modernequinevetfeb1513

How to examine the footIs lameness the cause of that saddle slip?

Equine VetThe Modern

February 2013 | Vol 2 No 2www.modernequinevet.com

Who's at faultwhen mares don't conceive?

2 February 2013 | ModernEquineVet.com

Table of ConTenTs

OrThOpedics

From AAep meeting: examining the foot ....................................... 8Good physical exam can help pinpoint lameness

is lameness the cause of that saddle slip? ....................................12This fundamental cause is often overlooked

regeNerATiVe MediciNe

Which stem cells best for tendon injuries? ...................................11A look at different types of stem cells to see which might perform better for tendon injuries

prAcTice MANAgeMeNT

Breaking bad news ...............................................................................................................14Excellent communication skills are essential in veterinary medicine

reprOducTiON

some conditions enhance survival of female embryos ..........................................17Horses among mammals that can adjust the ratio of male-to-female young

TO cONTAcT us, eMAil MArie rOseNThAl

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he said, she saidWho's at fault when mares don't conceive?

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Who's at fault when a mare doesn't conceive?


B y M a r i e r o s e n t h a l , M s

RepRoduCTIon

he said,she said

ModernEquineVet.com | February 2013 5

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When a mare fails to come into foal, mare owners tend to blame the stallion, and stallion owners tend to blame the mare. The fact is that any time there is human intervention, problems may exist, and addressing issues related to timing and management in advance can help make breeding easier on everyone.

“With today’s technology, we are solving fertility issues quickly,” said Laura Young, manager at South-wind Farms in New Jersey, “but at the same time we are creating new problems.”

Most stallion owners collect semen on a certain schedule, such as Monday, Wednesday and Friday, to assure adequate sperm counts in that collection. Once collected, extended semen lives about 48 to 72 hours.

Collecting sperm with a phantom mare. Photo by Bob Langrish, equestrian photographer • www.boblangrish.com

The mare’s egg, in turn, lives about eight hours after ovulation. She must be inseminated before she ovulates to maximize the chances of conception, so collection and shipping times might not always coincide with that mare’s cycle.

“There are many human issues — and it has nothing to do with incompetence or someone doing something wrong — but your hands are tied by the stallion’s sched-ule, and the shipping or airline schedules,” said Amanda C. Ragon, DVM, DACT, an equine reproductive spe-cialist at Equine Fertility Specialties in Michigan. “And sometimes, the mare doesn’t go through her cycle as you thought she would. Often, the timing cannot be coordi-nated ideally.”

The problem is living animals do not always work on human schedules, agreed Bridgette Jablonsky, VMD, farm manager at Hanover Shoe Farms in Pennsylvania. “Everyone wants breeding to work like an assembly line, but it’s nature,” she said. “You can do everything right and breed to a fertile stallion, and your mare just does not get into foal.”

But Adam Bowden, owner and general manager of Diamond Creek Farm in Kentucky, said technology has also given information where once there was none. Sci-ence allows breeders to get up close and personal with se-men, allowing them to check both motility and morphol-ogy. When Bowden checked 50 semen samples from 10 stallions shipped to his Diamond Creek Farm for about five months, he found that two of the 10 stallions con-sistently produced some less progressively motile sperm.

“The industry standard of 500 million progressively motile sperm is much higher than the doses we received, due to the fact that less than 30% of the 500 million were normal (morphologically speaking),” he said, “and was low enough to decrease the normal conception rate of the other eight stallions.”

Bowden acknowledged his was not a scientific study and it was a small sampling, but he found enough subpar samples to cause concern.

“If the mare had no reproductive issues and the quali-ty and motility of the semen were poor, it was more likely a semen issue rather than the mare,” he said.

But stallion managers say issues may also lie with mare management. Admitting “all stallions are not per-fect,” David Heffering, manager of Tara Hills Stud in Ontario, said that most farms do an excellent job in stal-lion management and shipping semen. While he knows his stallions’ thresholds to get a mare into foal, once the semen is shipped, mare management is out of his hands, and that is important.


“[Mares] need the proper ovulation drugs at the right time,” said Heffering. “We want everyone’s mares to get into foal or we are not going to make a dollar. But even with the best management on both ends, it’s not going to work every time.”

Each farm and stallion are different, but the arti-ficial insemination process is generally the same ev-erywhere. Mare owners notify a stallion’s manager right before they think she will ovulate. A stallion's semen is collected off an artificial vagina, and the ejaculate is assessed for motility, morphology and sperm count. The semen is then divided among the mares that booked to that stallion that day, placed into an extender and sent to the mares’ owners.

Sperm can be shipped overnight, sent by courier or picked up. Rarely does the mare come to the stallion’s farm for insemination.

There are several extenders available, but all include milk, glucose and an antibiotic. Veterinarians say the ex-tenders help the stallion, because they extend the life and volume of the semen and provide energy. Stallion own-ers test each stallion’s sperm in several extenders to see which is best for that horse.

