THE HORSE, THE VETERINARY PROFESSION AND EQUESTRIANISM’ FEI MEETING AT WEVA CONGRESS, , 2011

Morning session, chairman: Dr Colin Roberts:

9:30 Mr Graeme Cooke - Introduction - the horse, the veterinary profession & equestrianism Graeme Cooke graduated from the University of Cambridge Veterinary School prior to working in veterinary practice. He became a senior government policy adviser at the UK Department of Environment Food and Rural Affairs with particular expertise in planning, international trade and national strategy. He was a member of a Government panel for Bioterrorism and the UK government lead on equine health. In 2007, he won a scholarship to Cass Business School where he obtained an MBA with First Class honours. He then worked with a FTSE 100 Company leading biotech marketing strategy. He became Director of the FEI Veterinary Department in 2009 coordinating over a 1,000 FEI Veterinary officials. A Lt-Colonel in the reserve military forces, he served actively in Helmand province, Afghanistan in 2009 and was awarded an operational commendation.

9:40 Dr Warwick Bayly - The history of the equine veterinary profession A brief overview of the progression of the practice of veterinary medicine and surgery from that of "craft" to "profession" will be presented. 2011 marks the 250th anniversary of the creation of the first modern veterinarian school in Lyon, France. Prior to 1761, veterinary practice was definitely an art rather than science-based. Much has happened in the last two and a half centuries that has led to the quality of equine practice being regarded as the equivalent of anything available to smaller companion animal species and as good as or better than that offered to human populations in some parts of the world.

Warwick Bayly is Washington State University's Provost and Executive Vice President. He previously served as Dean, College of Veterinary Medicine and has a veterinary degree from the University of Melbourne, MS from Ohio State University and PhD from the University of Liege, Belgium. Dr. Bayly is a Diplomate of the American College of Veterinary Internal Medicine and a Fellow of the American Association for the Advancement of Sciences. He is a past-president of the World Equine Veterinary Association. He was named Washington Veterinarian of the Year in 2006 and received the Distinguished Alumnus Award from Ohio State in 2000. He is a co-author of the well-known textbook, Equine Internal Medicine. His professional interests are: equine exercise science and exercise associated diseases.

10:00 Mr Graeme Cooke - The role of the FEI in equestrian sport (for CV see above)

10:20 Dr. Hasneyn Mirza - The horse in India - past, present and future The fortunes of man have been borne on the back of a horse, at one time one’s life depended on it and now one’s existence depends on it. Exactly when this association with the horse started here is very difficult to say however according to Indian legend, the horse was created a winged animal. Beside its use in war, the horse was important in Indian eyes as an animal of sacrifice. In ancient India the horse was used predominantly for war and transport.

The four indigenous breeds of horses in India are the Kathiawari, the Marwari, the Manipuri Ponies and the Zanskar Ponies.

Tipu Sultan established stud farms in Ramnagar and Kunigal, there was a stud established in Tirhoot, Bihar in 1769 and the British established a stud in Babugarh in early 1800. was probably the only sport played on horseback in medieval India. The British brought organized to India and racing was started in Bengal in 1769, in the Madras Presidency in 1774 and in Bombay in 1796.

Today the horse is used predominantly for sport, transport and ceremony. The use of the horse in sport today is for racing, polo and equestrian, horse racing being the most popular. Show jumping, dressage, eventing, tent pegging and endurance are controlled by the Equestrian Federation of India there are over 3000 horses registered with them. Polo is controlled by the Indian Polo Association which was formed in 1892, there are 450 polo ponies registered with the IPA.

There is some fledgling breeding of the sport horse in India for polo and for show jumping. The future of the horse in the country is relatively secure.

Hasneyn Mirza is a practising equine veterinarian based in with both racetrack and stud farm practice. After graduating from the Veterinary College, Bangalore, he joined his family concern of the Kehelan Stud Farm until it closed in 2005. He spent some time with Rossdale and Partners in Newmarket, England. Dr Mirza is a Consultant to the Royal Calcutta Turf Club and an FEI Veterinarian for dressage, show jumping, eventing and endurance. He is the South Zone Steward for the Indian Polo Association and he has served on the Board of Directors of the Bangalore Turf Club. He is a scratch handicap polo player and he has competed in dressage at national level.

