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Antibiotic Resistance

Antibiotic Resistance

Jun 24, 2019 | Antibiotic resistance

Tuesdays with Tony

If I have learned nothing else about horses over the years, it is that they love to injure themselves. Most of the time we have no idea how they do it, but it’s usually late at night on a weekend or holiday.  You will call one of the docs here at Springhill on emergency and they will come out and assess your horse. They will likely prescribe your horse antibiotics. Injury is not the only reason one of my docs will prescribe antibiotics for your horse, antibiotics have their time and place in the treatment of different ailments. I have heard over and over again my docs discuss different methods for administering antibiotics, but boy was I surprised when I overheard them talking about all the wrong ways antibiotics are administered and all the problems that incorrect administration can cause. 

 

Mistake Number One

One of the most common mistakes many horse owners make is not finishing the entire course of antibiotic that their horse is prescribed. Your horse is prescribed an antibiotic by a veterinarian and you give it very diligently for several days. Then you start noticing that he is improving, and you think, GREAT, the antibiotic is working and my precious baby is all better. Here is where the mistakes begin.  

 

It is extremely common for owners to see their horse improving and decide to discontinue antibiotics before they have finished the full course. DO NOT do this, listen to the professionals! The problem with not finishing a full course of antibiotics is, it sets your horse up for antibiotic resistance. Antibiotics are prescribed for a specific length of time. During this time the bugs are being killed, which is why  you usually see such an improvement so quickly.  

 

What happens when you stop antibiotics early is that some of the bugs have not died yet, but they have been exposed to the antibiotic. They start to reproduce again and the next thing you know your horse is showing signs of infection again. Bacteria bugs are super smart and stealthy, not quite cat-like, but pretty darn close. Once they are exposed to an antibiotic, they begin to recognize it. When you see the clinical signs return, you assume it is safe to start the antibiotic again. This time however, clinical signs do not improve.  You call one of my docs out and they recommend a culture and sensitivity which shows that the bugs are now resistant to the antibiotic that previously worked on your horse’s infection. 

 

By discontinuing antibiotics before the full course was administered, superbugs are formed, and now the superbugs are reproducing. The superbugs recognize the first antibiotic and laugh at it when it is restarted, as they have developed superpowers to prevent the antibiotics from killing them. Now we have a superbug that needs an even stronger antibiotic. Hopefully, this time, you have learned your lesson and give the entire course of prescribed medication. However, as I have come to notice, often it takes you humans more than once to learn your lessons. So, you repeat the above scenario with stronger antibiotics, and a super-superbug forms and a stronger antibiotic is required. It isn’t long before there are no antibiotics left that the bug is susceptible to, and now your horse has a resistant infection that cannot be treated. 

 

Mistake Number Two

Mistake number two may be even more common than mistake number one. Everyone knows that you have old antibiotic lying around in your feed/tack room somewhere. Even the vets here do, believe me, I have catscanned all of their farms when they weren’t looking. I can guarantee that most of you have been a part of mistake number one which means you definitely have leftover antibiotics floating around.  

 

As we have already determined, horses get hurt and sick at the most inopportune times. You notice your horse has an infection and think, well, I have some of that old antibiotic in the tack room, I’m sure that it would be totally fine to treat my horse with that. That, my friends, is where I get to take off my sweet, innocent, lovable kitty face and put on my stern, mad, disappointed kitty face and tell you you are wrong. Never, and I mean NEVER,  administer a previously prescribed antibiotic to your horse, even if it was prescribed for him. ALWAYS call me at the clinic first, and let me get you in touch with my docs so they can better assess the situation.  

 

They may very well tell you to use the antibiotic you have on hand, but unless you want antibiotic resistance as described in mistake number one, don’t just do it on your own! Trust me, you will make my docs very happy when you call them and have not given your horse antibiotics, which in turn will make me happy, and you know the saying, Happy Tony, Happy Life.  

