him, than for my human children.  Going through a pregnancy, while working for a vet clinic, gave me plenty of chances to compare the client experience between human and veterinary medicine.  Having a baby meant that I spent countless hours in doctors offices, waiting for labs and  spending time on the phone coordinating appointments.  Once the baby arrived, it was numerous weight checks, nutritional consults and vaccines.  Vaccines were the worst!  Often, the brand name of a vaccine has nothing to do with the disease it is fighting.  Most of the time, I couldn’t pronounce either the drug name or the disease, let alone know how often it needs to be boosted.  I would have appreciated the opportunity to sign up for a program that monitored all of those appointments for me.  It’s a lot to keep track of, and can be quite overwhelming. 

With the recognition, that our clients are busy people we decided to create a Preventative Health Care Plan (PHCP) for your convenience.  We thought about the things that we would want for our horses.  Most people consider routine vaccines, dentistry and worming protocols as standard care.  We wanted to do more, by providing an even higher standard of care.  It is easy to overlook physical exams or baseline blood work, when there are no health issues at the forefront, but by including these services in a PHCP, you will appreciate having something to compare to, should the need arise!  What is exciting about offering this program (from an employee perspective) is that we get to provide a comprehensive health care program for your horse, you get to save some money, you receive reminders for appointments, and your medical records are easily accessible.

We have established that our clients are busy.  We also realize that different styles of owners require different services.  With this in mind, we developed 3 different plans to suit your individual needs.

Don’t become overwhelmed by everyday life. Take advantage of one of the health plan options available to you.  It will make your life easier, and we get to care about your horse as much as you do. Maybe we can learn to pronounce those vaccine and disease names together. 

Laura Holmes – Campbellville Office Manager

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Thank you for calling McKee-Pownall Equine Services

Thank you for calling McKee-Pownall Equine Services – or in this case, checking out our website!  My name is Laura.  You may have spoken with me on the phone or corresponded with me via email.  I am a part of the McKee-Pownall team, but not necessarily in a way that jumps to mind when one thinks of a veterinary practice.

I answer the phone and perform administrative tasks.  To some – it may not seem that exciting, but I love it.  I love the client interaction.  I love the wealth of knowledge that I have access to.  And I love the satisfaction of a good client/patient outcome. While a good patient outcome 100% of the time would be fantastic, it is not realistic.  Through all the highs and lows of horse ownership, the one thing that we can provide as a constant is excellent customer service.

Here is an example of where I was let down by less than stellar customer service. I had put my money in a bank that had wooed me with a points system and a slew benefits for switching to their services.  On paper it was a great deal, and the employees were all pleasant to deal with.

Then I was faced with the items I did not read in the fine print.  To benefit from the points system, the bank account HAD to be applied for online.  So, I applied online; however, a whole new bank account was created for me.  Now I had 2 bank accounts that served the exact same purpose – and would have to pay the same monthly fee.  I closed the initial account, only to have complications with the automatic payments.  While the request had been made in the system, the process was never completed, which resulted in some missed payments.  The bank was more than happy to charge me some administrative fees, for their error.  After resorting to (what I like to call) “Squeaky Wheel Syndrome”, the issue was sorted out: after 5 weeks, and one more series of missed payments.

I was the one who had to follow up, and I wasn’t very happy about it.

All that this bank had to do to make this a great client experience was:  Take the time to resolve the issue correctly, while keeping me updated.

Simple right?

It seems that the societal norm for customer service is excessive hold times, multiple transfers, speaking to a robot and falling short on expectations set.  I’m not the only one with a story similar to the one above.

Armed with personal experiences, the Customer Service Representatives at McKee-Pownall are given the opportunity to put themselves in the client’s shoes.  The guidelines are easy – Don’t surprise, don’t confuse and keep the communication open. Our mandate is to be the advocate for the client. We know how stressful a visit from the vet can be so we try to make the experience a positive one.

McKee-Pownall Equine Services believe that excellent support staff is a key element to the overall experience a client has with us. By working together, letting people do what they are good at, the vets, techs and CSRs are able to provide the type of service and veterinary care that we would want to experience as clients. A bonus to us is that we enjoy where we work and the people we work with.