11:10 Dr Connie Herholz - Transportation of horses Connie Herholz is set to head the Equine Science Department of the Swiss College of Agriculture in 2012. She had been, for ten years, at the Equine Clinic of the University of Berne. Her PhD thesis was on lung function testing in the horse. She is a specialist in equine medicine and a Diplomate of the European College of Equine Internal Medicine. For eight and a half years, she worked at the Swiss Federal Veterinary Office where she was responsible for international trade and export market strategies.

11:30 Mr Bernard Duvernay - Shoeing the competition horse Nowadays our profession is in no way comparable to that practised 20 years ago. Our knowledge of anatomy, of foot-balance and of pathologies has become so much sharper. The technology of materials used today has moved forward greatly, compared to that of our elders. All these advances are the direct consequence of a much evolved veterinary medicine, producing very precise diagnoses, which benefit from the use of the latest high-tech imaging equipment, in every way comparable to that used in human medicine (digital X-rays, ultrasonography, MRI, scintigraphy, thermography).

Consequently, today’s sport equine vets, riders, trainers, owners are much more demanding of the farrier’s work and knowledge. The athlete horse requires very specific foot and shoeing care. It will be shod every 4 to 6 weeks, preferably always by the same farrier. The slightest change in the phalange angle, in the foot balance, a different shoe size or type may really make the horse uncomfortable, even useless for its rider.

It is difficult to talk in general terms of typical shoeing by discipline, especially for show-jumpers, eventer or dressage horses. Nowadays, there is one overriding rule to shoeing horses in these three disciplines: excessive shoe length or extension are an aberration for normal, sound feet.

Bernard Duvernay has been at the head of a farriery company in Geneva, Switzerland for more than thirty years. Named the ‘Flying Anvil’ by his colleagues, he has been travelling the world as a consultant farrier in famous stables and in development programs. He is a well-known lecturer and organiser of continuing education programs in many countries, visiting the best stud farms in India regularly for the last twenty years. He was admitted to the farriers’ Hall of fame 2011 in the USA for his contribution to the improvement of the farriery standard in many countries. In 2010, he created the ‘Flying Anvil Foundation’ to help farriery in remote countries where there are no education structures or programmes for the farriery profession.

11:50 Dr Richard Corde - Respiratory disease and the competition horse Treating a coughing horse during competition season may be a challenge with sometimes oppositions between medical requirements and sportive considerations. Improvement in sensibility of dosage techniques for prohibited substances may result in prolongation of detection times and delays for competition. Moreover most of the therapeutic regimens used in management of acute or chronic respiratory inflammation lack of clear data about their pharmacokinetic, particularly with aerosol way of administration. Therefore experience, prevention, and environmental considerations play a major role in management of respiratory disorders in the athletic horse, and most of all in the days before and during sportive events.

Richard Corde graduated from the National Veterinary School of Maisons-Alfort (Paris) in 1981. He has been a partner at an equine veterinary clinic in Grosbois, Boissy Saint Leger, France, since 1984. He is Vice President of AVEF (French Equine Veterinary Association), a member of the WEVA president’s advisory group and a member of the FEI List Group. He was WEVA President from 2006-2008 and he is President of the anti-doping commission of the French Equestrian Federation.

Afternoon session, chairman Mr Graeme Cooke

13:45 Dr Colin Roberts - The FEI and competition horse welfare: The Atlanta Project and the sport horse in heat and humidity Although the FEI is not a research organisation, it has cooperated with numerous research establishments to support studies that benefit the welfare of performance horses. Important areas of interest have included limb hypersensitisation, NSAIDs, horse transportation, heat and humidity, endurance and working surfaces.

Before the 1996 Atlanta Olympics, the FEI led a global research effort looking at the effects on horses of hot, humid conditions. This work quantified the physiological challenges of heat and humidity, determined acclimatisation rates in hot, humid conditions and demonstrated methods for rapid cooling of horses. No horses suffered serious problems due to heat and humidity in the Atlanta Games and the methods devised then are now routinely used in adverse climatic conditions.