 

Mistake Number Three

All too often I will hear the office staff talking to people on the phone. From what I have heard as I drift in and out of dream land, is that sometimes people call asking for antibiotics to treat their horse and yet my docs have never even seen the horse. Not only is this illegal for my docs to do, it is also very dangerous for your horse. If my docs prescribe your horse an antibiotic for an ailment that they have not been seen for, they are risking their veterinary license. Not to mention you are putting your horse at risk for developing antibiotic resistance. 

 

A common misconception is that all infections are treated the same. This could not be further from the truth.  Some bacteria thrive in an environment without oxygen, some thrive in an environment with oxygen, others have super strong cell walls that require stronger antibiotics, and others are more easily treated. Even further, some infections are a mixed bag of multiple different bacteria. The only way for one of my docs to have any idea of what kind of infection your horse has is for them to see your horse. And did you know that viruses NEVER require antibiotics? 

 

Let’s say you suspect your horse has a bacterial infection. He has a fever, he isn’t eating well, and he’s lethargic. So you call the clinic and ask for an antibiotic from one of my docs even though the horse hasn’t been seen for this problem.  If my docs were to prescribe your horse an antibiotic without seeing him, you could be giving your horse an antibiotic that is not necessary, thus leading to antibiotic resistance (are you sensing a theme here?) not to mention spending money on an antibiotic that your horse doesn’t need.  

 

In contrast, you might think your horse has a bacterial infection. You do the right thing and call me at the clinic to have one of my docs out, and they find your horse has a very high fever and that his infection is not actually bacterial, but viral. They recommend supportive care and the next thing you know, you and your horse are back riding again, and you have saved money by not paying for unneeded antibiotics.  

 

I know it’s only Tuesday and it’s summer time, so the heat is getting to us all, but antibiotic resistance is a big concern. Luckily, it is easily avoidable simply by making sure you have a veterinarian examine your horse prior to treatment, following your veterinarians orders, and calling me if you are having trouble with the prescribed treatment.  Remember, I LOVE phone calls, it makes me feel even more important than I already am. So, call me, tell me you can’t administer the antibiotics that were prescribed, or that your horse refuses to eat them. That is totally ok, my docs are basically miracle workers and will find you another way to treat your horse and avoid antibiotic resistance. The future of equine healthcare is depending on it.

 

Until next week,

~Tony

Springhill Equine Veterinary Clinic

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Trailer Shopping

Trailer Shopping

Jun 17, 2019 | Trailer Safety, trailering

Tuesdays with Tony

You may have noticed Dr. Vurgason and her horse Smokey galavanting around town in their new horse trailer. Now who do you think Dr. V asked for advice about which horse trailer to get? That’s right- the one and only Tony! After all, I spend most of my day every day watching various makes and models of horse trailer pull around this office building. I’ve seen the good, the bad, and the very ugly! As a result, I consider myself quite the expert.

As a vet clinic cat, you shouldn’t be surprised that the first thing I’m going to tell you to consider in a horse trailer is safety. Now I’m all for buying a used trailer—that’s definitely how you’re going to find the best deal—however, you do need to make sure it’s safe. Look at and ask about the floors. Pull up any mats and check the condition of the boards or metal underneath. You also want to check out the tires and see if they are ready to be replaced. If your tire were to go flat during a haul, it could cause a serious accident. In addition, be sure to look and feel inside every square inch of that trailer for sharp things—because we all know how good horses are at seeking those out!

I would strongly recommend having a used trailer professionally inspected before purchase. Heck even if you’re not buying a new trailer it’s not a bad idea to get your Old Faithful checked out about once a year. After all, you’re going to be hauling a live animal in that thing, not just a sofa or something! The pros will make sure all your welds are strong, your hinges aren’t too rusty, and your floors are in good condition. One more word on safety, then I’ll get off my cat box: you should never have any loose items in the trailer when you are hauling a horse. So if you are planning on hauling anything in addition to your horse (hay bales, tack trunks, jump poles, barrels, buckets, etc.) consider a trailer with a separate tack room or floor-to-ceiling dividers between stalls.

