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In this video, Dr. Danielle Price shows you how to securely wrap a bandage around a horse’s lower leg. (Be sure to turn up your sound!)

Your veterinarian may recommended a foot poultice to treat a sole bruise, foot abscess or other condition. (Note that if your horse is shod, the shoe will need to be removed to place the poultice. Your veterinarian will advise you regarding shoe removal.) Wrapping a bandage around your horse’s hoof to keep the poultice in place can be tricky. In this video, Dr. Jacquelyn Dietrich shows you how to place a foot poultice and securely wrap a bandage around the hoof. (Be sure to turn up your sound!)

About EHV-1 Equine herpesviruses (EHV) are found in the majority of horses. Most horses have been exposed to the virus and have had no clinical signs or side effects. There are nine EHVs that we have been able to identify worldwide, but EHV 1, 3, and 4 are the strains that have caused clinical disease in horses. EHV-1 specifically has multiple manifestations of disease in horses: neurological form, respiratory form, and can cause abortion and neonatal death. There is also some evidence that it may cause chorioretinopathy (a disease process in the eye). Research has shown that greater than 80% of horses may be latently infected with the EHV-1 virus, but not all horses will develop clinical signs. The Science Behind EHM EHV-1 myeloencephalopathy (EHM) is still being studied today and we are constantly acquiring new information. There are multiple reports of theories describing how the virus causes neurological disease. A single point mutation in the DNA polymerase gene has been associated with neurological disease, causing the presence of aspartic acid (D) or asparagine (N) at position 752. AAEP reports that 80-90% of neurological disease cases are caused by D752 isolates, and 10-20% by N752 isolates. Recently, there has also been a proven association with a single nucleotide polymorphism at position 2254 in the DNA polymerase gene and the occurrence of EHM. The virus can become reactivated and furthers cell-associated viremia delivering the virus to endothelial cells in the uterus and central nervous system. Clinical signs occur due to the vasculitis and cellular damage caused by the virus. Infection of Horses Horses are affected through contact with respiratory secretion, aborted fetuses/placentas, or by fomites (infected objects, such as grooming tack). Following infection, a viremia is established as the virus circulates the body in infected cells. Following this, virus-infected cells are latently infected. Horses can shed virus in nasal secretions as early as day 1 of infection, and can continue to shed the virus for approximately 28 days. The virus can cause disease in infected horses or can re-activate from latency causing clinical disease in the horse. The virus can typically survive in the environment for up to 7 days, but this can vary based on the environmental conditions. Signs of EHM The incubation period of EHV is typically 4-6 days, but has the potential to be longer. Some clinical signs associated with the neurological disease may include: Fever Nasal discharge Hindlimb weakness Incoordination Loss of tail tone Lethargy Urine dribbling Head tilt Inability to rise Diagnosing EHM Clinical signs (neurological signs and fever) and