Muscular effort has an efficiency of only around 20%, the remaining energy utilised being released mainly as heat. During strenuous exercise, heat production in the horse can increase by 40-60 fold over resting values. Since heat is lost over the body surface, the ratio of body mass:surface area is important and compared to humans, horses have a significantly higher ratio.

The horse has a high sweating capacity. For a 500kg horse maximum sweat rate may be 10-15 L/h and sweating results in considerable electrolyte loss. The clinical consequences of fluid and electrolyte depletion can be life threatening. Vigorous cold water cooling has been shown to be appropriate for horses showing signs of hyperthermia.

Low intensity exercise, with little increase in core temperature, has minimal effect on thermoregulatory capacity, but exercise that increases core temperature by 1.5-2.0C for 30-60 min/day improves heat tolerance during exercise. Thermal acclimatisation can occur relatively quickly (by 5-10 days) and further changes are slight after 14-21 days. Acclimation is possible with only partial exposure to heat and humidity; it has been reported following as little as 100 minutes per day including 80 minutes of exercise.

Colin Roberts graduated from the University of Bristol Veterinary School before working in equine practice in Kent, where he became a Fellow of the Royal College of Veterinary Surgeons. Later, at the Animal Health Trust, he ran the clinical exercise testing programme and obtained a PhD for research into equine respiratory disease. He is a freelance consultant in equine medicine, an Affiliated Lecturer in Veterinary Anatomy at the University of Cambridge and a Fellow of Sidney Sussex College, Cambridge. He is a member of the Scientific Advisory Group of the British Equestrian Federation and a member of the FEI’s Medication Control Panel. He is an author on many scientific papers and has acted as a treating veterinarian at many top-level equestrian competitions. His interests include equine internal medicine, equine welfare and equine sports medicine.

14:05 Mr Graeme Cooke - The next Olympic Games: London 2012 (for CV see above)

14:25 Dr Colin Roberts - Doping and medication control in FEI competitions (for CV see above) In equestrian sport, most medications are prohibited at the time of competition, based on the notions that horses should compete on their own merits without unfair advantage and, more importantly, that horses must be protected from being made to compete when ill or unfit to do so. The FEI Clean Sport Campaign, agreed at the 2009 General Assembly, signalled a new approach to medication control. The Campaign aims to provide those involved in equestrian sport with the information and tools needed to comply with medication control regulations (see www.feicleansport.org).

The Equine Prohibited Substances List divides prohibited drugs into two categories: Banned Substances and Controlled Medication Substances. Banned Substances are agents deemed to have no legitimate use in equine medicine and/or a high potential for abuse, e.g. human antipsychotic agents and anabolic steroids. Their very presence in a horse is taken as evidence of doping. Controlled Medication Substances are drugs that are recognised as therapeutic in the horse, but which have the potential to enhance performance. Horses must be clear of controlled medications at the time of competition. The FEI List of Detection Times defines time intervals for commonly-used medications to fall below significant levels of detection.

At FEI events, if a horse needs treatment, permission must be obtained from the Veterinary Delegate/Commission before medication is administered (in emergencies, retrospective permission can be sought). All treatments given by injection must normally be given in a designated treatment box. No intra-articular medication is allowed during competition.

Normally around 5% of the horses at an event are selected for sampling although the proportion may be considerably higher at major events. Most horses are selected randomly but at major championships there is an obligation to test medal-winning horses and specific animals may be selected. Ideally, both urine and blood are obtained, but if the horse fails to produce a urine sample, blood alone is used.

14:45 Mr Paul Farrington - The detection of hypersensitisation in jumping horses Methods to increase the sensitivity of jumping horses’ legs to make them jump higher have been part of the competition scene for many years. Different methods will be described. To sensitise a horse in this way has obvious welfare implications and in addition would give a competitor an unfair advantage over his fellow competitors. Various methods of control have been attempted mostly associated with bandage and boot checks after the horse has competed and at major events in coordination with the MCP programme. It has been shown that, except in the most obvious cases, it has been all but impossible to prove deliberate manipulation to increase sensitivity. Medication control through urine and blood testing and occasionally the use of leg swabs produces negative results. Meanwhile it is possible to see horses at competition jumping abnormally with increased height over the fence with undue flexion of the limbs.