The next most important thing for us Floridians to consider in a horse trailer is air flow. There are several different options horse trailer manufacturers use to achieve some air movement inside those hot metal boxes. These range from sliding windows, to open slats (especially in stock trailers), to drop-down windows. The air flow inside a trailer can be further supplemented by front or ceiling air vents, built-in fans, or even air conditioning! Now even the coolest, most open stock trailer is going to get pretty toasty if you pack enough horses in there. So, remember to consider your packing density and the climate when selecting a trailer.

Now as long as the trailer is safe and cool enough that your horse isn’t going to overheat, the rest just comes down to personal preference—of both you and your horse. I’ll tell you from my observations at the clinic, horses are a bit claustrophobic; they don’t like walking into small, narrow, dark spaces. So if you have a young horse or one who might not be the best at loading, you may want a trailer that opens completely in the back, and is very bright and inviting. There is much debate on whether horses prefer to load on a ramp or a step-up; my cat conclusion is that horses like what they are used to. With the right combination of patience, treats, and training, any horse will load on any trailer.

There are a couple more items to consider when selecting your dream trailer. Perhaps most importantly, how much can your vehicle tow? Remember that you need to add the weights of each horse plus the weight of the trailer, and that weight should be well below the maximum towing capacity for your vehicle. Almost all new trailers are aluminum, which is much lighter than the older models. However, some people report the aluminum trailers are less robust and less sturdy than their older counterparts.

Springhill Equine Veterinary Clinic

In general with horse trailers, the old saying ‘you get what you pay for’ is true. If one brand is less expensive than another, it is probably more cheaply made, and thus may not hold up as well or last as long as a more expensive trailer of a more reputable brand. Also keep in mind if you are ever planning on selling your trailer that the more expensive big-name brand trailers tend to hold their value better.

Hopefully I’ve given you some things to consider before your next major trailer purchase. Now all you need is another horse to haul in it, right?

Don’t forget to come out to my annual Piggy Ice Cream Social this Saturday from 10:00-noon. Whether you own a pet pig or not, believe me you don’t want to miss this entertaining event!

Until next week,

~Tony

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Sand Colic

Sand Colic

Jun 10, 2019 | Colic, Sand colic

Tuesdays with Tony

Ahh, Florida. The rest of the world is sure it’s all sun, surf, and sand. They’ve got 2 out 3 right, and according to Meatloaf that ain’t bad. Where am I going with this? To the sand. For reasons I don’t understand, horses feel it’s appropriate to eat sand. This can, obviously, lead to problems. This week, we’re going to talk about those problems. More importantly, we’re going to talk about how to be smarter than your horse so that you can avoid these problems. I have faith you humans can do it. I’m not asking you to be smarter than a cat. That would be impossible.

 

How do I know they have sand?

 

Many of you have likely heard of the Ziploc bag test. I’m sure this is a use Ziploc did not envision for their handy plastic bags. This test involves grabbing a few fecal balls from a fresh, clean pile, adding water, sealing the bag (very, very important step), and shaking. Let the bag sit for a few minutes, and see if there’s sand in the bottom. There will be sand. After all, we do live in Florida. The question is how much sand is there? If there’s ¼ sand or less to ¾ poop in your sand-to-poop ratio, congratulations your horse is moving sand out of the gut. That word ‘moving’ is important. That’s the limitation of this test. It is moderately useful, but it only tells us that sand is moving out of the gut. You see, horses are sneaky. They also like to have a gut full of sand that’s just sitting there doing nothing! That sand won’t show up on the Ziploc test.