isolation of the virus are how we confirm EHM. Isolation of the virus can be done using quantitative polymerase chain reaction (qPCR) from nasal swabs and blood collection. Treating and Preventing EHM After confirming EHM, implementing a strict quarantine and biosecurity measures under supervision of local and state veterinarians is key. Treatment options include anti-inflammatories and supportive care. Vaccination and biosecurity protection are the two ways to help avoid disease outbreak. No current EHV-1 vaccine has a claim to prevent EHM. Some EHV-1 vaccines can reduce nasal shedding and possibly viremia. By vaccinating your horses, you induce a strong immune response to the virus without inducing clinical disease. It is important to clean tack, equipment and the environment to inactivate the virus. Cleaning first with a detergent or soap to allow for removal of organic material (such as soil) is recommended in order to prevent disinfectants becoming inactive when they make contact with organic material. There are multiple effective disinfectants that will kill the virus, including 1:10 dilution of bleach to water. Other key points for understanding EHM prevention include: Immunity following infection or vaccination offers limited protection Boosting (routine vaccination) contributes to herd immunity to help protect individual horses It is difficult for the body to establish immunity due to “evasion” properties of this virus Early recognition and diagnosis is key Quarantine and close monitoring of suspected cases is important Exposed horses should have their temperature taken twice daily Please note that this virus is still being investigated and new research is constantly being release as we try to better understand EHM. Additional resources: AAEP: Equine Herpesvirus Resources California Department of Food and Agriculture: Equine Herpes Virus References: Allen GP. Risk factors for development of neurologic disease after experimental exposure to equine herpesvirus-1 in horses. American Journal of Veterinary Research 69,         1595–600, 2008 Diallo IS, Hewitson G, Wright L, Rodwell BJ, Corney BG. Detection of equine herpesvirus type 1 using a real-time polymerase chain reaction. Journal of Virological Methods          131, 92–8, 2006 Diallo IS, Hewitson G, Wright LL, Kelly MA, Rodwell BJ, Corney BG.            Multiplex real-time PCR for the detection and differentiation of equid herpes- virus 1 (EHV-1)          and equid herpesvirus 4 (EHV-4). Veterinary Microbiology 123, 93–103, 2007 Dunowska M. A review of equid herpesvirus 1 for the veterinary practitioner. Part A: Clinical presentation, diagnosis and treatment. New Zealand Veterinary Journal, 62,         171–78, 2014a Dunowska M. A review of equid herpesvirus 1 for the veterinary practitioner. Part B: Pathogenesis and epidemiology. New Zealand Veterinary Journal, 62, 179– 88, 2014b Equine Herpesvirus (Rhinopneumonitis). (n.d.) Retrieved March 7 2016, from http://www.aaep.org/-i-173.html Goodman LB, Loregian A, Perkins GA, Nugent J, Buckles EL, Mercorelli B, Kydd JH, Palu G, Smith KC, Osterrieder N, Davis-Poynter N. A point mutation in a herpesvirus      polymerase determines neuropathogenicity. PLoS Pathogens 3, e160, 2007 Pusterla, N., & Hussey, G. (2014). Equine Herpesvirus 1 Myeloencephalopathy. Veterinary Clinics of North America: Equine Practice, 30(3), 489-506.