“Some semen looks terrible when it’s first collected,” Jablonsky said. “You add extender, and in five minutes it looks better, and in 10 minutes, it looks super.”

The sperm-to-extender ratio varies among stallions, but the industry standard says that 500 million “progres-sively motile sperm” be in each dose, regardless of the amount of extender.

“That old adage that it just takes one sperm to cause conception isn’t actually true,” said Ragon. “Every sperm cell has a sack of enzymes around the head, which are released as the sperm bump up against the

egg and help one sperm penetrate the egg.”Once extended, the semen is either inseminated or

packaged for shipment to another facility.“Once it leaves your farm its destiny is out of your

hands,” said Young. “Anything can happen if the se-men is being shipped overnight — weather, flight de-lays, customs, courier issues — and any of these can affect the semen.”

There are several techniques for inseminating the mare, but generally she is cleaned with a mild soap. (Avoid using betadine antiseptics, suggested Jablon-sky, because they are spermicidal.) Her tail is moved aside. The semen syringe is attached to a pipette and semen is deposited into her uterus. Jablonsky said if the mare is ready to breed, the cervix will be loose and open — like the end of a garden hose, but softer.

One step that some mare owners skip, Ragon add-ed, is asking the veterinarian to return the next day to make sure the mare has ovulated. If she doesn’t ovulate within a certain time, more semen needs to be ordered to try again.

Although mare owners might pay a deposit or a booking fee, stallion owners don’t get fully paid until the mare delivers a live foal. If the mare needs more semen, however, owners pay for it to be collected and shipped. The finger-pointing starts as soon as she doesn’t conceive.

Bowden said that rather than blaming each other after the fact, better communication between farms before breeding might prevent subfertile mares from being bred to subfertile stallions.

“I don’t think there is enough information be-ing passed between these two groups,” he said. “If a mare or a stallion has fertility issues, neither farm seems to know that. And if both parties knew that in-formation, solutions could be devised, which would increase the chances that the mare gets into foal.

“Instead the mare owner complains that it’s the stallion’s fault, and the stallion owner complains that it’s the mare’s fault.”

Ragon agreed. Rather than just asking if the stal-lion is fertile or checking sperm viability, she sug-gested that mare owners ask about the stallion’s first cycle conception rate.

“Sometimes it is easier for the veterinarians to talk with each other because we can talk about things on a medical basis, instead of a business basis,” she said. “There’s a lot to it. You just can’t order some semen, put it in the mare and expect to get a pregnancy, but unfortu-nately, that’s what some people think they can do.” MeV

This article was first published in Hoof Beats, a USTA publication, in Dec. 2009. It is used with permission. http://www.ustrotting.com

Dr. Shelby Hayden examines the inner catheter for semen following insemination during the transrectally guided deep-horn insemination procedure. She is assisted by technician Katrina LaCaze.

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oRTHopedICs

Sometimes veterinarians will block the foot to diagnose lameness and the horse is still lame, so they will disregard the foot as the cause of the problem. At the recent 58th Annual Convention of the Ameri-can Association of Equine Practi-tioners, Debra R. Taylor, DVM, MS, DACVIM, told veterinarians: don’t be too quick to make that call.

“If you look a little closer you might wonder what this horse is try-ing to tell you,” said Taylor, associ-ate professor at Auburn University College of Veterinary Medicine.

Pain in the foot is a common cause of lameness in all horses. The hoof is dynamic and always responding to various loads and stressors. Abnormal biomechanics of the foot may contribute to pain and lameness in other areas of the limb. Many signs, some subtle, some not so subtle, can indicate that the foot is contributing to the horse’s lameness, and Taylor re-viewed some of them at the meet-ing.

During the examination, ob-serve the horse walking on hard and soft ground. Taylor discussed one patient that corrected his high coronary band angle and his hoof pastern access when walked on soft ground. He did this several times. “Does he have to do this because the soft ground doesn’t properly support the toe or does he choose to do this because it is a more comfort-

able position?” she asked. The limbs should be symmet-

ric. Because symmetry is pleasing to the eye, asymmetry is easy to see. Laterality, high/low syndrome, mismatched feet and mild club feet may occur because of uneven weight bearing caused by asym-metric movement, asymmetric ten-don tension or pain.

Coronary bandThe coronary band provides a

lot of information, she said, so ex-amine it closely. A normal coronary band angle should be about 20° to 25° away from the ground and straight or slightly arched. The hair should lie flat along the hoof wall with the hair shafts directed distally.

“Farriers often talk about ‘angry hair’ and I used to wonder what that meant,” she said about her early days as an equine veterinar-ian. “When excessive hoof wall pressure is present, the hair of the coronary band will often stand out horizontally. It is important to watch for this as an indication of an overworked and distorted hoof wall,” she said.

