Search Our Website

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

Watch this video of a presentation on EHM by Dr. Nora Grenager. (Be sure to turn up your sound!) Related resources you may also be interested in: California Department of Food and Agriculture (CDFA): Equine Herpes Myeloencephalopathy (EHM) Fact Sheet California Department of Food and Agriculture (CDFA): Equine Herpes Myeloencephalopathy (EHM) FAQ American Association of Equine Practitioners (AAEP): Equine Herpes Virus Resources American Association of Equine Practitioners (AAEP): Equine Herpes Virus FAQ

Watch this video of a presentation on equine allergies by Dr. Amanda Hedges. (Be sure to turn up your sound!) Related resources you may also be interested in: “Equine Allergies” (Article) by Amanda Hedges, DVM, cVA, CVSMT “Maximizing the Golden Years: Care for the Aging Horse” by Amanda Hedges, DVM, cVA, CVSMT and Nora Grenager, VMD, DACVIM

By Amanda Hedges, DVM, cVA, CVSMT, published in the San Mateo County Horsemen’s Association (SMCHA) Newsletter, Q1 2021 An Immune System Gone Awry Molecules that irritate our horse’s bodies are all around. One of the jobs of the immune system is to protect us from the harmful effects of these irritants, maintaining the balance between stimulus and an appropriate response that keeps a horse healthy. Equine allergies can occur when an irritant or combination of irritants disrupts or overwhelms the immune system’s balance. An allergic reaction may be severe and life-threatening (anaphylaxis), sudden (acute), or more slow/insidious in onset (chronic). Signs of an Allergic Reaction Signs of allergies often appear as an immune system overreaction, resulting in local or systemic inflammation. We see hives, itching, oozing, scabs, hair loss, tearing, coughing, breathing changes, nasal discharge, hair loss, poor performance, and even gastrointestinal upset. Anaphylaxis is a severe acute allergic reaction characterized by increased respiratory effort, rate, or noise, recumbency, and/or shock. Anaphylaxis is a medical emergency necessitating immediate veterinary intervention. Sometimes an allergic episode (e.g., hives) is a one-off and other times a horse has developed allergies to something in his/her environment. Restoring Balance To restore balance to the immune system in non-life threatening cases, we need a two-fold approach: 1) decrease the irritants 2) calm down the immune system. Let’s look at some common equine allergens and what we can do about them. Common Allergens Changes in the environment and the horse’s immune system can make it difficult to identify the cause of a horse’s allergic response. Some common equine allergens include: Insects: The most common culprit of chronic skin allergies is the saliva of the Culicoides fly (a.k.a. gnats, no-see-’ums). Other fly species, other insects, and even arachnids (spiders) can cause an allergic response. Environmental: Components of dust, different molds and mildews, different plants and pollens, and even some topical products can all cause allergies. Note that food allergies are not common or well-understood; it is more common for a horse to be allergic to the components of dust on hay than the hay itself. Treatment Strategies for Equine Allergies Treatment strategies focus on minimizing the presence of the allergen and influencing the immune system to restore balance. Common treatments include: Environmental management: if you know what your horse is allergic to from an allergy testing profile (see “Desensitization Injections” below), then you can minimize his/her exposure to specific irritants. General recommendations to decrease irritants revolve around fly control and dust control, both of which will add fuel to the fire of an overactive immune system. Fly control: Remove manure from the living area at least once daily. Make sure that your horse is stabled far from the manure collection area. Consider feed-through fly products, fly traps, automatic fly spray systems that use permethrin, overhead fans, fly sheets including belly coverage, fly masks including ears, fly boots, natural predators (bats, birds, wasps), and other fly control strategies. Dust: Consider wetting down your horse’s hay at each feeding. Stable your horse away from dusty arenas, and avoid riding during times of peak arena use. Good ventilation is also good. Diet change: While food allergies are not common, it is even more challenging to diagnose allergies due to dusts, molds, and contaminants in hay. A trial diet can help assess the contribution