San Mateo County Large Animal Evac (SMLAEG) provides evacuation services and shelter for large/farm animals in the event of disaster, such as wildfire or flood, or in other emergencies. These efforts include the evacuation of animals, caring for the animals in holding areas after evacuation, and facilitating the return of animals to their owner/agent. SMCLAEG is activated by the San Mateo County Office of Emergency Services, or other first responders, and its efforts are staffed by SMCLAEG's core team members and volunteers. SMCLAEG is an all-volunteer 501c3. The group also provides preparedness workshops and site inspections upon request. HOW TO CONTACT SMCLAEG: In an emergency, call 911. Tell dispatch that you need the services of the San Mateo Large Animal Evacuation Group. BE PREPARED! Visit https://smclaeg.org/preparation to learn more... Steinbeck Equine Veterinary Clinics works with SMCLAEG as their primary veterinary contact to advise on planning evacuations and during emergency evacuations. LARGE ANIMAL EVACUATION RESOURCES: • Monterey County • Santa Clara County • Santa Cruz County • San Mateo County

By Nora Grenager, VMD, DACVIM and Tim G. Eastman, DVM, DACVS, MPVM Many horse owners in central California may have heard of “Pigeon Fever” — and if not, now’s the time to learn about it. Although also seen throughout the southern United States, California is particularly well known for having a high incidence of this disease, especially during the late summer and early fall. The more arid parts of our state are hit harder by Pigeon Fever. Some years the prevalence seems to be much higher than others, with almost a cyclic nature. Pigeon Fever is caused by a bacteria called Corynebacterium pseudotuberculosis that can survive for long periods of time in the soil. The bacteria is likely to penetrate the skin through abrasions, small wounds, or enter by fly bites (most common). Once the bacteria has entered the horse, it proliferates in these warm, moist cutaneous environments. Pigeons actually have nothing to do with the disease, but it historically causes abscesses and dramatic swelling in the pectoral region of the horse, making the horse’s chest resemble that of a pigeon. Other names for the condition include “Dryland Distemper,” “Pigeon Breast Fever,” “Dryland Strangles,” and its bacterial name, Corynebacterium pseudotuberculosis. The typical signs of Pigeon Fever include abscesses anywhere along the ventral midline (i.e., especially where flies bite!) including the chest, sheath/mammary glands, or in small chains along the lymphatic channel of a leg. However, abscesses can develop anywhere on the horse (see facial abscess image). Large plaques of ventral edema are also frequently present adjacent to the abscesses (ventral edema causes sponge-like swelling on the underbelly of horses)(see edema image). Pigeon fever abscesses usually take several weeks to mature, open, and drain, but rarely the infection may be long-lasting and recurrent for over a year. Pigeon Fever should be considered at the top of the differential list in any horse that has a swelling or abscess in a typical location. The diagnosis can be confirmed by culturing fluid taken from an abscess and growing the bacteria in the lab. Uncommonly, C. pseudotuberculosis can instead cause an internal abscess (less than 3% of all cases). Horses with internal abscesses present with fever, weight loss, depression, and sometimes lameness. If a veterinarian suspects an internal abscess, there is also an antibody blood test that can be performed to help rule in or rule out the disease. This blood test is performed at the University of California at Davis and is very affordable. Treatment of Pigeon Fever can vary depending on the severity and the body system(s) involved. Draining the abscess is the mainstay of treatment (see drainage image) but should not be performed until the abscess is mature. If done prematurely, drainage can be painful and the abscess is more likely to recur. The maturity of an abscess can be assessed by palpation (they generally get soft in the middle when they are mature) and/or by ultrasound. Ultrasound is also helpful in determining if there are multiple pockets of fluid and in identifying deep abscesses. Once opened, the abscess cavity should remain open and it should be flushed daily with an antiseptic solution like povidone-iodine or chlorhexidine. Most horses will be completely over the disease within 3 weeks of the abscess being drained. Again, rare horses will have recurrent abscesses. Use of antibiotics is controversial in horses with Pigeon Fever. Many veterinarians recommend against administering antibiotics for external abscesses because of the potential to delay abscess maturation. However, in cases involving internal abscesses, those involving the lymph channels of a leg (“lymphangitis”), or with very deep abscesses that are difficult to drain and are causing the horse extreme discomfort, long-term antibiotics are generally prescribed. While horses affected with external abscesses have an excellent prognosis, internal abscesses have a more guarded prognosis. Once a Pigeon Fever abscess matures and the condition resolves, over 90% of horses will remain immune to the disease in the future. In those rare instances where the disease recurs, it is unknown whether recurrence is due to re-infection or relapse of the original disease. It is possible it is more likely to recur, or even occur in the first place, in horses with somewhat compromised immune systems. Prevention is centered on good sanitation practices and fly control. Quarantine of affected individuals is not generally recommended due to the long distances that insects carrying the bacteria can travel. A vaccine has recently become available from Boehringer-Ingelheim and may be advisable in naive horses at high-risk for disease. The use of this vaccine should be a discussion between each owner and his/her veterinarian. Related resources: Pigeon Fever Presentation Video by Dr. Nora Grenager

Published by the American Association of Equine Practitioners (AAEP) When an emergency or natural disaster occurs, it is always in the best interest of the horses for both the equine practitioner and the horse owner to be prepared. Foreign animal disease outbreaks or other catastrophic events can adversely affect the health and well-being of horses. Preparation is a key part of making sure your horses are safe and taken care of in a crisis situation. One must understand who the other resources are and what their plan is in order for a coordinated response to result. The American Association of Equine Practitioners (AAEP) has collected helpful links to make sure you, the horse owner, have vital information available before a disaster strikes. Learn more...

The Equine Disease Communication Center (EDCC) is an industry-driven initiative which works to protect horses and the horse industry from the threat of infectious diseases in North America. The communication system is designed to seek and report real time information about diseases similar to how the Centers for Disease Control and Prevention (CDC) alerts the human population about diseases in people.

