Fall 2019 Newsletter

AmericAn AssociAtion of VeterinAry techniciAns & AssistAnts

AAEVT

We Believe Our Profession Is A Cause Worth Advancing | www.AAEVT.org

Message From Our PresidentWith the end of 2019 approaching I’ll soon be making my exit as President of AAEVT. With that I’d like to send a little note!

I’ve never been more proud, or more humble, to be a part of and lead such an amazing organization. It has shown me what change and hard work are all about! The support and professional development that I have found with AAEVT will go unmatched!

We as Equine veterinary technicians and assistants form a very bright and unique community and in the face of an ever changing industry it is up to us to keep the foundation strong. Each and every one of us is vital to this profession!

As my time on the board passes my commitment to AAEVT’s members, this profession, and the horse of course, will remain unchanged. I hope to always be able to do for others what others have done for me!

In closing, let’s continue to strive for the better and keep the bar high!

Cheers,

Lindsey Schoelen, LVMT2019 AAEVT President

AAEVT Regional Contacts:US West: AK, AZ, CA, CO, HI, ID, MT, NV, OR, UT, WA, WY

Meg Schenk Jenna Farley (303) 668-2936 (415) 505-5731 rckymtnhighmjs@gmail.com jfarley@sdequine.com

Nicole LaGrange Lexie Conrow (760) 672-9498 (775) 790-1150 Nicolelagrange@gmail.com lexieconrow@me.com US East: AL, CT, DE, FL, GA, KY, MA, MD, ME, MS, NC, NH, NJ, NY, OH, PA, RI, SC, TN, VA, VT, WV

Jacqueline Camacho Jlynn Flint (909) 967-0113 (607) 742-1331 jacamacho1120@gmail.com jlynn.flint@gmail.com

Kristy Matarazzo Jaime Newbill-Hicks (908) 268-5237 (804) 690-0389 kmatarazzo@hotmail.com jaimelvt84@gmail.com

Kirsten Pace Sandy Leslie(845) 399-1681 (203) 377-6171 pacenme@yahoo.com sleslie@grandprixequine.com

Katherine McIntyre Tina McPheeters (518) 429-9359 (217) 620-9171 katemcintyre26@gmail.com mcpheeters2@yahoo.com

Rachel Stegall Amanda Compton, LVT(731) 796-0716 (304) 582-5885racesteg@ut.utm.edu mndcmptn@gmail.com US Central: AR, IA, IL, IN, KS, LA, MI, MN, MO, ND, NE, NM, OK, SD, TX, WI

Rexann Morrison Karen Chapman 817-694-1711 (979) 255-1252 Rexannmorrison1@gmail.com kchapman@cvm.tamu.edu Canada/International: Katie Soobrian (604) 803-8787 ksoobrian@yahoo.com

Executive Director: Deborah B. Reeder B.A., RVT, VTS-EVNDBReeder@gmail.comCell:214-505-1548 Fax:760-301-0349544 Saddleridge Dr Wimberley, TX 78676

President:Nicole Bone, LVTBoneaaevt@gmail.comCell: (517) 282-3708Rood & Riddle EquineLexington, KY

President - Elect:Elyse Rowleyelyse@rivieraequine.comPhone: (805)6101899Riviera EquineSanta Ynez, CA

Vice President/ Member at Large:Andrea Whittle, LVTawhittlelvt@gmail.comPhone: (859)509-2747Rood and Riddle Equine HospitalLexington, KY

Treasurer & Membership Assistant:Katie Soobrian, RVT, BAksoobrian@yahoo.comCell: (604) 803-8787DVM Access Inc.Bellingham, WA

Secretary:Kimmie Burton, LVTKimmie@desertpinesequine.comPhone: (516)476-2794Desert Pines Equine CenterLas Vegas, NV

Immediate Past President:Lindsey Schoelen, LVMTlschoelen@tnequinehospital.comCell: (615) 591-1232Tennessee Equine HospitalThompsons Station, TN