of diet to an allergy response. A novel food source, for example timothy pellets, is fed for 3 months, and the horse’s allergy signs are monitored. If allergy signs improve, then a food allergy is suspected. Other feeds can then be added to further identify the allergen. Often wetting down the feed is helpful to minimize the amount of inhaled aerosolized allergens. Medications: Steroids: Short- or long-acting steroids may be used to help suppress the immune system. Steroids can have some unwanted side effects, so use the lowest dose needed for the shortest amount of time. Combine with environmental management, antihistamine, and omega3 fatty acid supplementation for better effects. Antihistamines: A key molecule in the allergic response is histamine. Oral antihistamines, such as hydroxyzine, cetirizine, or diphenhydramine, can suppress the histamine response. Unlike steroids, these drugs are safer for long-term use though they can make some horses a bit sleepy. Your vet can advise on which drug may be the best for your horse, and the ideal duration of treatment. In horses these medications are better at preventing an allergic reaction than at treating a current one. Supplements: Some supplement ingredients can help support the body’s immune system. In addition to good quality hay or pellets and a vitamin/mineral supplement, horses with allergies may benefit from: Omega3 fatty acids: Research supports that horses fed a high dose of omega-3 fatty acids may have a decrease in allergy signs, possibly by decreasing the inflammatory response. This should be used long term as effects are not immediate. Equine-specific research is poor or lacking for other compounds reported to help with allergic reactions such as ashwagandha (found in some plants in the nightshade family), American ginseng (plant in the ivy family), astragalas (herb in the legume family), MSM (an organosulfur compound), quercetin (a plant flavanol), spirulina (a biomass of cyanobacteria), and turmeric (in the ginger family). Combinations of these ingredients can be found in brand-name supplements and in traditional Chinese herbal medicine formulations. Immunotherapy (aka allergy shots): For a personalized treatment, consider requesting an allergy test. Two test protocols are available to identify the specific allergens to which your horse is reacting. The most precise test for skin allergies is called intra-dermal skin testing. To perform this test, a veterinary dermatologist injects a small amount of different environmental irritants under the skin and then monitors the strength of the horse’s immune response at 30 min, 4 hours, and 24 hours. The second option is blood sample, while this is a more convenient way to test for allergens, it is thought to be less specific than intra-dermal testing. Following testing, a personalized allergy shot protocol is developed for your horse, with a dosing regimen to slowly introduce the allergens to your horse’s immune system without overwhelming it, resulting in a more appropriate response. Environmental management is again key to maximizing the success of this treatment plan. While the frequency of injection decreases over time, most horses require life-long treatment to keep allergy signs at bay. Allergy desensitization is a great way to manage skin allergies long-term; it greatly reduces the allergic response in most horses (though give it up to a year to work fully). There’s not much proof that allergy desensitization shots work very well for respiratory allergies. Allergies and Aging With time, both the environment and your horse’s immune system will change. New irritants can come in the form of new landscaping, new products, changes in air quality, etc. As horses age, there is some evidence that they can experience immunosenescence, or the gradual weakening of the immune system over time. Both of these factors may mean that your horse’s allergy status and immune system needs may change with time. If you notice any allergy signs, contact your veterinarian to discuss further options! Setting Expectations It may take weeks, months, or even years to find the perfect combination of immune-support and environmental control to rebalance your horse’s body. This plan may need to be regularly adjusted depending on the season. After establishing a treatment plan with your veterinarian, it may take weeks to see results. Complete resolution of all clinical signs may not be possible. With patience and persistence, almost every horse can find some degree of relief from allergies.