The next time you are contacting the office, feel free to drop a line on things you like or wish we did.  We are always open to suggestions and believe that there is always room for improvement.

Laura Holmes ~ Office Manager

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Finding Nutritional Value!

This past year, McKee-Pownall has started doing nutrition consultations for patients with specific medical or performance issues.  We’ve found it to be very helpful to provide some medical guidance for our clients and patients, and rewarding to work together with their current feed supplier to find good solutions for their horses.  The great thing about nutrition consults is that they are always different and provide an interesting challenge to find a solution to help both the horse and the owner.  I have also really enjoyed working with the people in our practice who share a love of nutrition; Dr. Tovah Caldwell and our RVT, Stacey Thompson.  Together, we’ve worked on some diverse issues and made a meaningful difference in our patients’ lives.  Some of the cases our team have worked on:MWP_020910-47

  • Polysaccharide Storage Myopathy (PSSM)
  • Laminitis
  • Low energy
  • Stall rest and the high strung horse
  • Gastric ulcers
  • Tying up
  • Weight reduction/weight gain

I like to focus on cases with a medical issue, so that we can combine what we know about the case, as well as the horse and owner’s particular situation and put this together to make a personalized plan.  It is amazing what a difference good nutrition can make in a medical issue.  Food really can be amazing medicine!  It really makes me happy to reduce pain or put weight on a horse without using a bundle of medications, or to be able to cut back on meds he needed several months ago.  We know this to be true in human nutrition (it’s pretty unlikely that you’ll get six pack abs if you’re eating McDonald’s and ice cream, or even a bunch of pre-processed foods) and it is no less true in horses.  The wonderful thing about horse nutrition is that we can see quick results because horses can’t cheat and sneak an extra helping or a chocolate bar on the sly.  They eat what we supply them!  The interesting thing has also been a paradigm shift, as I look at the horse in a holistic sense.  This approach sits well with me, as I have looked at horses in a big picture way since taking the acupuncture course.  Chinese medicine uses food as medicine as well, and it’s kind of neat to see how Chinese food beliefs actually match up nicely with what we know from science about nutrition today!  As Thanksgiving draws near, here’s to happy eating for all of our horses and humans.  I know I’m going to enjoy some of the medicinal effects of pumpkin pie (pumpkin has great fibre content after all.)

Melanie Barham DVM

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Challenges of Supplying Medications

With the advent of online pharmacies in the US, as veterinarians, we are often asked why we don’t carry a certain product, or why prices are sometimes higher in Canada than what is advertised on a US online pharmacy. The simple answer is that Canada and the US do not share drug approval systems; so what is available and approved in the US may not be approved for use in Canada and vice versa. Also the product manufacturers often have separate Canadian and US divisions or suppliers. Believe it or not we share these same frustrations and often ask our suppliers these same questions. It drives us crazy that US veterinarians can purchase some products so much cheaper than we can as their counterparts. Unfortunately, the higher price for us means a higher price for clients.

 A case in point is Adequan: Even though the same product is sold in both Canada and the US, there are many differences. 

US

Canada

10 dose bottle

 

7 dose box

7 dose box

Luitpold is the manufacturer and supplier

Novartis sells in Canada

The selling price to vets is much less expensive in the US than in Canada. In the past we had seen some online pharmacies selling it at a retail price less expensive than we can get it from our suppliers! Fortunately for the past 2 years Novartis, the company we deal with in Canada, has tried to combat cross border shopping of the product and has lowered their prices. We are able to buy in large volumes thereby reducing our costs even further, which we are happy to be able to pass on to our clients. We now sell the 7 dose box the same price at the equivalent product shipped from the US, taking into consideration the cost of shipping the product to Canada.

There is another advantage of buying veterinary medications from a veterinarian and that is that we can advise you on the best medication for a condition and proper dosing levels. For example, recent research from the makers of Adequan has identified that instead of giving a 7 dose starter series followed by monthly injections one can give a horse the initial 7 dose starter series and then repeat that series in 6 months. There is no need for a monthly or biweekly “maintenance” injections. Instead of giving 18 injections a year (7 doses plus once a month) you only need to give 14 shots total per year ( two 7 dose series).

There is a shortage of Adequan in the US that is expected to last until the end of the summer. We have a large inventory of the product that we have available for our clients. Due to our limited supply we must limit purchases to one box per client. If you have any other questions on why some medications cost more in Canada than in the USA please let us know.