Assistant Executive Director:Wiss CostanzaWisscaaevt@gmail.comMobile: (603)631-4301Lancaster, NH

Regional Director:Jacqueline Camachojacamacho1120@gmail.comPhone: (909)967-0113Rood & Riddle Saratoga

2020 AAEVT Executive Board:

Spring Regional Education EventMarch 6-8, 2020 • Alamo Pintado Equine Hospital . Los Olivos, CA

AAEVT AAEP Annual ConventionDecember 5-9, 2020 • Las Vegas, NV

NEAEP AAEVT CE EventSeptember 26, 2020 • Rood and Riddle Saratoga Springs, NY

Anesthesia Society CE Events/Practice Management/ Receptionist/ Office Staff Training DayDates and Locations TBA. Visit: www.AAEVT.org/ce-events

2020 CE EvEnts:

From the time I was a junior high schooler, I knew I wanted to be a veterinarian. My interest in horses began in my late teens when I started volunteering in a large animal ambulatory practice. As my familiarity with horses increased, I came to appreciate them for the athletes they are. That’s why navicular has been such a frustrating dis-ease throughout my career.

During my 35 years in practice, there haven’t been a lot of medical options for managing navicular. In the past, a diagnosis of navicular disease in middle-aged performance or sport-horses was usually career-ending. Not only would the horses no longer get to do the job they loved, but also the owners would lose the joy of competing with horses they were invested in financially and emotionally.

Even with the bleak outlook, I did my best to manage na-vicular, typically by implementing a regimen of a vascular-effect drug like Isoxsuprine or aspirin. I’d also prescribe therapeutic shoeing and look for ways to manage footing by recommending the horse try different exercises on different ground. If horses didn’t respond, sometimes I’d inject a corticosteroid in the coffin joint or navicular bursa. If the pain was still uncontrollable, I might perform a neurectomy.

That was then.

Now with the introduction of bisphosphonates – my treatment of choice is Osphos® (clodronate injection) – the prognosis for 60 to 70 percent of my navicular patients

has improved significantly. Every day in practice I see a diverse population of equine athletes, everything from Saddlebreds to racehorses to English hunter jumpers to Western performance horses. And every day I see a case of navicular in at least one of them.

Protocol for prescriptionI start working up a lameness case the same way I always did: by putting my hands on the horse, asking the owner a lot of questions and getting a good history. Here’s a little more detail about the typical clinical scenario when I pre-scribe a bisphosphonate for navicular:

• Consider breed and discipline. Genetics and conforma-tion predispose horses to navicular, as does a horse’s discipline. Western performance horses, especially Quarter Horses, experience higher incidents of navicu-lar, but I see the disease in other event horses as well.

• Confirm foot pain. Like I said, I start with the basics of a complete examination and history. • Block and image. I do a nerve block and most of the time take digital radiographs.

• Recommend advanced imaging. Because dramatic radiographic changes aren’t always present, an MRI or CT can help differentiate any soft tissue injuries that might be in the heel region. Not all clients are econom-ically able to opt for additional imaging. In those cases,

Bisphosphonate: Next-level navicular treatmentImplementing a bisphosphonate treatment protocol has elevated my practice, our client relationshipsand, most important, the prognosis for our navicular patientsBy Steve Colburn, D.V.M.

continued on next page

I rely on the history and radiographs.

• Diagnose and prescribe. If the horse shows some evidence of mild to moderate changes in the navicular bone and presents with an appropriate history, I pre-scribe and administer Osphos according to the product label.

• Monitor clinical response. After injecting Osphos, I recommend clients give the horse some light work and watch the response over the next six to eight weeks. If there’s no positive response or if the horse worsens, I look at a change in course.