Chronic overloading can affect the shape of the coronary band. “Even a small dip of the coronary band at the dorsal hoof wall is in-dication for taking a radiograph because there will often be bone remodeling that can be a source of hoof pain,” she said.

A low coronary band angle (<20°) is often associated with a high palmar/plantar angle, and a high angle (>30°-45°) is often as-sociated with a low or negative pal-mar/plantar angle. This affects the forces exerted by the deep flexor tendon on the navicular.

If the coronary band of the hind foot is normal and someone were to project a pointer from the coro-nary band, the ray would strike the knee or below. If it is abnormal, it would strike well above the carpus. Take the time to look at the direc-tion of the coronary band angle to determine if the horse might have a


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negative plantar angle.“Many horses with negative

plantar angles are presented for hindlimb lameness. While these horse’s seldom block sound to the hoof, correcting the negative plan-tar angle often diminishes the lame-

ness. This observation warrants fur-ther study,” she said.

Hoof wallA normal hoof wall should be

smooth, without flares or cracks, which would signal chronic, ex-cessive overloading. The surface should have a light sheen. Growth rings should not be prominent. If the growth rings are narrower in any particular region, this could be a sign the hoof has undergone

excessive ground-reaction force in that region, and the circulation is altered or uneven.

Hoof tubules should be straight, and the sole should meet the tight white line at the hoof wall. A foot under stress will be flared or dished.

Look for bruising. Bruising, which can be hard to see, might be easier to see on a photograph, she said.

FrogThe frog’s morphology changes

in relation to the hoof demands and the terrain. The frog width should be 50% to 60% of its length. The frog of a healthy foot has sufficient depth at its dorsal aspect to reach the bearing surface.

“We want the frog to reach the bearing surface. It is stimulated by the ground. If it does not interact with the ground, it is not contribut-ing to weight bearing,” Taylor ex-plained.

The central sulcus of the frog should be wide enough that the vet-erinarian can lay his or her finger in it. If it is narrow and contracted, it will harbor thrush-causing organ-isms and can become a primary source of pain.

Collateral grooves can be used to predict sole depth, P3 suspen-sion, palmar angle and heel de-velopment. The veterinarian can predict distal phalanx orienta-tion by assessing the depth and slope of the collateral grooves. Sole depth decreases as collat-eral groove depth decreases. The slope of the collateral grooves in the front half of the foot parallels the palmar/planter angle. This in-formation might help decide what types of hoof care and protection the horse may need when radio-graphs are not readily available.

PalpationPalpation should start with as-

sessment of the temperature of the

hoof wall, coronary band and heel bulbs by using the palm or the back of the hand.

• Elevated temperatures can sig-nal inflammation, infection or the prodromal stages of lami-nitis.

• Decreased temperature can sig-nal poor perfusion and a host of problems, such as chronic laminitis.

When palpating the digit, the normal coronary band should be full or spongy with no evidence of a shelf or ledge where a finger can be placed behind the proxi-mal aspect of the hoof capsule. A ledge or shelf would indicate the distal phalanx is located deeper than normal within the hoof cap-sule. If this occurs, there are usu-ally other abnormalities present, such as thin or flat soles and/or coronary band distortion.

When palpating the heel, the volume of the heel is important because it represents the volume of the digital cushion. The digital cushion should be 2 inches thick and three or four fingers wide. It should feel firm like a tennis ball or a well-done steak. When the digital cushion is pushed, there should not be a lot of give, and the frog should flex slightly.

Collateral cartilages should be thick and slightly bendable with moderate pressure, Taylor noted.

Although hoof testers might help rule in or out the presence of pain associated with the hoof wall, sole, dermal tissues and digital cushion, false-negative and false-positive in-dicators are common, according to Taylor. However, they can help as-sess the integrity of the structures of the hoof capsule.

Many foot problems produce similar clinical signs, so careful examination of the feet can help the clinician diagnose the location and cause of a horse’s lameness, ac-cording to Taylor. MeV

Photo courtesy of Dr. Taylor

Walk the horse on hard and soft ground because lameness caused by pain in the distal portion of the limb tends to worsen when the horse is trotted on hard ground.


Tendon injuries can affect athletic horses at all lev-els. Researchers from the University of Connecticut are studying the use of stem cells in treating equine tendon injuries.

“My work focused on determining appropriate conditions for expansion of umbilical cord blood (UCB)-derived stem cells,” said Sarah A. Reed, PhD, assistant professor, department of animal sci-ence, at the University of Connecticut. “Often, stem cells are cultured to expand the population prior to injection. The culture parameters are extremely im-portant, as they can greatly influence gene transcrip-tion, protein production and cell identity. My work describes the effect of different culture media and basement substrata on gene expression in UCB and adipose-derived mesenchymal stem cells.”