 

Behold! The awesomeness of x-rays and ultrasound! If my Docs have a sand suspicion, but no sand on the baggie test, they pull out the big guns. They will start with the ultrasound. My Docs will put an ultrasound probe right on the middle of the bottom of the abdomen. If there’s sand, they will see a colon with no ridges. Those ridges are what they call sacculations of the large colon. These sacculations are what allow the colon to expand with gas and food, then shrink down as it empties. Sand, however, fills all that up. Sometimes, it can be a little tough to decide on ultrasound thanks to gas. Ultrasound can’t see through gas, so if your horse has a lot of it, and horses often do have a lot of gas, the Docs will switch to x-ray. They shoot an x-ray through the bottom of the abdomen, and get an image that looks like this:

Getting Rid of Sand

 

Great, you’ve now identified that your horse has sand in the belly. How do you get rid of it? If there’s lots of it, my Docs will tube your horse with a combination of psyllium (basically Metamucil), Epsom salts, and mineral oil. The psyllium and Epsom salts work to grab the sand, pick it up, and move it out of the gi tract. The mineral oil works to protect the walls of the GI tract from all that abrasion as the sand moves. You can just imagine how abrasive that can be…..go ahead, imagine. Usually one treatment clears the sand, but sometimes it takes more than one. Rarely, my Docs have to bring one of these guys into the clinic for IV fluids along with the Epsom salts, and psyllium. I will say it is very impressive when they start passing sand. There’s nothing like sand, psyllium, Espom salt diarrhea to really make a mess out of stall!

Springhill Equine

Even better, keep sand out

 

“On ounce of prevention is better than a pound of cure” was never more true than sand and horses. The number one key is hay. Yep, hay, and lots of it. As far as horses are concerned, this is the key to preventing lots of things. For sand, hay acts like a vacuum. As all that roughage travels through the GI tract, it sucks up the sand, and sends it out the back end safely. If you’ve paid any attention to my blogs, or the awesome seminars my minions have, you know that the minimum amount of hay a horse should eat is 1-2% of their body weight daily. That’s 12-24 pounds for the average horse every day. Live on a sand hill? Stay closer to that 24 pound number!

 

Minimizing the amount of sand that goes in will also help. Feeding hay from slow feed hay nets, or off clean rubber mats can help reduce sand consumption. Keeping your fields from being overgrazed can also help. When horses are seeking out the small amounts of grass in an otherwise sandy field, they will eat way, way more sand. Bringing horses into a stall for grain meals can also reduce the amount of time they spend snuffling through sand to get that very last pellet they dropped. (Total shameless plug for our ‘How To Handle Your S#!t Seminar’ this Thursday at the Clinic, to help you keep those fields in good shape.)

 

With a little strategy, you can avoid those pesky unscheduled calls with my Docs for a sand colic. And I know how much you humans enjoy a good unscheduled visit. Think your horse might have sand? Call the Clinic to schedule an x-ray or ultrasound to see what’s inside!

 

Now be a good human and subscribe to my blog. That way you can get all my awesomeness a day before everyone else.

Until next week,

~ Tony

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Hurricane Prep

Hurricane Prep

Jun 3, 2019 | Disaster Preparedness, Hurricanes

Tuesdays with Tony

Yes I know I do this every year around June 1st, but it’s because you humans are very bad at listening. Hurricane season has officially begun. It’s time to play “Let’s get prepared for a disaster!” The Farm Version.

 

Dump Run

 

Hurricanes love to pick stuff up and throw it around. Look around the farm for those items. Make a burn pile for the stuff can get burned, and a dump pile for the stuff that can’t. Once in piles, actually remove them. Wait until we get some rain, but then burn that burn pile. No need to wait for anything for the dump run. Bonus: Dump runs can usually be counted on for some entertainment from other humans making dump runs as well. Most important: do something with the debris. Don’t let it sit around until the next Hurricane Michael is at Cedar Key. At that point everyone in your county will be at the dump trying to get rid of their debris. Be a smart human!

 

Identify your stuff

 

Microchip your horse. It’s easy. It’s cost effective. It’s permanent. Do it now.  Also works for your dogs and cats. I say it works for humans too, but some frown upon that.

 

Identify more than just your pets and relatives, though. Take a few minutes to shoot a video or take pictures of your truck and trailer, vehicles, tack room, and barn. Anything you think you would claim on insurance should be documented. Those phones you humans carry around to take pictures of yourself and your horse can be used for this, too. Upload it to that place called the cloud so it’s safe. A few moments now can save you a ton of hassles with insurance later.

