AAEP tackles tough issues in the Big Easy

A record breaking number of equine veterinarians, technicians, guests, and students from across the country and around the world—20 percent more than last year—gathered in New Orleans, Nov. 22-25, for the 49th Annual Convention of the American Association of Equine Practitioners.

Though the outstanding Cajun and Creole food and jazz music of the French Quarter were undoubtedly big draws for the 6,175 total attendees, including exhibitors, event organizers said improved continuing education offerings have helped the convention grow. About 3,100 veterinarians, veterinary technicians, and students attended.

More than 100 continuing education credits were offered on wide range of topics ranging from laminitis treatments to neurology. Many of the sessions focused on the equine foot, and practice management. An entire morning was devoted to sessions on equine reproduction, including a new feature, the Reproduction News Hour—a spin-off of the popular Kester News Hour. Drs. Terry Blanchard and Claire Card presented the Reproduction News Hour, which provided brief updates on the latest news in equine reproduction.

Despite the "let the good times roll" atmosphere of New Orleans, the AAEP did not shy away from addressing controversial issues facing the profession.

The keynote speaker, William D. Brown, PhD, a clinical psychologist, gave a presentation on professional ethics, focusing on ethical dilemmas that equine practitioners face. Horse welfare issues, including slaughter and adoption of horses used in pregnant mare urine industry, were addressed during the Kester News Hour. Dr. Charlotte Lacroix gave a presentation on the risks practitioners face when using compounded drugs, and a panel of prominent equine practitioners and Dr. Brown discussed ethical decisions in equine practice.

Advice from an ethicist
In his keynote address, Dr. Brown, who worked with AAEP member Dr. Jim Morehead to learn more about the profession, talked about situations that equine practitioners commonly face:

• Requests from clients for unethical, illegal, or dangerous procedures
• Unethical or illegal behavior by colleagues
• Horse sales where one client wants to sell to another client
• Requests to euthanatize a healthy horse that has lost its economic value

Dr. Brown said that sometimes, the easiest answer to an ethical dilemma is often the wrong one. For instance, when a client who accounts for a quarter of the veterinary practice's income requests false documents a practitioner may feel torn between ethical and legal obligations as a veterinarian, and financial obligations to employees and family. It may be easier for the veterinarian to acquiesce to the request than risk endangering the practice. But Dr. Brown urged veterinarians to take a step back and ask themselves: "Is acquiescing to such a request worth it?"

He said that even if there is an instant payoff for an unethical decision, there are long-term consequences that veterinarians need to consider.

"Doing the right thing will improve the veterinarian's reputation in the long term," he said. "Surely, the veterinarian with integrity is the one clients will embrace."

Dr. Brown gave the attendees an "ethical yardstick," a list of questions they can ask themselves if faced with an ethical dilemma, including:

• Does your chosen course of action seem logical and reasonable?
• Does the solution you choose pass the test of sportsmanship?
• Where do you think your plan of action will lead?
• How well will you think of yourself when you look back at what you have done?
• How would (the person you most admire) respond to this problem?
• What difference would it make if everyone (including friends and family) knew about your decision?

He also discussed the dilemmas the AAEP is facing, including how to handle animal rights groups such as People for the Ethical Treatment of Animals, and whether the association should take a larger role in policing illegal or unethical activities among AAEP members.

Kester News Hour
Dr. John Madigan and Dr. Larry Bramlage also tackled controversial issues during the Kester News Hour, which provides brief updates on the latest news of the profession. The news hour was sponsored by an ongoing grant from the late Gen. Wayne O. Kester, a former president and executive director of the AAEP for more than a decade. Dr. Bramlage, who became the 2004th president of the AAEP at the close of the convention, talked about recent criticism of the AAEP's stance on horse slaughter by some horse organizations.

"The AAEP is getting hammered with some bad press," he said. "We're going to arm you with the facts, and then you can go home and talk intelligently about it whenever anyone asks you, 'how can you be for the slaughter of horses?'"

Dr. Bramlage said a controversial bill has been proposed that would ban the slaughter of horses for food in the United States. A congressional committee is reviewing the bill, which has spawned a heated debate in the horse industry. A Thoroughbred organization, Blue Horse Charities, is the main proponent of the bill and has attacked the AAEP for its stance on horse slaughter.

"We oppose the bill, but not because we like slaughter. We oppose it because we're pro-horse," Dr. Bramlage said. "That bill has some big holes in it, and some huge flaws."

He said the slaughter bill contains provisions for the confiscation of horses destined for slaughter, but no funding or provisions for their long-term care. Dr. Bramlage estimates that if the ban were passed, on the basis of 2002 data there would be 85,000 new unwanted horses a year in need of long-term care. In addition, the Bureau of Land Management is currently caring for 28,000 wild horses and burros awaiting adoption.

