The State of Equine Practice
Glimpsing into the future of equine medicine via the work and research underway at the UC Davis Center for Equine Health.
In the last decade, veterinary medicine has embraced new technologies, from advanced equipment to new computer software, which has elevated our ability to treat patients and educate veterinary students and residents. “In many cases, technological advancements have provided alternatives to using live animals in classes and laboratories,” said Carrie J. Finno, DVM, Ph.D., Diplomate ACVIM (LA), director of the UC Davis Center for Equine Health.
Another focus in recent years has been the response to diversity, equity, and inclusion (DEI) initiatives and recognizing the need to provide underrepresented students with the same opportunities and exposure to veterinary medicine, she said.
“In the future, we will likely see a shift towards precision medicine, similar to what we are seeing in human medicine. Precision medicine targets treatments and prevention to the patient’s specific needs based on genetics, biomarkers, metabolisms, etc.,” Dr. Finno said.
From technology, to culture, to the way horses are treated, equine medicine is poised to see many changes in the coming years. And education hubs like the UC Davis Center for Equine Health (CEH) are poised to be at the forefront of those advances.
The mission of the UC Davis Center for Equine Health (CEH) is to advance the health, welfare, performance, and veterinary care of horses through teaching, research, and outreach. This is accomplished by providing academic leadership and by serving as the organizational umbrella under which equine research is funded and conducted at UC Davis. “We bring together research facilities, students, veterinary residents, researchers, and veterinarians to tackle important problems affecting horse health,” Dr. Finno said.
Research findings are directly applied to patients of the UC Davis veterinary hospital, facilitating continuous improvements in the standard of equine veterinary care.
The CEH also plays an important role in the training of future veterinarians, academic clinicians, and researchers by providing valuable hands-on learning opportunities to undergraduates, veterinary students, residents, and graduate students.
Through these research and educational efforts, the faculty and staff of the CEH continually strive to provide new information and improved diagnostic and therapeutic options to benefit the owners of California’s diverse horse population and beyond.
New technologies and treatments
Since 2015, CEH has been proud to provide funding for research and development associated with Dr. Mathieu Spriet’s work to adapt positron emission tomography (PET) to horses, Dr. Finno said. A nuclear medicine technique similar to scintigraphy, PET reflects physiologic changes but displays the results in three dimensions with increased anatomical accuracy. Depending on the radiotracer used, information can be collected for either bone or soft tissue. UC Davis was the first veterinary institute in the world to use this imaging technology for equine patients and was the first to offer PET scans to clinical equine patients.
“Today, several veterinary hospitals across the country and around the world are utilizing PET scanning in horses,” Dr. Finno said. “This type of imaging has had an important impact on reducing the risks of catastrophic fractures in racehorses.”
A truly groundbreaking advancement has been the ability to perform advanced imaging in the standing horse, she said. In the past, horses had to undergo general anesthesia to obtain diagnostic images with modalities such as magnetic resonance imaging (MRI), computed tomography (CT), and PET. The ability to utilize these technologies on standing horses under sedation allows for more routine use and provides more options for patients that are not able to undergo anesthesia. It also reduces the time and costs associated with obtaining diagnostic images.
“Another exciting area that is developing quickly is the ability to perform testing for infectious diseases, such as equine herpes virus 1 (EHV-1) stallside, as opposed to sending samples out to laboratories, to maximize our ability to control outbreaks at shows,” Dr. Finno said. “Horses are more mobile than ever, regularly traveling locally, nationally, and internationally for competitions. Dr. Nicola Pusterla has been leading the research in this field. Advances in detection of infectious diseases is important to ensuring the health of performance horses.”
Practicing equine medicine today
The business model for equine veterinary medicine, in which the practitioner travels to the horse in most cases, is different from small animal practice, in which the majority of patients come in to the clinic. In rural areas especially, equine practitioners often must drive significant distances between visits, meaning that they can see fewer patients per day than, say, a small animal practitioner working in a local veterinary clinic.
“These differences are compounded when it comes to emergency coverage and responding to non-emergency calls after hours,” Dr. Finno said. “Equine practitioners often feel that they are always on call. In fact, many equine clients have their veterinarian’s personal cell phone number. The expectation that equine practitioners are available to respond at all hours, even for non-emergencies, leads to burnout for many veterinarians.”
From a financial perspective, equine practices carry higher debt loads than small animal practices due to the need for vehicles to travel to see patients, specialized equipment, etc. Equine practitioners also generally have lower starting salaries compared to companion animal practice, but graduate from veterinary school with similar student loan debt. This makes it hard for new practitioners to catch up financially.
“We are also seeing a bit of compartmentalization in veterinary medicine in which veterinarians pursue specialties such as radiology, surgery, ophthalmology, etc.,” she said. “These
specializations are important, but when many people specialize, we lose the generalists who are critical to overall horse health.”
The American Association of Equine Practitioners (AAEP) has launched an Equine Veterinary Sustainability Initiative to address many of these issues, support one- and two-doctor practices, and provide outreach to horse owners and industry partners. A shortage of equine practitioners would become an equine welfare issue, so it is important to recruit and retain equine veterinarians. UC Davis is committed to recruiting and retaining the next generation of equine veterinarians.
CEH has undertaken several noteworthy initiatives recently. For instance, in December 2021, Gina Bornino Miller donated her 52-acre Templeton Farms equestrian property, located in Templeton, California, to CEH. This additional location will provide new opportunities to bring veterinary students, residents, researchers, and veterinarians together to tackle important problems affecting horse health.
UC Davis alumna Bornino Miller and her late husband William J. Miller opened Templeton Farms for business in 2011 as a world-class sport horse training, sales, and breeding facility near Paso Robles. Templeton Farms has been home to generations of carefully and lovingly bred performance horses, as well as a thriving boarding program.
Templeton Farms is currently serving as a second location for CEH’s contagious equine metritis (CEM) quarantine program for imported horses. Future plans include expanding opportunities for undergraduate and veterinary student teaching, as well as offering veterinary services.
Also noteworthy is the future Equine Rehabilitation Center that will be housed at CEH. The facility, part of the future UC Davis Veterinary Medical Center, will feature world-class services, including an equine underwater treadmill, vibration plate therapy, a covered Eurociser, and more. UC Davis is committed to providing horses with the highest levels of innovative care through cutting-edge clinical treatments and solution-oriented research, Dr. Finno said. Future plans include expanding equine sports medicine and rehabilitation services, offering a dedicated equine sports medicine and rehabilitation residency program, and providing opportunities for advanced research to inform protocols and guidelines in these areas.
Horse health pioneers
At CEH, Dr. Finno has been leading the Pioneer 100 Horse Health Project, a first-of-its kind precision medicine study in horses. In the future, genetic data and advanced diagnostics could be used to tailor medical treatments to an individual horse’s genetics, its environment, and the interactions between the two. The goal is to be able to create a scientifically sound wellness program using a combination of multi-omics (genomics, proteomics, metabolomics, etc.) approaches focused on disease prevention. Data from this project could help evaluate, for example, how a particular patient is likely to respond to one drug versus another, making it possible to target treatments for the most successful outcomes.
“At UC Davis, we are looking forward to construction of the future UC Davis Veterinary Medical Center, which will set the gold standard of care while defining advanced clinical research and education,” Dr. Finno said. “It will be home to more than 30 clinical specialties and supported by an extensive array of clinical laboratories to provide comprehensive and innovative patient care. The center will advance the hospital’s ability to handle the ever-increasing caseload while allowing for the adoption of the latest technologies.”