Watch this video of a presentation on pigeon fever by Dr. Nora Grenager. (Be sure to turn up your sound!) Related resources you may also be interested in: “Pigeon Fever” by Nora Grenager, VMD, DACVIM and Tim Eastman, DVM, DACVS, MPVM AAEP Infectious Disease Guidelines: Pigeon Fever EDCC (Equine Disease Communication Center)

By Nora Grenager, VMD, DACVIM Equine gastric ulcer syndrome (EGUS) is prevalent in our equine population and can be a cause of a huge variety of clinical signs ranging from suboptimal performance and behavioral issues to poor appetite and mild colic. It has been estimated that 50 to 100 percent of adult horses have gastric ulcers depending on level of work and management practices. Unlike in humans, a horse’s stomach continuously secretes gastric acid because horses were designed to graze throughout the day. The equine stomach is divided into two parts — a smaller upper squamous portion (about one third) and a larger lower glandular portion (about two thirds) — separated by a raised border of tissue called the “margo plicatus.” The upper squamous portion is like a continuation of the esophagus; the lower glandular portion is where acid is produced. EGUS occurs when there is an imbalance between gastric acid secretion and the stomach’s normal protective mechanisms. Types of Gastric Ulcers There are two syndromes of EGUS that have different predisposing factors, signs, and treatments — gastric ulceration in the squamous portion and gastric ulceration in the glandular portion. The glandular portion of the stomach secretes acid and other compounds. It has intrinsic protective mechanisms to deal with acid and is accustomed to acid exposure. Ulceration in this portion is likely due to both an increased acid exposure as well as a decrease in its protective mechanisms. Gastric ulcers in the squamous portion is likely due to the fact that this region is not accustomed to, nor equipped for, acid exposure. The majority of gastric ulcers in the squamous portion of the stomach occur along the margo plicatus, which is closest to the glandular acid-producing portion. Risk Factors Factors that likely predispose horses to glandular ulceration include stress and administration of nonsteroidal anti-inflammatory drugs, called “NSAIDs,” such as phenylbutazone (Bute™), flunixin meglumine (Banamine™), and less commonly firocoxib (Equioxx™). Stress decreases the stomach’s natural protective mechanisms. NSAIDs also decrease the stomach’s natural protective mechanisms, more often with high doses or long duration of treatment. Factors that predispose horses to squamous ulceration include infrequent feedings, high concentrate diets, and intensive training. Stress and NSAID administration can augment these processes in this region as well. Feed deprivation or infrequent feeding has been found to cause gastric ulcers because when the stomach is small and contracted the squamous portion of the stomach is exposed to acid. The byproducts from fermentation of high concentrate diets can also cause acid injury of the squamous portion. Consuming hay and the salivation that accompanies eating (because saliva contains natural buffers) help to buffer stomach acid. Intense exercise potentially increases intra-abdominal pressure and delays gastric emptying time, which increases the exposure of the squamous portion to acid. Clinical Signs Many instances of gastric ulceration probably go unrecognized. Interestingly, the severity of a horse’s clinical signs does not correlate with the degree of gastric ulceration. Horses with EGUS may have poor or picky appetite, weight loss, rough hair coat, poor performance, poor body condition, sore back, “girthy” behavior, or changes in attitude (the horse may seem “grumpy”). A horse with EGUS can present with excessive teeth grinding or excessive salivation, mild recurrent colic or even a more severe acute colic episode, though this is uncommon. Diagnosis Suspicion of EGUS may be based on history and clinical signs, but evaluation of the stomach with an endoscope (a procedure called “gastroscopy”) is the only way to confirm the presence, type, and severity of EGUS. This procedure can be performed at the barn or at a referral veterinary facility. The procedure is usually done in the morning after an overnight fast (the horse must be fasted for a minimum of 12 hours prior to gastroscopy so that the stomach is empty for evaluation). The horse is typically sedated and the endoscope is passed through the nostril down the esophagus into the stomach. The presence, severity, chronicity, and type of gastric ulceration is determined. Unfortunately, there is no blood or fecal test available that can accurately diagnose EGUS. Treatment Several types of drugs are available and commonly used to treat EGUS, and it depends on whether ulceration is present in the squamous, glandular, or both parts of the stomach. Treatment duration usually lasts 4–8 weeks. The gold standard treatment for squamous ulceration is omeprazole (Gastrogard™), a proton-pump inhibitor drug that directly blocks acid secretion. It is formulated as a flavored oral paste given once daily and has been proven to most effectively cure gastric ulceration. Ideally this is given on an empty stomach, 30–60 minutes prior to feeding (so usually first thing in the morning or just before lunch). Antacids (such as aluminum or magnesium hydroxide and calcium carbonate) can help relieve immediate clinical signs, but do not effectively treat the ulceration. Antacids also have a short duration of effect and need to be administered orally every 2–3 hours so they are not convenient for long-term treatment. The typical treatments for glandular gastric ulceration include sucralfate and misoprostol, sometimes along with Gastrogard™. Sucralfate coats ulcerated areas and stimulates the GI tract’s own local protective mechanisms. It is sometimes used alone, or in conjunction with Gastrogard™ for mild to moderate cases of glandular ulceration. Misoprostol is used for moderate to severe glandular ulceration (usually in conjunction with sucralfate +/- Gastrogard™). It increases the body’s own protective mechanisms against glandular ulceration. It cannot be used in pregnant mares and it can occasionally cause transient cramping at the start of administration. Therapy is typically tapered off rather than stopped cold turkey. We usually recommend repeat gastroscopy at the end of the treatment interval to assess the response to treatment. Most cases of squamous ulceration respond well to appropriate treatment, but glandular ulceration is less predictable. Some cases respond well to one month of treatment, while others require longer; unfortunately, it is difficult to predict into which category a horse will fall. Last but certainly not least, it is widely believed that EGUS does not occur in a vacuum. There is typically something else driving the condition — be it musculoskeletal pain, other GI pain, stress, or feed changes. It is very important to try to home in on any other potential causes to maximize the efficacy of your treatment and prevent recurrence. Prevention Gastrogard™ given at a quarter dose once daily (called Ulcergard™ — available over the counter) is effective at preventing the formation of gastric ulcers. This is often recommended around times of stress or NSAID administration in horses at risk for EGUS. Corn oil added to the feed has also been shown to help increase gastric pH (i.e., decrease the amount of acid), although some horses can become “hot” with corn oil supplementation. It has been shown that supplements containing pectin and lecithin can help prevent EGUS, and mineral-rich calcified marine algae helps prevent squamous ulceration. Most importantly, prevention of EGUS involves recognition of situations that may predispose a horse to gastric ulceration. Horses on high doses of NSAIDs or long-term treatment with NSAIDs are theoretically at higher risk for EGUS. Horses in training or who are fed high concentrate meals without access to roughage are at an increased risk. Performance horses are not the only horses at risk for EGUS, as severe ulceration has been diagnosed in recreational and retired horses in seemingly calm environments. It is important to keep EGUS in mind if a horse is being exposed to potential stresses, particularly those horses that have had EGUS in the past. Recognition of clinical signs with appropriate diagnosis and treatment of EGUS improves attitude, performance, and quality of life for our horses.