Tendon injuries in horses tend to worsen over time, as damage to the tendon creates lesions. Currently, horse owners treat tendon injuries by resting the horse and then carefully exercising it to control the growth of scar tissue in the tendon, which requires substantial recovery time, as well as, carries a high risk for reinjury, according to Reed.

“Stem cells have great promise as a therapeutic aid, but we have little data regarding proper dose, timing and expansion protocols to promote optimal repair. Much research is needed to allow researchers and vet-erinarians to make informed decisions about the best implementation practices. Veterinarians should seri-ously consider their options,” she said.

Stem cell injections are already common in veteri-nary medicine, and scientists are curious about how to make stem cell treatments more effective. In this re-

view, the researchers looked at the use of three types of stem cells: bone marrow-derived mesenchymal stem cells (BMSCs), adipose-derived stem cells and UCB-derived stem cells because these cell types have the po-tential to strengthen a tendon after injury.

Implants of BMSCs can increase collagen produc-tion and organized collagen fibers in the tendon. Ad-ipose-derived stem cells can express certain proteins important in healing.

UCB stem cells may have the most potential for healing horse injuries because these cells may be bet-ter able to grow into new types of cells and repair ten-don damage. So far there have been no studies of UCB use in actual horse tendon injuries. But in vitro studies show that UCB could be capable of tendon regenera-tion, according to Reed.

“We predict that UCB stem cells would perform bet-ter in the tendon because they are more naïve and do not differentiate as completely in culture as adipose-de-rived stem cells. There have been no published experi-ments using UCB to treat tendon injuries at this time,” Reed said.

UCB stem cells are actively being banked by several companies, she added. BMSCs are readily available from each individual horse and can be isolated fairly easily. However, most veterinarians do not have the cul-ture facilities to expand the true MSC population. There are hospitals that offer this service.

More studies are needed about the best implantation techniques and the role of stem cells in different parts of the tendon. With this knowledge, horse owners, veteri-narians and animal scientists can help keep equine ath-letes healthy. MeV

For more information:

Reed SA, Leahy ER. Growth and development symposium: Stem cell therapy in equine tendon injury. J Anim Sci 2013 Jan;91(1):59-65. doi: 10.2527/jas.2012-5736. Epub 2012 Oct 16. http://www.ncbi.nlm.nih.gov/pubmed/23100589

Umbilical cord blood derived stem cells grown on gela-tin. The staining is phalloidin (green – stains the actin fila-ments of the cells) and Hoescht 33342 (blue – stains the nuclei). Photo by Dr. Reed.

Which stem cells fortendon injuries


RegeneRaTIVe MedICIne

A number of factors can cause saddle slip, not just a poorly fitted saddle. Often, lameness is the cause, according to Sue Dyson, VetMB, PhD, head of clinical or-thopedics at the Center for Equine Studies, Animal Health Trust (AHT) in the United Kingdom.

For many years, Dyson has noticed saddle slip on horses with hindlimb lameness. Often, how-ever, lameness is not recognized as the fundamental cause of the saddle slip, she told The Modern Equine Vet.

“I was prompted to initiate the study because I had seen a horse with saddle slip in which the sad-dle slipped a lot, but the rider sat squarely, and I could not see lame-ness. But when I blocked the tar-sometatarsal joint, the saddle slip resolved. I became intrigued and wanted to know more about the incidence of this and thought that it was an excellent project for my intern, Dr. Line Greve,” Dyson explained.

Together Dyson and Greve con-

ducted a prospective study of 128 horses referred to AHT for lame-ness or poor performance, or were undergoing a prepurchase exami-nation. Some were overtly lame, and some were not moving proper-ly but lameness had not necessar-ily been recognized, according to Dyson. The horses were ridden by two riders during the assessment.

Saddle slip was defined as the saddle consistently slipping to one side when observed from the ground (this may have been only on one rein but was a consistent feature). With grade-1 saddle slip, the riders continued without readjusting the saddle. In many cases, the riders were not aware of the saddle slip. However, they generally became aware if they intermittently had to stop and re-adjust the position of the saddle (grade-2 saddle slip).

Saddle fit was assessed in all horses. “In two horses, one with forelimb lameness and one with hindlimb lameness, we identified an ill-fitting saddle. Saddle slip


This fundamental cause is often overlooked


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lameness

was not eliminated by resolution of the lameness; saddle slip was eliminated when we used a cor-rectly fitting saddle,” she said.

The saddle consistently slipped to one side in 38 of 71 horses that had hindlimb lameness, compared with 1 of 26 horses with forelimb lameness. There was no saddle slip in 20 horses with back pain and/or sacroiliac joint pain or in 11 sound horses.

Saddle slip improved in 97% of horses after the lameness was ad-dressed.

“I was surprised by the pro-portion of horses with hindlimb lameness that we documented with saddle slip,” Dyson said. “I was not surprised at all that 97% improved after elimination of the lameness.

