2022 AAEP Convention Bonus Coverage: Antimicrobial Stewardship

Very pregnant American Paint mare horse on a cattle ranch in the Umpqua Valley near Roseburg Oregon

Huh, Who’d Have Thought?

Part Three: Who’d Have Thought Antibiotic Stewardship is as Easy as a TikTok?

There’s a popular TikTok going around that shows clips of a dog reacting to different foods, clothing, and activities. It’s called, “How I feel about certain things with little to no explanation.” I love this trend, and I now go through daily life making impromptu decisions on whether I like something or not. There is something cathartic about playing this game, especially when experiencing a new town and meeting new people at the 2022 AAEP Convention.

Thoughts on the 2022 AAEP Convention With Little to No Explanation

If I were cool enough to know how to make a TikTok, I would. But I’m not. Instead, here is a list of how I feel about San Antonio and the 2022 AAEP Annual Convention choices with little to no explanation:

  1. Free pens and lip balms at the tradeshow—yes. 
  2. Standing MRI units for sale directly to practitioners—absolutely!
  3. Vendors providing samples of sparkling water instead of still—one hundred percent no. 
  4. Ghost tour by Sisters Grimm through the Menger Hotel haunted by 80 different ghosts—of course.
  5. Boat tour on the River Walk because it reminds me of the Venice canals—most definitely. 
  6. Horse-shaped stress-relieving squeeze toys—Nope. But only because these anti-stress vomiting fried eggs are way better.
  7. Random games such as plinko and Pac-Man at the booths that have nothing to do with the product—I’m 50/50 on this one. Mostly because the lines were too long and I didn’t get to play. 
  8. The fact that the escalator going down from the third floor to the second floor travels faster than the handrail—surprisingly and irrationally annoying. 
  9. The lack of yoga at this year’s convention—I hate this! But this one gets an explanation. The AAEP traditionally offers complementary yoga as part of their wellness program to help equine practitioners achieve the work/life balance we are crying for. But this year, due to lack of interest, yoga was discontinued. Perhaps this is simply due to conference attendees being unaware that the yoga program existed. To show your interest in yoga and support the growing Bring Yoga Back movement, contact the AAEP now

And finally, number 10: veterinary endorsement of antimicrobial stewardship—hands down yes!

Antimicrobial Stewardship at the 2022 AAEP Convention

The phrase antimicrobial stewardship refers to choosing the right antibiotic for the right patient, at the right time. This involves finding the right dose, and the right route, to cause the least harm to the patient and future patients. This topic came up at last year’s convention, and it seems to have an even stronger following this year. For example, Tamara Dobbie, DVM, Dipl. ACT from the New Bolton Center in Pennsylvania discussed the responsible use of antimicrobial agents to treat material endometritis in mares. 

She said, “To increase antimicrobial stewardship, antibiotics should be used when there is confirmed infection, and treatment should be based on antimicrobial sensitivity. The unfettered use of postbreeding antibiotic infusions in mares is a practice with questionable efficacy that has potential to accelerate bacterial resistance to antibiotics in equine reproductive medicine.”

Not only is unconstrained antibiotic harmful to horses, but it is also harmful to humans. Many of the medications used in equine practice are either critically important or highly important antimicrobials for humans. These include gentamicin, ampicillin, trimethoprim and sulfamethoxazole. This list, according to Dobbie, is a “sober realization that emphasizes the need for their judicious use.”

Routinely Administering Antibiotics Postbreeding is Not Justified

In sum, routinely administering antibiotics postbreeding is not justified. Moreover, when contemplating the use of an antibiotic, Dobbie said, “Uterine sampling is incredibly important. Samples need to be accurate and representative. Make sure they aren’t contaminants.”

Ryan Ferris, DVM, MS, Dipl. ACT from Summit Equine, Inc. in Gervais, Oregon, followed Dobbie’s plea for improved antimicrobial stewardship with his own presentation on treating post-mating induced endometritis (PMIE) without antibiotics. 

He assured attendees that PMIE is a noninfectious condition of the uterus. He said that antimicrobials should only be considered “If the uterus is inoculated with significant and known quantities of bacteria during the breeding or treatment period.” 

2022 AAEP Convention Topic: Alternative Options for Treating PMIE

Ferris presented the various options for treating PMIE like a menu, providing various options for eliminating intrauterine fluid by 48 hours after ovulation. Like fine dining, he said, veterinarians need not choose every item on the menu. Rather, they should develop an appropriate treatment plan to meet that specific patient’s needs. 

In Ferris’s hands, oxytocin is a go-to treatment that allows the mare to clear the fluid on her own. Next, ecbolic agents, lavage, and acupuncture can each be considered. One or more of these will work in most cases, assured Ferris. 

A novel approach that Ferris shared he was excited to try in the 2023 breeding season is a simple, inexpensive procedure: exercise.

He said, “Seventy-eight percent of mares will accumulate fluid if locked in a stall after breeding. If they are forced to exercise, the fluid reduces by 66%. It’s a no-brainer, really, but few studies have been performed on this.”

Going back to the “How I feel about certain things with little to no explanation” theme—briefly exercising mares to resolve PMIE? LOVE.

Exercise Also Improves Mental Health

Exercise is also great for improving mental health and is encouraged by the AAEP Wellness Committee. The AAEP has many valuable resources available online to help equine practitioners, who are extremely active, engage in more exercise. To start, contact the AAEP now to Bring Yoga Back at the 2023 Annual Convention in San Diego! 

Brought to you by ADM Cellarator Advantage

Demands of exercise are a stressor for the performance horse. Heavy work can overwhelm the body’s natural ability to deal with oxidative stress, which can damage muscle proteins, lipids and DNA, release pro-inflammatory cytokines leading to muscle pain, and damage the mitochondrial membrane decreasing energy production. Cellarator Advantage RECOVERY+ by ADM Animal Nutrition™ was designed to help the performance horse combat the stress of exercise. To learn more, go to go.adm.com/recovery and come visit with the ADM experts at AAEP, booth #17095.

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