 

Stockpile a few things

 

Think about what you will need if power is out. Take advantage of the Tax Holiday in Florida on some things. Common stuff you can stockpile now include batteries, flashlights, tarps, duct tape (can you ever have enough?), and gas cans. Horses drink a LOT of water. Think now about how you are going to provide that water. Plastic trash cans with lids work great! Large water troughs work well, too. Whatever you are going to use, now is the time to make sure you have it, and it doesn’t leak. If you are going to evacuate (more on that in a sec), be sure you have enough water and feed buckets for everyone.

Springhill Equine Veterinary Clinic

Should I stay or should I go?

 

There’s a different answer for everyone, but the important thing now is to make a plan. Even if you intend on staying, you should still make an evacuation plan. It’s just a good idea. The tricky part about evacuating with horses is the timing. You need to leave the area 4-5 days before the projected hit. Traffic is way too bad if you wait until the last minute. Now is the time to call places you may evacuate to and find out what they require. The Agriculture Inspection Station will often waive the Health Certificate requirement during evacuations. However, your destination will likely require a Coggins at a minimum, and may require certain vaccines as well. Check your Coggins now on ALL the horses you might evacuate. Getting them done as a routine appointment is so, so much easier than doing them as an emergency. Bonus: my Docs can microchip your horses at the same time! Easy peasey.

 

We all like to pretend hurricanes are no big deal, but this cat has been around long enough to know you humans don’t really believe that. Spend some time now getting ready, and then you can enjoy that hurricane party as you watch for Jim Cantore’s latest location.

 

All well trained humans will now scroll down to the subscribe button. Press the button, enter your email, and get my blog a day before everyone else. If that’s not motivation, I don’t know what is!

Until next week,

~Tony

P.S. Want more? Check out the podcast my docs do called Straight from the Horse Doctor’s Mouth. They just released an episode on Disaster Preparedness, and it’s chock full of good information.

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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Equine Asthma

Equine Asthma

May 27, 2019 | Equine Asthma, Heaves

Tuesdays with Tony

Wowza!! It has been a hot one this weekend. Hopefully you all made it through the long weekend. Who am I kidding? Of course you made it through the weekend, you had to in order to read my blog this week.  Luckily, my staff knew just what a scorcher it was going to be and left me and Teeny in the lovely air-conditioned office for the weekend. I spent my weekend getting caught up on my sleep and refreshing my memory about equine asthma.

 

Equine Asthma, COPD, Recurrent Airway Obstruction, Heaves, Inflammatory Airway Disease, which is it? Why can’t these humans pick a term and stick with it? Well, as I found out this weekend, there is a reason why it has so many different names. The current accepted term for equine airway disfunction is Equine Asthma. Subcategories of equine asthma include Inflammatory Airway Disease and Heaves/RAO. To break it down even further, Heaves/RAO can be divided into Pasture-associated and Barn-associated. So, how do we determine if your horse has Equine Asthma, and if they do, which form they have? That’s where my docs and I come in. I’m going to give you a brief overview of the different forms of Equine Asthma and if you have a concern about one of your horses, you’re going to call the clinic and schedule an appointment with one of my docs.

 

Inflammatory Airway Disease

 

IAD is a respiratory disease that typically affects younger horses. It is characterized by a lingering cough, poor performance, increased breathing efforts, and prolonged recovery after exercise. Some horses may have watery-to-white nasal discharge but will never develop a fever. What sets these horses apart from horses with Heaves is that they are normal at rest with no increased respiratory effort or rate. Their appetite and attitude remain unchanged at rest.

 

What do you do if you notice your horse showing any of these symptoms? First, you call my clinic and my docs will come out and perform a thorough physical examination. This may include a rebreathing exam where they place a bag over your horse’s nose and mouth. While your horse is staring at you like, “what the heck are they doing to me, mom?” my docs will be listening closely to your horse breathe. Once the bag is removed, they will continue to listen while monitoring how long it takes your horse to breathe normally again, as well as note any change in lung sounds or coughing. Depending on what is seen and heard on the physical exam, my docs may recommend you bring your horse to the clinic for further diagnostics.