“The fact that saddle slip oc-curred with at least two riders and was abolished when the lameness was resolved proved a causal rela-tionship between hindlimb lame-ness and saddle slip,” she added.

Hindlimb lameness probably alters back movement, she ex-plained. “In most affected horses with saddle slip the saddle slipped toward the side of the lame or lamest limb, but in a small pro-portion the saddle slipped toward the less lame hindlimb. There-fore, horses must be adapting their gaits in the face of lameness differently.

“It gets quite complex,” she said. Saddle slip worsened when the horse was ridden in a circle vs a straight line, reflecting the way in which horses change their gaits on a circle compared with straight lines. It worsened in rising trot than sitting trot because of the way

in which the forces on the stirrups change. In some, it was worse dur-ing canter, presumably because the three-beat asymmetric gait produces different forces than the two-beat trot, according to Dyson. She plans to study the biomechan-ics of this.

Dyson also noted that horses with a rounder back in the caudal saddle region were more prone to saddle slip than less rounded horses.

“Interestingly, the presence or absence of saddle slip was not re-lated to the severity of lameness, but we need more numbers to see if horses with different types of pain causing lameness are more at risk for saddle slip,” she said.

Veterinarians experienced in

recognizing lameness should ex-amine a horse carefully if the own-ers complain of frequent saddle slip. But first, make sure the saddle fits properly, and the rider is sitting squarely on the saddle. When as-sessing lameness, remember that the saddle normally slips toward the side of the lamer limb, but not always. “It can be confusing because occasionally, it slips the other way,” Dyson said.

Dyson indicated that the AHT

riders were probably better at feeling saddle slip than the typi-cal horse owner, and veterinarians and technicians should train own-ers about how to “feel” saddle slip. Have someone stand behind them and watch the movement of the saddle, she suggested. MeV


oRTHopedICs


Greve L, Dyson S. An investigation of the relationship between hindlimb lameness and saddle slip. Equine Vet J 2012 Dec 18. doi: 10.1111/evj.12029. http://www.ncbi.nlm.nih.gov/pubmed/23360352

Above: Saddle slip as a result of lameness.Left: Saddle slip worsens when the horse is ridden in a circle vs a straight line.

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pRaCTICe ManageMenT

When emotions are high during an emergency, the veteri-narian and technician must remain calm and focus on the patient’s needs, while recognizing the best ways to communicate with clients.

“By their very nature, emer-gencies are unexpected, and peo-ple are thrown off balance. So, emotions are high,” said Amy L. Grice, VMD, a partner at Rhine-beck Equine in New York. “Cli-ents have no idea what to expect. Is their horse going to live? Is their horse going to die? Will they lose the use of the horse? Will it be lame for a long time? How much is it going to cost?”

Clients often have no way to assess the clinical and technical skills of their horse’s doctor, so they tend to judge the entire vet-erinary team by the way everyone communicates, Grice said at the 58th Annual Convention of the American Association of Equine Practitioners held in December in Anaheim, Calif.

“People may not remember what you say, but they will al-ways remember the way you made them feel,” she added.

Veterinarians and their staffs

need similar skills to those fol-lowed by pediatricians and their staffs who also deal with caregiv-ers. Equine veterinarians do the same. They aren’t just treating

a horse — they are explaining and getting buy-in from owners, trainers and others involved in the horse’s life.

Human medicine researchers have found that assigning a pa-tient navigator or facilitator helps both the patient and family. In one study, researchers randomly assigned pediatric patients into two groups: families with a pa-tient navigator and families with-out. The patient navigator an-swered any questions the family

had, explained laboratory results and provided other information the family wanted.

The researchers found that families with a patient navigator rated the care better than families who did not have a navigator. This could be a good role for a vet-erinary technician, especially in a large equine hospital.

“The simple act of listening and answering their questions had a marked effect on the overall satis-faction of the family,” Grice said.

Several studies in veterinary medicine have found the same effect, according to Grice. “Es-sentially, communication drives satisfaction,” she said.

Watch what you doThe human body communi-

cates, sometimes more loudly than voices. Nonverbal commu-nication or body language com-prises about 60% of the com-munication that people receive. “Your tone of voice, your facial expressions, your gestures, how you hold your head and hands, how you hold your body and body contact. The way that you look and listen and move and re-

Breaking


Bad NewsExcellent communication skills are essential in veterinary medicine

people may not

remember what you

say, but they will

remember the way you

made them feel.


act tells the other person whether you are actually listening and care,” Grice explained. “If your nonverbal signals do not match the words you are saying, they can generate tension, mistrust and confusion.”

Nonverbal communication can reinforce or contradict the message.

To effectively use nonverbal communication to reinforce the message, Grice suggested that veterinarians and their staffs rec-ognize and manage their own emotions, as well as, send the right messages to their clients and inter-pret clients' messages accurately.

“Sometimes, we have to act as advocates for the horse because the

client won’t hear the message that we are trying to give. Sometimes you have to stand up tall, square your shoulders and really speak firmly. Be the advocate for the horse to get your message across.”