Mike Pownall DVM

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Head it Off at the Pass- Preventative Preparations for Show Season

As we prepare for show season, most riders think of extra lessons, fitting up their eventers with conditioning programs and trailering in to school at different arenas and venues and buying new accessories and gear. As a vet, my perspective is a little different, as I think of the ramped up work load as an extra stress/strain on joints and muscles, vaccination, deworming, nutrition and dental floating. Just as people are getting geared up for bikini season with extra training sessions and if we’re lucky, a new wardrobe, so are our horsey companions. However, they aren’t getting prepped to lay on a sandy beach with a cold beer, they’re getting ready to work harder in the summer heat!

As I found when training for a half marathon, in a new training program, your muscles are sometimes sore and problems you never knew you had come to light. Before you know it, you’re finding it difficult to train/compete due to an injury! Before my first ½ marathon, I developed very painful shin splints, and found out I needed orthotics and needed to retrain myself to run in a more ergonomic way, as well as perform exercises on an ongoing basis to strengthen my muscles to avoid further injury. If I had taken the principles I apply to my patients, I could have avoided the agony of sore shins and had a much more comfortable race. A mid-training dynamic exam with a physiotherapist/ sports medicine doc would have revealed these problems and helped me solve them sooner!

Typically, I encourage as many of my patients as I can to take advantage of a pre-season checkup, which includes a physical exam and a dynamic musculoskeletal exam. I consider myself one part of the horse’s health care team, and I hope to be one of the voices to let the rest of the team know what is going on. I could obviously tell my doctor that my shins were killing me. Horses have all different ways to let us know; whether through actual limping, mild tenderness on palpation, a change in attitude etc. It’s best if the horse has been in at least moderate work prior to the examination so that we can gain the most information. Listening to the heart, lungs, GI tract and looking in the eyes are just part of the physical exam. I have often identified new heart murmurs (potentially dangerous when jumping obstacles!), or cataracts or other ocular abnormalities that would otherwise be unknown, even on horses who have been normal in previous years. Additionally, it allows us a chance to take a dedicated look at the horse in a holistic sense. Is there weight gain/loss? Muscle loss, or uneven development? Is his coat all of a sudden dull and burnt out?

The palpation and dynamic aspects of the exam is an important annual aspect as well, allowing me to monitor ongoing problems and identify new ones prior to investing in expensive show fees. Conformation issues, shoeing changes, or new lumps and bumps and areas of referred pain give me clues to changes or areas of soreness in the body. Sometimes we’ll find some lower back pain prior to true hock pain, or a small splint that has been causing a left drift. The dynamic aspect of the exam is usually performed on the lunge line to start, and involves a thorough look at how the horse behaves in motion. A new way of moving a limb, out of character behavior, or new musculature issues can all be clues to a small underlying soreness. We may perform an under saddle portion, or surcingle exam. Flexions are a part of the exam allowing us to stress a particular joint and see if there is any change to movement. When I look at horses annually, I get to know them pretty well. Sometimes I forget a horse’s face marking, but I can often recall their legs and way of traveling for years! Of course good record keeping is also key!

A common misconception many clients have is that pre-season checkups always end with the recommendation to inject specific joints and a huge bill. Sometimes this is elected, but I tailor my approach to the level of competition of the horse, age, issues we know to be at hand, and what is best for the horse. Understanding your goals for the season helps me make better recommendations. For example, if you were hoping to jump FEI in 3 weeks’ time, leaping over 1.50m fences and continuing with an aggressive schedule for the season with your campaigner with some extra arthritis baggage, I’m going to recommend something different than a young clean horse in his second year of A level or Trillium level competing! Often I will make shoeing recommendations together with the farrier, provide exercises to strengthen an area, recommend a nutrition change, or recommend preventative care such as Adequan, acupuncture or chiropractic to maintain a specific problem. The rider is usually more aware of specific deficits their horse has, so they can work on them with their coach too. All in all, a pre-season examination usually yields good preventative results for most horse rider teams, it allows us to get a handle on how the horse is doing going into the season, and have some idea of what bumps there might be in the road ahead.

Melanie Barham DVM

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