The American Association of Equine Practitioners (AAEP) provides a wealth of information and resources for horse owners on horse health, how to find equine veterinarians and dental practitioners, disaster preparedness, disease outbreaks, and much more. “To protect the health and welfare of the horse” is one of the AAEP’s most important pursuits. The association and its members provide direct benevolent assistance to horses and charitable groups, including rescue and retirement facilities, international aid projects and emergency relief during natural disasters. Key industry initiatives, such as the Unwanted Horse Coalition and the Racing Medication & Testing Consortium, were formed from the AAEP’s sponsorship and commitment to equine welfare and practices in the best interest of the horse. .

Oral joint health supplements (OJHSs) “are a group of nutritional supplements that contain one or more non-nutrient, non-drug ingredient,” according to John P. Caron, DVM, MVSc, Dipl. ACVS, a professor in the Department of Large Animal Clinical Sciences at Michigan State University. With scores of OJHSs on the market, it can be difficult for horse owners to decide which one to try. Below you'll find an outline of the seven-step “ACCLAIM” approach to assessing OJHSs — for more details, see “Oral Joint Supplements for Horses” by Stacey Oke, DVM, MSc, published by The Horse. Below is a list of some common OJHS ingredients and what they may do to benefit horses, with dosage recommendations from the American Association of Equine Practitioners (AAEP). Note that combination products seem to have the best results. Steinbeck Peninsula Equine Clinics veterinarian, Amanda Hedges, reminds us that “Oral supplements rely on research in horses and other species to make claims for effectiveness. Challenges of oral supplements include lack of FDA-regulated supply, mixed results from evidence-based-research, widespread anecdotal claims, and palatability. Oral supplements may be beneficial in that they can be less expensive than some treatments and are relatively easy to administer. It is important to weigh out the cost vs. possible benefit as compared to other therapies, in the long-term.” For more information, see “Options for Managing Osteoarthritis” by Dr. Amanda Hedges.

By Laramie Winfield, DVM, DACVIM, cVA, CVMMP Annual vaccinations are a large part of our preventative health strategy here at Steinbeck Peninsula Equine Clinics. As your veterinarians, we are happy to be one of your main sources of information concerning your horse’s health and vaccines. However, we also realize that many owners would like additional opinions and sources of information. While there are many excellent sources of information available to you on the internet, there are also many sources of information that are misleading, incorrect, and full of misguided advice. The American Association of Equine Practitioners (AAEP) provides a compendium of sound information and Guidelines for Equine Vaccination. Should you vaccinate your horse or not? An article from Horse & Rider titled "Vaccine Wars: The Great Debate" does an excellent job of answering many of the common questions we hear about vaccination and if it is necessary for your horse. We do recognize that some horses are very sensitive to vaccination and alternative vaccine forms and schedules may be best for those horses. Each horse and situation may benefit from a different protocol and we are happy to develop an individual plan for you and your horse. Rabies is a fatal disease that can be transmitted to humans. Given the severity and significance of rabies infection it is included in the core vaccines recommended for horses. The UC Davis School of Veterinary Medicine offers more information in the article "Do Horses Need Annual Rabies Vaccination?" West Nile is a mosquito born viral disease transmitted to horses causing neurologic signs, fever, and in 30% of horses is fatal. Given that available vaccines are highly effective at preventing disease and safe to administer we strongly support the administration of vaccines to protect against West Nile Virus. The California state government monitors new cases an offers a website with updates and more information on West Nile virus.

By Laramie Winfield, DVM, DACVIM, cVA, CVMMP Veterinary medicine has changed in recent years, with more practitioners choosing to become board certified in a specific area of practice. This allows us to have a more precise focus in one particular area like surgery or medicine. To best serve your horse's needs, Steinbeck Peninsula Equine Clinics provide veterinarians board certified in multiple different specialties including general equine practice, surgery, internal medicine, and sports medicine and rehabilitation. Learn more about what it means to be a specialist... Learn more about some of our specialtIes: Equiine Practice Internal Medicine Surgery Sports Medicine and Rehabilitation

