RCVS Practice Standards Scheme
As you will see from the logos on this page, we are now a fully accredited practice within the Royal College of Veterinary Surgeons accreditation scheme. All our branches are individually accredited which means they have each been inspected and accredited separately. The small animal practices in Cubbington and Coventry have been accredited and approved to meet the standards required to treat companion animals. Several of our neighbouring small animal practices have also been approved. However, our equine practice based at Weston-under-Wetherley, Leamington Spa premises has been approved as a level two equine practice, and also our farm animal practice, also based at Weston has been separately approved as a level two farm animal practice. Currently we find the next neighbouring accredited equine practice is thirty five miles away and sadly, a reflection of the state of agriculture, the next approved farm animal practice is even further away. We actually were inspected about a year ago and as a result were registered in June 2005. However, there were issues with the health and safety aspects of the use of our new x-ray machine, which at that time had not been delivered and installed. This new powerful x-ray machine has now been delivered and commissioned. To gain final approval from health and safety authorities and the Royal College of Veterinary Surgeons, this installation had to be inspected by official agencies and our written instructions for the safe use of this equipment had to be approved and certified. Some of the delay has admittedly been due to our staff work load, but liasing with official bodies takes a tedious length of time. This Royal College Standards scheme has been developed over a number of years, but actually only came effectively into existence from the beginning of 2005. The scheme might be roughly compared to the British Standards I.S.O. scheme for businesses. We have not only to staff the practice with suitably qualified personnel, to have certain equipment, i.e. proper modern anaesthetic machines, sterilisation equipment, x-ray machines, scanning equipment and to provide in house laboratory facilities, but the premises must be in good physical order. We have to meet all relevant health and safety regulations and be able to show we have good business practice and proper ways of maintaining records both of clinical history and business. To meet these requirements, particularly on the equine and large farm animal departments has required the production of a large amount of paperwork and this is what has taken so much time. We were however pleased to find we already met or exceeded all the equipment levels required.

Azoturia
This year has proved to be slightly unusual in that we have had longish dry spells and then some rain, which has encouraged grass to grow rapidly on otherwise well grazed and even poached pasture. Apart from resulting in a sudden increase in laminitis cases, we have had a spate of azotoria (equine exertional rhabdomyolysis, set fast, tying up). This is always described in books as occurring in horses principally kept in, being fed high concentrate diets, and having not been exercised. However, it also occurs in horses kept at grass, usually fairly fit and subject to periods of fairly intensive exercise. We have recently seen it in Games Ponies and Showjumpers. The animal typically is brought in, groomed, tacked up and taken on exercise. After about twenty minutes, the animal begins to shorten its stride and slow up. If the animal is pushed on, it quickly shows reluctance and even inability to move. If this happens, transport should be summoned and the animal taken back to its box, unless the distance is very short the animal should not be forced to walk home. When examined it will be found that the horse has the greatest difficulty in moving its hind legs, and the muscles of its hindquarters are stiff, hard and sore to touch. If the animal has to move in its loose box, it will often do so by moving its front legs in an arc of a circle, pirouetting round its hind legs without moving them. Though not described in the books, we have had several cases recently where the horse is stuck and unable to move in its field, and needs to be transported back to its stable. These cases which we have seen recently seem to be related to sudden spurts of rapid grass growth after a period of heat and drought. The diagnosis can easily be confirmed by blood enzyme measurements. The treatment is basically box rest and careful diet management based on hay and water until the enzyme levels fall (over days) and then a careful return to exercise and work. The point of this note is to make owners aware that this condition can occur off grass.

Summer pasture related ROA disease
The other condition we have been seeing recently, and is weather related, is summer pasture related obstructive airway disease, or sometimes known as summer pasture COPD. This looks like the ROA (or COPD) sometimes called hay fever seen in housed horses in winter on dry hay. Instead of occurring when the horse is stabled, it occurs when the horse is turned out at grass. The horse has a dry, non productive choking like cough and ‘heaves’ when it breathes out. Wheezing can often also be heard at the nostrils. These horses, in contrast to those suffering from COPD, are better when kept in. These horses with summer pasture COPD will be better if given Ventipulmin in their feed, but most respond very well to steroid preparations used for human asthma. These medicines are administrated by a simple equine inhaler, usually twice daily, which takes about a minute and is well tolerated by the equine patient.

Sarcoids
At last we have a spell of warm weather, the ground is beginning to dry up and competitive equestrian events are beginning to take place again. This means that people are buying and selling horses again with more enthusiasm. A very frequent question we are asked, is about warts or sarcoids – not necessarily the same thing. People report that they have been offered a very nice horse “but it has a tiny wart on its inner thigh, it will be alright wont it?” Well probably it wont be alright because it is probably a sarcoid. A sarcoid is a locally aggressive non-malignant fibroblastic tumour of the equine skin and is probably the most common neoplasm (cancer) of horses. It is commonly accepted but not yet proved that the cause is a virus that causes warts in cattle. It appears that susceptibility may be inherited. Certain breeds are also more susceptible.

