Back in the saddle again

AAEP draws record crowd in Vegas
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The bright lights of Las Vegas proved a reliable draw for the 2009 American Association of Equine Practitioners 55th Annual Convention, Dec. 5-9. A record 7,611 attendees came to the continuing-education event, which broke the previous record of 6,842 set during the 2007 convention in Orlando, Fla. Of that total, 3,788 were veterinarians, veterinary technicians, and veterinary students.

Drs. Macpherson, Palmer, and Rush
Drs. Margo L. Macpherson, Scott E. Palmer, and Bonnie R. Rush give the past year's highlights in equine medicine during the Kester News Hour.

AAEP outgoing President Harry G. Werner acknowledged the likely negative impact the economy has had on most equine practitioners in the past year, saying it has presented more challenges than many have seen in their entire careers.

"It's hard to keep perspective, but knowledge is power," Dr. Werner said. "The pursuit of professional development is the most important thing you can to do to strengthen your practice and gain confidence for the future and revitalize your mind."

AAEP incoming President Nathaniel A. White II noted the 2009 convention program included a new series of in-depth specialty lectures on equine behavior, parasite control, and evidence-based medicine. More sessions, too, were devoted to business topics, including how to improve efficiency and profitability in practice.

This past year the AAEP saw no change in its overall membership figures after years of steady growth. One area that did see an increase, however, was new student memberships, which jumped by 37 percentage points from the preceding year.

The AAEP also enacted its first dues increases in six years. The rate for active members grew by $40, from $255 to $295.

Enjoy the ride

Keynote speaker Steve Gilliland kept the mood light in his talk, which outlined a road map for success. The North Carolina-based presenter focused on encouraging everyone to "enjoy the ride" of life.

"It's not how you start. It's not how you finish. It's how you do your journey," he said. "When you begin to enjoy the ride, it makes the trip more enjoyable."

Gilliland gave a few tips on how to achieve this mindset.

First, he asked the audience members to check their passion. By that, he meant people should love what they do, know why they do it, and enjoy who they do it with.

Those who aren't sure whether they have that passion, he said, should ask themselves, "If every job paid the same, would I wake up tomorrow doing what I'm doing?"

The second tip Gilliland gave was to cure "destination disease." People often focus on the next thing or what's coming, he said. They don't remember that there is no guarantee when a person will die. He encouraged everyone to savor each moment so they don't look back with regret.

Gilliland's final point was advising the audience to refocus their attention. To do that, he said, they should decide what is important and never take it for granted.

"There's no such thing as time management," Gilliland told the crowd. "You can only manage the activities that will rob it or give it. … Examine all the distractions and you'll realize you don't enjoy the ride because you're so distracted."

Keeping informed

For the third consecutive year, Drs. Margo L. Macpherson, Bonnie R. Rush, and Scott E. Palmer talked about the past year's biggest news, including topics such as drug compounding, synthetic racetrack surfaces, and equine pregnancy, during the Kester News Hour.

Dr. Rush began by reviewing recent developments concerning the drug pergolide mesylate. In March 2007, the Food and Drug Administration withdrew pergolide from the market because of adverse reactions seen in human patients.

She said this has been a big problem for equine veterinarians because pergolide was the only treatment for pituitary ailments. Knowing this, the FDA allowed the drug to be compounded from bulk product, which is an important deviation from the guidelines, Dr. Rush said.

Over time, however, practitioners noticed that some horses being treated with pergolide were relapsing. A study in the Feb. 1, 2009, issue of JAVMA, "Effects of compounding and storage conditions on stability of pergolide mesylate," found that the compounded form of the drug can become unstable and potentially ineffective under certain storage conditions.

Dr. Rush reminded veterinarians that they should familiarize themselves with the guidelines implementing the Animal Medicinal Drug Use Clarification Act.

"These regulations are not permission to compound from a bulk drug," Dr. Rush said. "And neither cost nor convenience is justification. The veterinarian assumes all liability when using compounded prescriptions."

Dr. Macpherson was in Florida when 21 polo ponies died from a selenium overdose caused by a medication mistake this past April (see JAVMA, June 15, 2009) and was able to talk to key stakeholders. She said there were lots of factors that played into the deaths and advised equine practitioners to write clear and legible prescriptions. She said pharmacies have the onus to become certified to ensure deliverance of a good product.

Dr. Rush devoted some time to discussing a noteworthy study in the July 1, 2009, issue of JAVMA on the effects of furosemide on exercise-induced pulmonary hemorrhage in Thoroughbred racehorses. The results indicated that prerace administration of furosemide decreased the incidence and severity of EIPH in horses.

"This is a question we've had for 30 years," Dr. Rush said.

Giving context to the importance of the study, she quoted statistics suggesting that 90 percent of horses have some degree of EIPH and that the industry cost of EIPH approaches $100 million.

Dr. Macpherson discussed a study that examined the impact exercise and high temperatures have on reproductive function in mares, particularly as these factors relate to body temperatures.

"Embryo recovery from exercised mares," published in February 2009 in Animal Reproduction Science, evaluated the effect of exercise on mare reproductive efficiency by comparing rates of embryo recovery from mares assigned to either an exercise regimen or a nonexercise control regimen.

Results indicated horses that exercised had fewer embryos recovered, displayed a reduction in embryo grade, and experienced an increased time to their next ovulation.

In another study that analyzed intrauterine temperature of mares under various management conditions, investigators showed that housing affected body temperature. In that study, horses housed in stalls with fans had lower body temperatures than did those housed outside.

Dr. Macpherson recommended better housing for mares that have problems breeding and suggested that athletic mares might need a rest from working during the time they are being bred.

Looking at horse racing, Dr. Palmer cited a study published November 2008 in the Journal of Experimental Biology that concludes sprinting speeds of Thoroughbred horses have reached their peak.

"Limits to running speed in dogs, horses and humans" analyzed records of the running performances recorded in U.S. Triple Crown races from 1896-2008.

Investigator Mark Denny noted in his findings that race speeds have not increased noticeably in the past 40 to 60 years. Denny asserts that plateaus were reached for the Kentucky Derby in 1949, the Preakness Stakes in 1971, and the Belmont Stakes in 1973.

The Journal of Clinical Microbiology published a paper this past March suggesting that virulent Rhodococcus equi infection is a contagious disease, as opposed to the long-held belief that it is an opportunistic infection of environmental origin.

Dr. Rush explained that R equi was thought to be naturally inhaled from sources such as manure; however, the study findings indicated that the concentration of R equi in exhaled air from naturally infected foals was five times the concentration in environmental samples. This indicates a chance for horse-to-horse transmission.

The equine piroplasmosis outbreak in the United States received much attention this past year. The epizootic, which affected hundreds of horses, began in Florida in the fall of 2008 with 20 cases, and it appeared transmission occurred through blood doping. Dr. Macpherson suggested that the initial outbreak was handled well. But this past June, seven cases appeared in Kansas and Missouri. Again, blood doping in a match race was found to be the cause.

Four months later, a 7-year-old mare in southern Texas was found to have the disease. At last count in early January, 357 cases had been confirmed in 12 states, with most confined to Texas. All cases have led back to an index premise in Kleberg County, Texas.

What distinguishes from the most recent incidents is that natural transmission has been suspected, instead of blood doping, Dr. Macpherson said. The tick population is suspected to be contaminated.

At the end of the news hour, the trio announced that this year would be the last for Dr. Rush on the panel. She was the program's first medical correspondent. Dr. Rush will be replaced by Dr. Stephen M. Reed of Rood & Riddle Equine Hospital, Lexington, Ky.