Merial, now part of Boehringer Ingelheim Animal Health, has been a sponsor of the AAEP Resort Symposium for several years. In 2017 they sponsored coverage of the AAEP Resort Symposium in EquiManagement magazine. This full article from EquiManagement magazine is brought to you by Merial/Boehringer Ingelheim Animal Health.
Included in this report were the topics of Neurologic, Lame or Both? and EPM: One Disease, Many Symptoms. Both were presented by Amy L. Johnson, DVM, DACVIM (in large animal internal medicine and neurology). She is an assistant professor of large animal medicine and neurology at the University of Pennsylvania’s New Bolton Center.
Presentation Summaries From Other Speakers
There were many other exceptional presentations during the 2017 AAEP Resort Symposium, but with limited space to present those presentations, we will instead give you the presenters’ summaries for each talk.
Lyme Disease and Neuroborreliosis: What Do We Know?
Johnson also gave this presentation, concluding that “infection with Borrelia burgdorferi is common, but rarely results in neuroborreliosis. Horses with neuroborreliosis have variable signs and laboratory results. Therefore, diagnosis is challenging and relies on fulfillment of several criteria plus exclusion of other possible diseases.”
Headshaking: Where to Start?
On this topic, Johnson noted that headshaking “... is a self-explanatory syndrome, but diagnosis of the underlying etiology can be difficult, and clinical management can be even harder. Recent investigation has provided more information regarding the underlying physiologic problem in many cases, and newly described treatment modalities (PENS treatments) can help improve horse comfort.”
Cervical Radiographs: A Neurologist’s Perspective
“Cervical vertebral problems are a relatively common cause of decreased performance in sporthorses,” Johnson concluded after this presentation. “Equine practitioners should be knowledgeable about proper acquisition and interpretation of cervical radiographs, so that they can advise clients appropriately.”
Radiography in a Digital Age
The presenter on this subject was Sarah M. Puchalski, DVM, DACVR, of Palm Beach Equine Clinic in Florida, who noted: “Digital imaging has greatly improved the radiographic capabilities of equine practitioners. The common use of digital radiographs also opens the doors for many opportunities and many pitfalls.” Her presentation covered commonly encountered problems with acquisition and interpretation, including digital artifacts, artifacts of positioning and factors leading to errors in interpretation.
Advanced Imaging of the Equine Athlete
In this presentation, Puchalski maintained that performance problems in the sporthorse “... take on many different presentations, ranging from unilateral lameness to neurologic dysfunction. Making an accurate diagnosis is universally accepted as critical to appropriate treatment and rehabilitation, yet choosing which of the numerous available techniques remains confusing.” She provided a review of nuclear scintigraphy, MRI and CT, also introducing some novel techniques such as PET and robotic imaging. For those modalities she discussed indications, clinical rationale for appropriate use, logistics, practical applications and the costs of the readily available techniques. In addition, she provided numerous case examples to illustrate the use of each technique.
A New Look at Old Problems: Observations on Fetlock Subchondral Injury and Proximal Metacarpal/-tarsal Pain
“Advanced imaging techniques have provided greater insight into problematic anatomic sites,” Puchalski noted in this presentation. Her areas of focus were the fetlock, the proximal cannon bone region and novel lameness conditions.
In this presentation, Turner noted that sporthorse lamenesses are no different than any other lamenesses, “ ... with the exception that they are probably more subtle. The rider, driver or trainer notices issues much sooner. In fact, these issues may be as simple as perceived loss of speed or [an]other performance factor.” Turner said that the examination was critical and must be both systematic and thorough.
Gizmos and Gadgets: Witchcraft or Wizardry?
“The horse industry likes gizmos and gadgets, and there are companies that make products to appeal to this interest,” Turner said in this presentation. He questioned whether there was evidence that any of these tools have an effect on horses, let alone a beneficial one.
Training and Rehabilitation
In this presentation, Turner advised that in order to be effective, a rehabilitation program “... should utilize specific veterinary and physiotherapy interventions to ensure pain-free range of movement is achievable.” He added that along with that pain-free range of motion, the veterinarian must strive to instill in the horse strength, balance and proprioception training using “clinically reasoned treatment protocols based upon evidence-based practice and a thorough knowledge of equine functional anatomy and biomechanics.”
Practical Equine Rehabilitation for the Practitioner
“Injections and surgery are the most common sports medicine techniques used by veterinarians,” Turner noted in this presentation. “However, veterinarians are learning that the difference between the success and failure of these treatments is aftercare.” He added that rehabilitation was based on healing, improving flexibility and physical conditioning, strengthening the injured tissue, then slowly returning to full activity.