Live from CVC Kansas City: Equine veterinary medical updates

Thomas Divers, DVM, DACVIM, DACVECC, of Cornell University College of Veterinary Medicine, offered CVC Kansas City attendees a sampling of research and practical developments that can aid equine veterinarians with their patients.

> Fecal transfaunation. A new therapy that has been used with a 90 percent success rate in human medicine has also been used successfully in horses with diarrhea under Divers’ supervision at the Cornell veterinary hospital. In this procedure—called “bacteriotherapy” in human medicine—a fecal sample is obtained from a healthy, Salmonella-free donor horse, diluted with water and transmitted into the ailing horse via tube. Horses (and people) treated in this way can have normal feces the next day. The procedure is most successful in treating diarrhea associated with Clostridium difficile or antibiotic-associated GI upset, Divers says.

> Cryotherapy and laminitis. Divers is extremely enthusiastic about using ice to prevent laminitis in toxemic horses. “We know that it works,” he says. He adds that it’s important to use crushed ice—not cubes, which can stick to the skin and cause dermatitis and cellulitis—mixed with water to form a slurry. This mixture is held in a 5-liter bag or specially designed boot that wraps around the horse’s foot. Testing has shown that the hoof stays cold for up to an hour after the ice is removed, Divers says, so if a horse steps out of the boot or the bag falls off, “it’s not an emergency.”

> Coronavirus outbreaks. In the fall of 2011 and spring of 2012, coronavirus-associated disease broke out in adult horses in four states—California, Texas, Wisconsin and Massachussetts—causing pronounced anorexia, fever and, in some horses, diarrhea. The outbreaks were notable because coronavirus typically causes problems in foals rather than adult horses. Although researchers describe the disease, which is transmitted via a fecal-oral route, as “self-limiting,” two horses did die, Divers says.

> Foal diarrhea testing. A 10-disease PCR test manufactured by IDEXX has been used to test the feces of neonatal foals with diarrhea, Divers says. Findings by researchers suggest that, while coronavirus infection does not necessarily cause clinical disease on its own, when combined with other pathogens such as Cryptosporidium species, it does. This means co-infection may be a possibility in many instances of diarrhea.

> Analgesia. Divers says he and others have realized that meloxicam is well tolerated and highly effective for pain control in horses. “It’s not approved for horses, but it’s been tested, so we know the pharmacokinetics,” Divers says. “It’s got a nice ratio of COX-1 and COX-2 inhibitors, and the oral form is generic and reasonably priced.” Divers says that the drug is well-tolerated in horses and shows no evidence of causing damage to the stomach.