Dr. Bramlage also noted that if the ban goes into effect, horses might be shipped out of the country to slaughterhouses that are obviously not regulated and inspected by the Department of Agriculture. In the two equine slaughterhouses in the United States, horses are euthanatized with a captive bolt gun, an AVMA-approved method of euthanasia and one Dr. Bramlage described as instantaneous. The AAEP officers have visited slaughter facilities to evaluate the euthanasia methods and ensure humane aspects. Additionally, AAEP-backed legislation regulating the care of horses being transported to these facilities came into effect in February 2002.

In a survey two years ago, 88 percent of AAEP members indicated they would prefer that slaughter be preserved as an option for horse owners, Dr. Bramlage said.

"Again, that doesn't necessarily mean we're pro-slaughter," he said. "We prefer to put them in adoption facilities, give them another job—there are a lot of alternate careers for something like an ex-racehorse, but the alternative careers for an ex-packhorse are pretty limited."

In fact, he said, many equine practices, including Rood and Riddle, where Dr. Bramlage works, support equine adoption facilities by providing free care, or care for just the cost of medications.

"The (Blue Horse Charities) argument is that there is no concern (among equine practitioners) about the accumulation of unwanted horses," he said. "It is our feeling that there is concern (among equine practitioners) that (the passage of the slaughter ban) will lead to abuse. We need to find better ways to deal with those horses than to ban their humane euthanasia at slaughterhouses and have them everywhere, and let them starve to death or be ill-cared-for."

He encouraged equine practitioners to talk to their clients about the issue and explain it.

"You won't win it in a public debate," he said. "You have to win it one-on-one and educate people individually."

Dr. Madigan addressed the reduction of horses in the pregnant mare urine industry. There has been debate about the well-being of horses used in the pregnant mare urine industry for several years. Premarin, a hormone replacement drug for women, is produced, in part, from the urine of pregnant mares. Some horse welfare advocates have argued that the mares on ranches where the urine is collected are subjected to inhumane treatment and that too many of the foals produced by the mares are sent to slaughter. Officials from the AAEP and the AVMA have toured the ranches and concluded that the horses were treated humanely.

The latest controversy surrounding the industry began in October, when Wyeth-Ayerst Global Pharmaceuticals, the company that produces the drug, decided to reduce the number of ranches collecting mare urine from 409 to 264. This was done to adjust to lower demand for the drug, according to the North American Equine Ranching Information Council, an organization that represents the ranchers.

According to Dr. Madigan, fears about the safety of hormone replacement therapy have reduced the demand for Premarin. As a result of the reduction in production, 10,000 to 13,000 horses from these ranches will be sold over the next year, according to the NAERIC. Horse welfare groups are concerned that thousands of the horses will be sold to slaughterhouses.

Wyeth has established an equine placement trust fund to help defray the costs associated with veterinary inspections, transportation, and placement of mares in suitable homes, Dr. Madigan said. He said about 7,500 pregnant mares are currently available for adoption.

"Maybe we should tip our hat to Wyeth for being responsible citizens and getting these horses adopted," Dr. Bramlage said.

Some equine welfare groups have urged Wyeth to establish permanent retirement facilities for all the unwanted horses.

The continuing spread of the West Nile virus was another hot topic discussed during the news hour.

Dr. Madigan said new findings about the epidemiology of the disease suggest that it will be difficult to predict its future spread. He said officials had predicted a reduction in cases on the East Coast as previously exposed animals developed immunity; however, the cases have continued to increase, with 1,050 West Nile virus infections in equines the mid-Atlantic in 2003, up from 201 infections the previous year.

Researchers have learned more about the role of birds as a vector of the virus.

"Some species of birds can develop a very high viremia. This is a very key point to understanding the epidemiology," he said. "For every one West Nile virus infection of a mosquito by a Canada goose, there were three infected by mallards, and more than 11,000 infected by house sparrows."

The disease can also pass from bird to bird without mosquitoes, he said.

Fortunately, Dr. Madigan said, research has shown the currently available West Nile virus vaccine has helped to protect horses.

Milne lecture focuses on equine stomach
Dr. Alfred M. Merritt, the Appleton Endowed Professor in Equine Studies at the University of Florida, received the Frank J. Milne award for his contributions to the understanding of the equine stomach, and presented the Frank J. Milne State-of-the-Art Lecture. The lecture is named after the late Dr. Frank J. Milne, an AAEP past president.

The first half of Dr. Merritt's lecture focused on the physiology of the equine stomach. In the second half of the presentation, he discussed treatments for equine stomach problems. Dr. Merritt focused on equine gastric ulcer syndrome and the role that intense exercise and stress may play in causing the disease. He concluded by saying that given recent research on the connection between intense training and stress and disease, equine practitioners need to change horse management, feeding, and housing practices to reduce stress.