By Wade Tenney, DVM Published in Bay Are Equestrian Network in June 2007 There was a time when the only practical use of ultrasound in equine medicine was to diagnose pregnancies and bowed tendons. With recent advancements in ultrasound technology, the image quality has improved tremendously. It is now possible to identify subtle injuries and to image parts of the horse that before now could not be seen. In fact, you may be surprised at the number of ways that ultrasound is being utilized in equine medicine. The cornerstone of ultrasound use in equine athletes still centers around the tendons and ligaments that course down the back of the front and hind limbs. These supporting structures are under a tremendous amount of stress during exercise, making them prone to injury. We are able to evaluate the cross-sectional area (size), echogenicity (density) and fiber pattern of these soft tissue structures. Once the injury is diagnosed, recheck ultrasounds (generally at 60 day intervals) allow the veterinarian to evaluate the healing and strength of the injured tendon/ligament. This information allows the veterinarian to constantly adjust and customize your horse's rehabilitation program to prevent re-injury. The evaluation of joints is another important use of ultrasound in our equine athletes. While radiographs (x-rays) give us important information regarding the bony changes within a joint, we need ultrasound to evaluate the soft tissue structures within the joint. Some of the structures we evaluate include the joint fluid, joint lining (synovium), collateral ligaments, menisci and articular cartilage. The joints that we commonly evaluate via ultrasound include the coffin joint, fetlock joint, hock, stifle, elbow, shoulder and even the temporomandibular joint. By combining the information from radiographs and ultrasound, your veterinarian can get a very thorough picture of the condition of the joint. Ultrasound guided procedures have allowed veterinarians to fine tune many diagnostic and therapeutic procedures. Once the target area is visualized with ultrasound, a needle or biopsy instrument can be introduced and visually guided directly to the target area. For instance, ultrasound can guide a needle into deep joints such as the neck or hip so that they may be blocked or treated with steroids. Ultrasound can aid in the biopsy of deep organs such as the lung, liver or spleen. It can also be used to obtain a sample from a deep fluid pocket or internal abscess. One increasingly popular treatment is ultrasound guided injection of stem cells into a core lesion within a tendon or ligament. Without this useful tool, many disease processes would go undiagnosed or untreated. Fortunately, heart problems are not that common in horses. However, if your veterinarian diagnoses a heart murmur in your horse, ultrasound is an invaluable tool to provide information regarding cause and prognosis of the murmur. Ultrasound can tell us which valve is affected and how severe the regurgitant blood flow is. Ultrasound may also help guide the treatment plan; for instance, the treatment will be very different for a heart valve with an infection versus a valve with a degenerative lesion. Some ultrasounds have specialized programs to determine the size of heart chambers, thickness of walls, and the speed of blood through a valve. This information can be used to give a prognosis and potentially help determine if your horse is safe to ride. Ultrasound of the equine abdomen is more commonly implemented, especially in cases of colic, diarrhea, weight loss and liver or kidney disease. On the right side of the horse, ultrasound can visualize the cecum, right kidney, right liver lobe and right dorsal colon. On the left side of the horse, we can evaluate the spleen, left kidney, stomach and left liver lobe. The small intestine and large colon can be seen throughout the abdomen and can be evaluated based on size, motility and bowel wall thickness. Internal abscesses, such as those associated with pigeon fever or Strangles, may also be visualized with ultrasound. In many cases involving eye trauma, examination of the eye may not be possible due to swelling of the eyelids or severe cloudiness of the cornea. Ultrasound allows the veterinarian to evaluate deeper structures and assess the amount of damage within the eye. The iris, lens, optic disc and retina are all readily visible with ultrasound. This allows immediate treatment to begin without waiting for the swelling to subside so that a complete ophthalmic exam can be performed. As you can see, virtually every part of the horse's body can be evaluated to some extent with ultrasound. Ultrasound is a relatively inexpensive and non- invasive means to gather a lot of information regarding disease processes in your horse. So, the next time your horse presents himself as a "diagnostic challenge" ask your veterinarian if ultrasound might shed a little light on the problem...