 Springhill Equine Veterinary Clinic

When you bring your horse to the clinic there are a couple diagnostic tests we will perform. First, my docs will perform a Bronchoalveolar Lavage (BAL) where they will obtain samples from your horse’s airway to send to the lab and look for inflammatory cells. They will also perform an endoscope exam to the upper airway. A small camera is passed up your horse’s nose and into their trachea where they will look for excessive mucous buildup.  I sure hope my docs don’t ever try and stick anything up my nose. I can’t promise I won’t scratch anyone if they do!

 

Based on the diagnostic results, my docs will recommend certain treatments, including environmental changes. The goal of environmental changes is to reduce dust allergens. This can be accomplished by soaking hay and grain, and bedding horses on paper or wood shavings. Your horse should be out of the barn during cleaning and remain out for an hour after chores are complete. This will prevent them from breathing in excessive dust particles that may be floating about after cleaning is complete.

 

My docs may also recommend a course of systemic steroids to reduce inflammation in the airways. It has been shown that Omega-3 fatty acids help to reduce inflammation as well. I’m not convinced that horses will readily eat fish oil, but it sure sounds delicious to me! There are commercially-developed Omega-3 fatty acids that are more palatable to horses than straight fish oil. My docs may also recommend bronchodilators such as clenbuterol or albuterol which may come in oral or inhaled forms.

 

Luckily, if your horse is diagnosed with IAD, the prognosis of a full recovery if treated is excellent. If cats got IAD, I would just take it as my sign that I should never exercise again. Oh wait, I don’t currently exercise. I guess we will never know if cats get IAD.

 

Heaves/Recurrent Airway Obstruction

 

Unlike IAD, a horse with Heaves/RAO is not normal at rest. You may notice your horse breathing rapidly or with more effort. You may even hear them coughing more frequently. You may also notice nasal discharge along with exercise intolerance. Horses with Heaves will have the classic “heave line” at the bottom of their ribs due to increase in abdominal muscle mass from excess work performed in order to breathe. Some horses with Heaves may become in appetent, although why horses decide to stop eating is beyond me. The horses usually experience weight loss due to decreased feed intake. Similar to IAD, horses with Heaves will not typically have a fever.

 

You may recall I mentioned early on that there are two different types of Heaves, Barn-associated and Pasture-associated. Horses with Barn-associated Heaves spend the majority of their time kept in a stall where they are exposed to typical molds, dust and endotoxins in hay and straw. Horses with Pasture-associated Heaves typically reside in the Southeast and spend the majority of their time on pasture where they are exposed to inhaled allergens. Both types of Heaves result in lower airway inflammation, but exact factors causing the airway dysfunction is unknown.

 

Heaves is diagnosed by BAL and endoscopic examination. Radiographs and thoracic ultrasound are also useful diagnostic tools used to further characterize the inflammation in your horse’s lungs.

 

Treatment for heaves is similar to that of IAD. At the forefront of treatment is to reduce allergens by soaking hay and grain. It is also important to keep horses with heaves off of round bales as they are very high in endotoxic and organic dust. Horses with Barn-associated Heaves should be kept on pasture and horses with Pasture-associated Heaves should be kept stalled except in the winter months when allergens are low. Systemic steroids and bronchodilators are also recommended for horses with Heaves.

 

Now that you are an expert on Equine Asthma, if you are concerned that your horse may be showing any of these signs, be sure to contact me at the clinic and I will get you in touch with one of my docs.  We will get out to check on your horse as soon as possible.

 

Now it’s time for me to go back to enjoying the remainder of this holiday weekend in the cool AC. Take a moment to remember all those who have served our country and provided us with the freedom to nap all day.

 

Until next week,

~Tony

Tuesdays with Tony is the official blog of Tony the Clinic Cat at Springhill Equine Veterinary Clinic in Newberry, Florida. If you liked this blog, please subscribe below, and share it with your friends on social media! For more information, please call us at (352) 472-1620, visit our website at SpringhillEquine.com, or follow us on Facebook!

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