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. .

Watch this video of a presentation on nuclear scintigraphy by Dr. Jacquelyn Dietrich. (Be sure to turn up your sound!) Learn more about Nuclear Scintigraphy at Steinbeck Peninsula Equine Clinic...

Watch this video of a presentation on equine colic by Dr. Danica Wolkowski. (Be sure to turn up your sound!) Related resources you may also be interested in: “Equine Colic: What to Expect,” by Nora Grenager, VMD “Enteroliths: A Rock and a Hard Place,” by Timothy G. Eastman, DVM, DACVS, MPVM “Colic in Horses: What You Should Know,” by Timothy G. Eastman, DVM, DACVS, MPVM “Colic Questions Answered,” by Lindsay Berreth, published in Chronicle of the Horse “Colic Updates and Prevention,” by Dr. Nancy Loving, published by American Association of Equine Practitioners (AAEP) “Colic: Minimizing Its Incidence and Impact in Your Horse,” published by American Association of Equine Practitioners (AAEP)

Watch this video of a presentation on equine geriatrics by Dr. Amanda Hedges and Dr. Nora Grenager. (Be sure to turn up your sound!) Related resources you may also be interested in: “Options for Managing Osteoarthritis” by Dr. Amanda Hedges “Choosing Oral Joint Supplements" “End-of-Life Considerations” by Dr. Amanda Hedges