Are you listening?One study that looked at medi-

cal doctor-patient interactions found that doctors typically inter-rupt their patients after an average of 23 seconds. Without interrup-tion, the patients take an average of 60 seconds to explain the problem. Grice suggested taking a few more seconds to listen to clients. When taking the patient history ask open-ended questions. “Tell me...What?

How? Describe for me” are good ways to start the discussion. And avoid using why because it sounds judgmental.

A good technique is called re-flective listening, which involves repeating back to the client what you heard to make sure you under-stood. This not only assures the cli-ent that you understand him or her, but gives the client a chance to cor-rect or add information.

Veterinarians and staff can help clients deal with negative emotions by expressing and naming those emotions. “Say things such as, ‘I can see how much you care for your horse. This must be hard for you,’” she suggested.

Bad News

Psychologist Carl Jung suggested people fall into these

communication styles.

Adaptors5%

Intuitors 10%

Thinkers 25%

Feelers 25%

Sensors 35%


Use empathy, but remember empathy is non judgmental. “You did the best you could to help him. No one could have known that he would try to jump that ravine.”

Another physician study found that those with the best communi-cation skills had fewer malpractice claims than those who were judg-mental, lacked empathy and did not spend time communicating. Physi-cian communicators told patients what to expect from the visit or procedure. They used humor. They asked the patient’s opinion. They checked their understanding. They encouraged them to talk and they spent longer in routine visits, 18.3 vs 15 minutes.

“Think about that time: spend-ing 3.3 minutes prevented mal-practice claims. Three minutes is not a long time,” Grice said.

Communication can be en-hanced by recognizing a person’s preferred communication style and tailoring the message to fit that style. Carl Jung described several communication styles, including intuitors, thinkers, feel-

ers, sensors and adaptors. Intuitive communicators are

creative, unique and innovative. Under stress they can be reactive or detached. Make an emotional con-nection by appeal to their emotional side. Speak slowly and calmly.

Thinkers are logical, sequen-tial and thorough. Under stress, they become cautious and make decisions more slowly. Be clear and complete. Give them time to process the information. It might be a good idea to set the process in motion as early as possible, es-pecially if they will have to make a difficult decision.

Feelers are compassionate, traditional and like consensus. Under stress, they are volatile and can be difficult. They can become unhinged. Be sensitive to their feelings and not reactive. Be soft spoken and caring. Make eye contact. Slowly and calmly repeat your message.

Sensors are driven, focused and bottom-line oriented. Un-der pressure, they are impatient. These folks want to know if their

horse is going to die before the veterinarian has even examined it. “They have difficulty with deliberate, methodical exams, so educate them or ask the tech-nician to educate them, giving them information along the way,” Grice advised.

Adaptive communicators rep-resent only about 5% of the pop-ulation. They can easily handle any communication style.

“When you are delivering bad news, bridging statements can help clients prepare. A general statement ‘I am very worried’ gives a little bridge so the brain can process that something very serious is going to happen and then you tell the client what it is you need to say,” she said.

“The use of bridging state-ments, as well as slowing the pace of your communication, can help the client stay calm and make critical decisions.”

Better communication can im-prove client satisfaction and loyal-ty, as well as, help you help patients through a difficult time. MeV

1. Be a compassionate listener.

2. Confidently state your observations.

3. Don’t label; don’t judge.

4. State your expectations and limitations.

5. Express yourself directly and honestly.

6. Evaluate how other people are feeling.

7. Be aware of nonverbal communication.

11 Ways to communicate effectively

8. Ask open-ended questions. 9. Listen reflexively and listen with empathy.

10. Recognize communication styles and if you can adapt, do so.

11. Use bridging techniques and pacing.

Many mammals can adjust the ratio of male-to-female young, depending on surrounding condi-tions at the time of conception, but precisely how this is accomplished is unknown.

A recent study published in the journal Theriogenology, has provided important information about the survival of female em-bryos, which may be enhanced under conditions that would oth-

erwise tend to favor the birth of males.

Because of the process in-volved in the formation of sperm cells, there should be an equal chance that a mammalian egg will be fertilized by "male" sperm, carrying a Y chromosome, as by a "female" sperm, carrying an X chromosome. The symmetry of the system ensures that roughly the same number of males and

RepRoduCTIon

Lipizzan mare with her foalPhoto: Spanish Riding School - Federal Stud Piber


Equine embryo

Some conditions

female embryosenhance survival of


females are born, which is clearly helpful for the species' long-term survival. Surprisingly, though, many mammals do not produce equal numbers of male and fe-male offspring.

The discrepancy could be explained theoretically by dif-ferential fertilization efficiencies of male and female sperm (Y chromosomes are smaller than X chromosomes, so perhaps male sperm can swim faster?) or by different rates of survival of male and female fetuses in the uterus.