Sarcoids rarely cause irritation. The lesions come in various forms but appear warty, or proud flesh like. The growths sometimes are round and smooth on a stalk. Sometimes the animal appears to develop a type of immunity and the sarcoid is pushed up out of the skin which eventually ruptures and a smooth solid ball is pushed out – like a horse chestnut coming out of it’s shell. If this white ball is cut through it is found to be solid with no apparent change from outside to inside. The flat ‘crocodile skin’ type of sarcoid may remain fairly stable for years before nodules begin to sprout and spread.

Sometimes sarcoids regress and disappear on their own, or as above is rejected and pops out of the skin. Treatment is rarely totally successful and most treatments just halt growth for a while because the wart puts out web like growths under the skin for considerable distances. Surgical removal will usually result in some of these growths remaining to grow again. Surgical removal, with the use at the same time of local electrical burning, freezing, or irradiation is rarely successful. Application of tissue toxic agents has been tried with some success and this is the basis of some of the commercial products on the market. Strangely the use of human BCG vaccine as used in children has been very useful particularly in the case of sarcoids near the eyelids where other forms of treatment would be too dangerous to use. The BCG is injected into the growth on two or three occasions. The BCG works as it stimulates the animals immune response particularly to tumour specific antigens. Probably the most common treatment for sarcoids is the use of an ointment developed by Liverpool University Vet School containing heavy metal salts. This has proved to be 80 - 90% successful. However we must remember that equine sarcoid is a skin tumour (cancer) and only very very rarely can it be treated totally successfully. The take home message is that in the end an equine sarcoid is likely to curtail a horses usefulness and quite possibly it’s actual life so don’t buy one even it is a very small insignificant lump!.

Spring Worming
In this issue of the newsletter we would like to revisit worming: Spring seems to be on the way and those pesky wrigglies will start waking up soon. We are all aware that we need to reduce our usage of wormers in order to prevent resistance building up in the worm population, but when should we be using wormers and which ones? The important worms and treatments are detailed below: Large strongyles (large roundworms) and small strongyles (small redworms or cyathostomes) We recommend a strategic worming programme for these, including regular poo-picking from pasture, rotation of pastures where possible and 3 monthly faecal worm egg counts (WECs). This enables us to worm affected horses only, thereby reducing the chance of resistance and saving you money on the cost of wormers. Small redworms can become encysted (hidden in the gut wall) during the winter and then emerge in large quantities in the spring, sometimes causing very severe weight loss and diarrhoea. Therefore we recommend using moxidectin (Equest, Equest Pramox) in November and February if your horse is at risk (eg. he/she has not been on a suitable worming programme during the grazing season).

Tapeworms Large numbers of these can sometimes cause colic and so we will often take a blood sample to check for these if a horse has had colic with no obvious cause. Horses should be given praziquantel (Equitape, Equimax, Eqvalan Duo) or double dose pyrantel (Strongid P, Pyratape P) twice yearly. We recommend Dec/Jan and June/July Bots Ivermectin (Eqvalan, Eqvalan Duo, Equimax, Eraquell) should be used once a year in Dec/Jan. Eqvalan Duo or Equimax can be used to treat bots and tapeworm at the same time. Ascarids (roundworms) These normally only affect foals because immunity is acquired by the time the animal is 1 year old. Therefore, foals should be wormed with pyrantel (Strongid P, Pyratape P) or praziquantel (Equitape, Equimax) at 3, 4 and 5 months of age. Worming the mare will help reduce problems for the foal. Please contact us for more information.

How do we know our wormers are working? We can test this by doing a faecal egg count reduction test (FECRT), where dung samples are tested before and after using a wormer. If the WEC is still high after worming then we know there is resistance to that wormer. Correct dosing It is important to dose wormers correctly for the weight of the horse, especially with youngsters. We saw a case back in the autumn of 2008 where a yearling had been given a massive overdose of wormer. It consequently collapsed and required intensive treatment to save its life. The weight of a horse can be estimated using a weigh-tape. How do I get a WEC done? Please collect a fresh walnut-sized piece of dung from each horse to be tested, package it in a waterproof bag, label it and drop it to us at our surgery in Weston. Alternatively, we can receive these samples at our Cubbington or Wyken small animal branches. The cost of a WEC is £9.20 + VAT. A 5% discount is offered if 3 or more samples from same yard are brought in for testing at same time.