Before administering treatment on any horse with any product, I discuss the potential benefits and challenges with clients. With Osphos specifically, I share the informa-tion below and ask clients to strictly follow the steps:

• Pause nsAID use. Bisphosphonates can affect the kidneys, especially if used with nonsteroidal anti-inflammatory drugs (NSAIDs). I advise my clients to stop giving NSAIDs four to five days before we inject Osphos and to keep the horse off NSAIDs for up to two weeks afterward.

• Hand walk the horse for 15 minutes immediately fol-lowing injection. This helps minimize the sensitivity horses may experience.

• Observe the reaction. We watch the horse to make sure it’s not experiencing any side effects beyond some potential transient stinging. I’ve administered thou-sands of doses of Osphos, and I’ve never seen a horse develop a serious case of colic or experience any level of renal failure.

• Call me in six months. My practice sends a six-month reminder after an Osphos treatment, and about 70 to 80 percent of clients respond. When we talk, we openly discuss how the horse is doing. This conversa-tion lets me know when clients are pleased with the re-sults, and sometimes we decide to administer a follow-up dose. Once in a while, a client will say the product hasn’t made much difference in the horse. I welcome this discussion too, because it tells me we may need to look further into a soft tissue issue, for example.

Why bisphosphonates?I didn’t buy into Osphos immediately after it was launched five years ago. I’m a creature of habit who leans toward pessimism about new products. I don’t want to be the first – or last – to jump on board. I like a product to be on the market for a while so I can monitor the incidence of side effects and negative responses.

I tried Osphos in just a few cases at first, measuring my patients’ results as well as results in the overall market. As my confidence in the safety and efficacy improved, my use of Osphos grew exponentially. I like that it is a trusted, FDA-approved tool backed by science rather than hearsay. Osphos has dramatically improved navicular prognoses in my patients, and I consider it to be one of the most signifi-cant advancements in equine sports medicine.

Problem-solving with clients around issues like navicular is what drives me. I thoroughly enjoy working as a team with clients to get their horses performing to potential. Through tending to a horse’s needs year after year, I de-velop a relationship with the horse and its owners. These personal relationships are important to me. Finally having a tool to treat navicular is a relief for me and my clients, and it makes my relationship with clients even stronger.

Brief summary:As with all drugs, side effects may occur. In field studies and post-approval experience the most common side ef-fects reported were signs of discomfort, nervousness, and colic. Other signs reported were: renal insufficiency/failure, anorexia, lethargy, hypercalcemia, behavioral disorders, hyperkalemia, hyperactivity, recumbency, hyperthermia, injection site reactions, muscle tremor, urticaria, hyper-glycemia, and fracture. In some cases, death has been reported as an outcome of these adverse events. The safe use of OSPHOS has not been evaluated in horses less than 4 years of age or breeding horses. OSPHOS should not be used in pregnant or lactating mares, or mares intended for breeding. NSAIDs should not be used concurrently with OSPHOS. Concurrent use of NSAIDs with OSPHOS may increase the risk of renal toxicity and acute renal failure. Use of OSPHOS in patients with conditions affecting renal function or mineral or electrolyte homeostasis is not recommended. Refer to the prescribing information for complete details or visit www.dechra-us.com.

Bisphosphonate: Next-level navicular treatmentcontinued

About the authorDr. Steve Colburn is owner and founder of Creekside Veterinary Service, a four-doctor practice in Escondido, Calif. Dr. Col-burn graduated from the University of California, Davis School of Veterinary Medicine in 1984. His wide range of experience in equine practice includes working with racehorses, broodmares and stallions, gaited show horses, western show horses, rodeo performance horses, dressage and jumping horses, and backyard pleasure horses. Dr. Colburn has a special interest in maintain-ing horses’ peak performance, and his team of associate veterinarians employs their respective expertise in managing orthope-dic, dental and reproductive problems. Dr. Colburn prides himself on offering the latest technologies in a comprehensive, caring and cost-effective manner. He and the team at Creekside Veterinary Service avidly support equestrian riding and advocacy groups in their local community.

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