Indeed, it does seem as though male embryos are better able to survive under conditions of high energy intake. But how does this work?

Jana Beckelmann, DrMed-Vet, DECAR, at the Vienna University of Veterinary Medi-cine (Vetmeduni Vienna), pre-sented provocative evidence that a particular protein, insulin-like growth factor 1 (IGF-1), might somehow be involved. When examining about 30 equine em-bryos, Beckelmann noticed that during early pregnancy (between eight and 12 days after fertiliza-tion) the level of messenger RNA (mRNA) encoding IGF-1 was approximately twice as high in female embryos as in male em-bryos.

The difference could relate to the fact that female embryos have two X chromosomes, which might produce more of the fac-

tor required for expression of the IGF-1 gene (which is not encoded on the X chromosome) than the single X chromosome in males is able to generate. Beck-elmann was also able to confirm that the IGF-1 protein was pres-ent in the embryos, confirming that mRNA is actually translated to protein.

IGF-1 is known to have im-portant functions in growth and to inhibit apoptosis. As IGF-1 treatment of cattle embryos pro-duced in vivo improves their survival, it is likely that the fac-tor has positive effects on the de-velopment of the early embryo in the horse. So why should female embryos contain more of the fac-tor than males?

Losses in early pregnancy are unusually high in the horse and it is believed that female embryos are especially prone to spontane-ous abortion. Male embryos are known to be better able to sur-vive under high glucose concen-trations, so well-nourished mares preferentially give birth to male foals.

“We think the higher IGF-1 concentrations in female embry-os might represent a mechanism to ensure survival of the embryos under conditions that would oth-erwise strongly favor males.” If this is so, the ratio of the sexes in horses is the result of a subtle interplay between environmental and internal factors, including IGF-1, Beckelmann noted. MeV


Beckelmann J, Budik S, Helmreich M, et al. Sex-dependent insulin like growth factor-1 expression in preattachment equine embryos. Theriogenology 2013; 79(1): 193 DOI:10.1016/j.theriogenology.2012.10.004.

Day of pregnancy

Rela

tive

gene

exp

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ion

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8 10 120

10

20

30 malefemale

Relative gene expression of IGF-1 (related to β-actin) in male and female (n = 28) equine embryos on days 8, 10 and 12 of pregnancy (effect of sex: p = 0.01)

Agarose gel staining from RT-PCR with Xist specific primers of equine female (f ) and male (m) primary cell cultures and RNA of different embryos as well as one negative control (nc).


Most people are familiar with stage fright and its manifestations, such as rapid pulse, dry mouth, shaky voice, blushing and sweaty palms. But is the condition restricted to people? Does stress increase in horses when they perform in front of an audience?

It is well-known that horses show signs of stress when ridden but rela-tively little attention has been paid to the effects on their riders. This is surprising, as equestrian sports rely on close cooperation between the ani-mals and their riders. How does the horse-rider team cope with the stress involved in competing in an equestrian event?

Researchers in Vienna found that horses react identically regardless of whether spectators are present, but riders suffer more stress when perform-ing in front of an audience than when practicing for the event.

The horses and their riders thus perceive the challenges of competition

beHaVIoR

Horses don’t have stage fright — Bl

azej

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but their riders do




von Lewinski M, Blau S, Erber R, et al. Cortisol release, heart rate and heart rate variability in the horse and its rider: Different responses to training and performance. Vet J 2013 Feb 1. pii: S1090-0233(13)00003-8. doi: 10.1016/j.tvjl.2012.12.025. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/23380228

in equestrian events differently, according to the study, which was published online in the Veterinary Journal.

Mareike von Lewinski, Dr

Med Vet, and colleagues at the University of Veterinary Medicine, Vienna (Vetmeduni Vienna) and at the Ecole Nationale d’Equitation in Saumur, France, looked at six rid-ers and their horses and measured the changes in various stress-re-lated parameters, such as salivary cortisol concentrations, heart rate and heart rate variability. Measure-ments were taken during practice before the event without an audi-ence and after completion before 1,000 spectators. The results were compared to assess how the riders and their mounts responded to the presence of an audience.

In line with previous experi-ments, the researchers could ob-serve signs of stress — higher cortisol concentrations in the sa-liva and more irregular heartbeats — in both horses and their riders during the study. However, the presence of spectators resulted in more pronounced changes in car-diac activity among the riders than the horses.

The researchers found that cor-tisol concentration increased in both horses and riders (P<0.001) but did not differ between perfor-mance and rehearsal. The heart rate in horses and riders increased during the rehearsal and the pub-lic performance (P < 0.001 ) but the increase in heart rate was more pronounced (P<0.01) in rid-ers than in their horses during the public performance (from 91±10 to 150±15 beats/min) compared with the rehearsal (from 94±10 to 118±12 beats/min).