The demand for greater control came from the riders themselves through the FEI Jumping Committee as a result of which a research programme was initiated reviewing the possible use of thermography together with a clinical examination. This work was carried out by Professor Jack Snyder in the USA. Subsequently a protocol for examination in competition was developed by the FEI in association with ‘field trials’ over the last few years.

One of the major changes that has taken place in the development of the protocol is that, knowing that it is very difficult to prove deliberate hypersensitisation, it is only necessary to prove hypersensitivity, a process that is carried out by appointed Veterinarians specially trained for the task and confirmed by the Veterinary Commission. It is considered that such a positive result does carry welfare implications for further jumping and an unlevel playing field even if the hypersensitivity has occurred for innocent reasons. A positive case results in immediate disqualification through The Ground Jury. Initial positive cases produced strong reactions from the riders involved and wide press coverage. However as the protocol has become more accepted positive cases this year have received minimal publicity in much the same way that a horse eliminated through lameness is reported. There is no doubt that the problem will continue and new practices developed to try and avoid detection so the FEI will need to maintain vigilance through the Clean Sport initiative.

Paul Farrington qualified from the Royal Veterinary College, London in 1970. He is an equine practitioner who started his own practice in 1977, which developed into a six veterinarian practice with surgical facilities. His special interest is sports horse medicine and orthopaedics, particularly in eventing, show jumping and dressage. He was Team Veterinarian to the British Three Day Event Team at the Olympic Games in Barcelona in 1992. Since then, he has worked as an FEI Veterinary Delegate at many events, including the Olympic Games in Athens and Hong Kong. He has served on the FEI Veterinary Committee and has helped develop the FEI education programme for veterinarians. For many years, he has acted as a consultant advisor to insurance underwriters in the UK.

15:50 Dr Hal Schott - Challenges to hydration in equestrian sport Equine athletic events may occur under challenging environmental conditions that can threaten effective thermoregulation. Because sweating is the primary means of heat dissipation in equids, prolonged exercise can result in substantial losses of body water and electrolyte content. Pre-existing dehydration from transport, subclinical illness, or medication administration may also challenge effective thermoregulation during exercise. Unfortunately, an occasional animal can become seriously overheated or exhausted and suffer organ failure and even death. Although dehydration contributes to development of these medical problems, the “exhausted horse syndrome” is likely multifactorial and remains incompletely understood.

Despite frequent access to water during prolonged competitions, most equine athletes lose about 5% of their body mass during endurance events, from both a loss of body fluid in sweat and a decrease in intestinal fill. Of interest, most of this body mass loss occurs during the initial half of competition, indicating that equids generally drink and eat at a pace that nearly replaces ongoing losses as the event progresses. However, there is a wide range of body mass loss during exercise with some successful athletes tolerating losses exceeding 10%.

A warning sign that a horse may be in the early stages of trouble during competition is a lack of thirst or appetite; unfortunately, this problem may not be reported to veterinarians examining horses at rest breaks. Other signs include a persistently elevated heart rate, a decrease in intestinal sounds, and a lack of impulsion that may prompt elimination from competition. When problems are detected early, many horses may recover without treatment although administration of fluids to “at-risk” horses has become a common practice at endurance events. Administration of oral electrolytes, at a rate to match 30-40% of expected losses, has also become a common practice and can result in greater water intake but benefits to performance are less clear. Finally, strategic planning of equestrian events, including course changes and active cooling efforts, have improved welfare of equine athletes that compete under challenging environmental conditions.

Hal Schott received his DVM degree in 1984 from the Ohio State University College of Veterinary Medicine. He began his career with three years in a private equine practice in Southern California. Dr. Schott subsequently pursued advanced training by completing a residency in equine internal medicine and a PhD in equine exercise physiology at Washington State University. Since 1995, he has been an equine medicine clinician at Michigan State University, with a strong clinical interest in both urinary and endocrinological disorders. In addition, he pursues a research interest of fluid and electrolyte balance in endurance horses.