The horses appeared to be un-affected by the presence of spec-tators: their reaction to the course was essentially independent of

whether an audience was present or not. In other words, the horses and their riders responded differ-ently to the challenges posed by performing for spectators, with the horses not suffering from the in-creased levels of stress shown by their riders.

The results implied that the riders do not communicate their heightened anxiety to the ani-mals. The lack of transfer of emo-tions between rider and horse was unexpected, according to the re-searchers.

“We started with the assump-tion that rider stress would af-fect the horse but this does not seem to be the case. Nevertheless, we should bear in mind that we were working with experienced horses and highly skilled riders: our findings cannot be general-ized to inexperienced riders, who might be less able to prevent their horses from being stressed by the situation,” said Christine Aurich, DVM, PhD, DECAR, head of the group at Vetmeduni Vienna. MeV

Show program at the Ecole nationale d`équitation in Saumur, France.

Taking a saliva sample

Phot

o: Ve

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uni V

ienna

/J. Au

rich

Phot

o: Ve

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a horse's reaction

to the course was

independent of

whether an audience

was present or not.

fRee dIgITal MagaZIneRead us Today aT www.ModernequineVet.com

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For veterinarians and technicians

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If you are a consumer who buys a lot of items on-line, the fact that you often do not have to pay sales tax on these items is great news. I mean, who doesn’t want to save a few bucks?

But this might not be such a great deal if you’re a veterinarian trying to compete with an online phar-macy.

Marketplace fairness, however, is not the only issue when it comes to purchasing medications for horses and pets. The American Veterinary Medical Associa-tion (AVMA) said there is a lot more at stake than just money – there are quality-control and safety issues.

“While it is evident that losing customers who turn to online companies for their pets’ medications results in a negative impact on the business of veteri-nary medicine, it is important to understand that our first concern involves the lack of quality control for our patients’ prescriptions and our inability to ensure that they are receiving not only the right products, but safe products," said Mark Lutschaunig, VMD, MBA, director of the governmental relations divi-sion, AVMA.

“It is essential that this legislation is passed so that veterinarians are not at an unfair disadvantage when

it comes to providing the products and medications that our nation’s pets need and deserve,” he added in a release.

Power in numbersThe AVMA and more than 200 business and trade

associations from across the country are trying to level the playing field. They formed the Marketplace Fairness Coalition to support the passage of federal legislation, which would empower states to update their sales and use tax laws.

Businesses of every size, sector and channel of product distribution, including both brick-and-mortar and online sellers, have joined the group to advocate for modernizing the current sales and use tax framework so that all businesses will play by the same rules.

Congress is finally listening. Led by a group of bipartisan legislators, companion Senate and House bills were recently introduced. It is hoped that the Marketplace Fairness Act will level the playing field for all sellers and support a marketplace that is vi-brant, viable and equitable for everyone.

The Marketplace Fairness Act should

Marketplace fairness not the only issue when it comes to purchasing medications for horses

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• give all sellers the chance to compete in a free mar-ket without government preferences,

• relieve consumers of having to self-report sales and use taxes they already owe,

• exempt truly small businesses and• give states a road map for simplification that will

provide them with flexibility to respond to today’s evolving marketplace.

This is a good first start for veterinarians every-where, but another area where legislators really should look would have a real impact for equine veterinar-ians – the feed store. Many products can be purchased without a prescription at the feed store, even though the customer is not a licensed veterinarian.

I understand why the rules allowing farmers to do this were put in place, but those rules were enacted in another era when veterinary medicine was less sophisticated, and when it was farmers and ranchers who bought them.

There are so many reasons why this might not be a good idea today:• Many drugs have interactions with other products. • Animals just like people can have adverse reactions

that might need medical management.• Resistance to all kinds of products can develop

from overuse and misuse.• There are also survivalist websites that champion

the use of feed stores to stockpile veterinary medi-cations for themselves and their families to avoid a Dr. Miller’s books and videos are available for sale at www.robertmmiller.com

By Dr

. Rob

ert M

. Mille

r

doctor’s prescription. Isn’t it time for the FDA, USDA and everyone

else regulating animal medications to take a look at these rules? They've started taking a closer look at compounding pharmacies. This seems like a natural next step.

Although many end-users might think that the only reason why they go to the doctor or call the veterinarian is to get drugs, what they really get is years of education and experience – and that is the real reason why we should be getting prescriptions.

Marie Rosenthal, MSEditorThe Modern Equine Vet

The Marketplace fairness act should

give all sellers the chance to compete in a free market without government preferences

relieve consumers of having to self-report sales and use taxes they already owe

exempt truly small businesses

give states a road map for simplification that will provide them with flexibility to respond to today’s evolving marketplace.

Reach your veterinarians where ever they are, whenever they want.

FOr AdVerTisiNg rATes ANd iNFOrMATiON, eMAilMarie Rosenthal, MS


[email protected]

modernequinevetfeb1513

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