16:10 Prof Tim Greet - The management of acute trauma in the competition horse This talk will give a brief overview of the management of a variety of acute injuries suffered by horses in competition. Many such acute injuries involve the locomotor system and the triage and immediate management of horses with fractures and dislocations is absolutely critical to the ultimate prognosis. The use of splints, casts and Robert Jones bandages will be described as well as the considerations for transporting such injured patients.

Wounds particularly affecting synovial cavities also carry a very guarded outlook if managed inappropriately. The various imaging techniques (radiography, ultrasound, MR and CT) and their value in specific circumstances will be illustrated. A few simple guidelines for the repair of the more common fractures and dislocations will be presented. The methods of confirming and managing synovial sepsis will be described. The repair or alternatively open management of wounds involving various parts of the equine upper body will be discussed.

Acute injuries to the head and upper respiratory system may also present with life-threatening complications unless dealt with in a logical manner. The use of tracheotomy tubes can be life-saving in the presence of severe upper airway dyspnoea.

Finally, the collapsed or fallen horse during an event can present amongst the most difficult and challenging situations for veterinary surgeons dealing with competition horses.

Tim Greet graduated from the University of Glasgow in 1976, obtaining a Master`s Degree there in 1977. He worked at the Animal Health Trust in Newmarket before joining Rossdale’s equine practice in Newmarket, becoming a partner in 1984. He is the practice’s senior surgeon with interests in general and minimally-invasive equine surgery. He has won numerous clinical prizes and has lectured around the world on equine surgery. He has published numerous papers in veterinary journals and has contributed to several textbooks. He is an Honorary Professor in the Clinical Department of the University of Glasgow Veterinary School and an Associate Lecturer in the University of Cambridge Veterinary School. He is a past President of the British Equine Veterinary Association and the British Veterinary Association, and is currently President of WEVA.

16:30 Dr Gina Pinchbeck - Epidemiology in the investigation of morbidity in sport horses Epidemiology is “the study of the distribution and determinants of health-, welfare- and production- related states in specified populations and the application of this study to control of health problems” and in the investigation of sport horse morbidities is an essential tool. Epidemiology can help us to determine what injuries are important and in what sports they are occurring using measures such as prevalence, mortality rates and population attributable fractions and assessing days lost from training due to injuries. More importantly it can provide direction for injury prevention by identification and quantification of risk factors for injuries and the introduction of preventive measures. In addition ongoing surveillance can identify changes in the frequency and circumstances of injury and allow appropriate investigation and action.

Previous epidemiological studies in FEI sports to date have been limited to the cross country phase of eventing where overall fatality rates (~0.2/1000 starts), injury rates (~4.5/1000 starts ) and fall rates (~7.6/1000 starts) have been reported. Identification of risk factors has been limited to those associated with horse falls in eventing.

In contrast, injuries in the sport of horse racing has been extensively studied allowing international comparisons. In the UK the British Horse racing board monitor and assess all racecourse injuries and fatalities, enabling examination of yearly trends and prompting numerous focused studies on particular injury types and in particular race types. In addition focused studies on injuries sustained in training have been conducted.

In human sports there are numerous examples of studies both in single sports events and also in multi-sport events in high level competitions such as championships and Olympics. FEI sports can use and improve on experience gained in these other sports to develop a quality injury reporting system that will enable accurate reporting of injury rates, direct focused studies on disease risk and allow progress to made in the prevention of horse injury.

Dr Pinchbeck graduated in Veterinary Science from Liverpool University in 1993. After some time in practice she completed a training scholarship in equine medicine and surgery, obtaining an RCVS Certificate in Equine Surgery (Orthopaedics). She then completed a PhD in Epidemiology at Liverpool University, investigating risk factors for falls and injuries in National Hunt horses in the UK. Following this, she took a temporary lectureship post in Veterinary Epidemiology at Massey University, New Zealand, before returning to Liverpool as a Senior Lecturer in Epidemiology. She is a Diplomate of the European College of Veterinary Public Health. Her research involves epidemiological studies of injuries in horses. She teaches postgraduate epidemiology to students on Masters programmes in Veterinary Infection and Disease Control and Epidemiology.