Biltimore Final Ana

[Roger Rittenhouse-vmaxept <roger@vmaxept.com>]

The below paper was written BEFORE the Liberty Run ride. I tried to get
it posted before I went, had too many things going on .
So here is the final paper on that ride...

Biltmore- OMNI- The Rest of the Story


This paper will conclude the issue of my horse, OMNI, colicing at the
Biltmore50.
I will discuss the issues as I believe they are relevant and apply to
this one time situation. 
I appreciate all the input form Ridecamp. Many were right on the
problem. Some issues caused me to think and NOT ASSUME I had the
complete answer. 

I spoke at great length with Dr Kathleen Crandel MS Ph.D. ( not a vet),
with Jim Helfter of Advanced Bilogical Concepts, and a good many riders.
I sure appreciate their input advice and help in resolving this issue.

I did not buy into the conclusion that 'stuff happens'. I am still of
the opinion that a metabolic problem is rider error. That is, I missed a
major or minor problem with the horse, either at home or at the ride.
Repeat metabolic problems, indicate a problem with the horse (not
suitable) or consistent rider error. I wanted to know what I missed,
where was my error and how to help LIMIT this happening again. Did he
have a pre-excesting issue, or was this a one time occurrence.

Since I live very close to Univ. of Tenn. Vet school. We made an
appointment for an internal evaluation.

REVIEW OF PROBLEMS AND CAUSE EFFECT

1. EMPTY GUT NOT EATING - on Thursday or Friday. 	
	 UT Internal medicine.  We scoped his GI track.  I thank the riders who
suggested ULCERS. We found no real major damage and no active ulcers. We
did find there was old damage, estimated to be about 2 weeks old. The
diagnosis was 'thicking of the squamous metaplasia around the pylouis".
This means,  he had damage due to high levels of HCL acid. You can
create ulcers in  a  horse by not feeding him. The horse will produce
HCL all the time and fill the stomach. This results in an irritation to
the lining and eventually ulcers. This occurs because the horse did not
eat. Thus he gets acid indigestion, belly ache, then even when hungry
will not eat. Thus the problem gets worse. So 2 days with out eating to
fill his gut was the beginning of the problem. 
He had a void in the GI track that later in the race stopped to
function, thus colic. The rectal exam at the ride supported this or was
the proof of the empty gut. 
He ate at VC 1 - was very hungry, why then? He had flushed out the HCl
by working and drinking on the first loop, now he feels better and wants
to fill the void. However, we only stayed the 40 min hold. A longer time
spent in the hold would have greatly reduced the chance of the colic.
There was no indication a problem was in process.

Problem is how to manage the pre-race stress. It appears this horse 
gets to camp and frets. A normal willing eater, stops eating his normal
amount and picks at the same feed diet he gets at home. The problem
starts when we load up in the trailer.
UT Suggestion. Place him on a product that reduces the flow of HCl in
the gut. It is called GASTOGARD ( omeprazole). I do not think this is a
viable option. I am sure it will test, and what is the effect IF he eats
his normal amount  and does NOT have enough HCL to begin the digestion
process? Well, he may colic due to bloat or impactation.  I MAY consider
using this product( drug) when we haul to New Mexico. I have not found
the clearance time.

Dr Crandel and KER has a product called NEIGH-LOX. This is a unique acid
neutralizer. It only works to manage the HCL over load. Like Maalox. 
I use Maalox - as many of us do - In the electrolyte mix. The concept is
- we want to neutralize the acid that comes from the electrolytes. 
HOWEVER, too much Maalox will cause a Magnesium imbalance. This will
cause major muscle problems - like tie up. KER NEIGH-LOX contains NO Mg.
It is NOT a drug and is very safe, only problem it is controlled under
Rx. Has to do with the FDA approved active ingredient. The plan is to
use this or small doses of Maalox IF - (note IF)- he does NOT eat. That
is I will mange his acid indigestion only IF and WHEN it occurs. This
could be used before  and during the ride. Many endurance horses are
already on this product. I will be getting some. I suspect many of the
colics we see are caused by low gut fill and acid indigestion.

2. ELECTROLYTES and PRO-BI
	The issue of electrolytes in this case, is NOT an issue. He was not
dehydrated. As we have learned we should NOT put much value on the blood
test for Potassium (K), taken at the ride. ALL the horses tested were
LOW in K. But we do not really know what the actual internal level of K
was. They LOW K horses did not display the symptoms of low K. That is
tremors, erratic HR or random jumps in HR. This is not related to muscle
cramps or tie-up. The electrolytes and the dosage protocol I have been
using for this horse have been working - no need to change.
A low blood K level also indicated he did not eat enough, since most of
the free potassium comes from hay. I sort of align this concept with the
Ca - alfalfa problem of free and bound Ca. It's not the same but the
idea is close enough.  

PRO-BI - I feed the ABC liquid product. It is NOT LIVE cultures. It is
suggested by many that feeding LIVE cultures to the horse when there is
NO problem, will cause an imbalance in the micorflora. If you were to
feed LIVE cultures, the best product to use is one with many species of
microbes. I choose to use ABC PRO-BI since it is a product produced
from  fermentation process byproducts. It provides a medium that is
conducive to the growth of the correct species of microbes. I have been
using this product for years without PERCEIVED problems.

Old Sins Come BACK to Get You. Remember when I spoke about Fame the
Carbo-Rat and the trip to the OD. I did get this thrown back at me--
WELL- remember I feed electrolytes AND PRO-BI. At that time I did NOT
suspect that caused a problem. She had very mild colic 2 days after we
arrived and before the vet in. So we did not start..
It HAS been the position of Jim/ABC and myself - that you could NOT
over-dose the PRO-BI since it was NOT a live culture. 
Based on discussions with the staff at UT and others, I am NOT so sure
about this now.
The issue is - IF the horse is eating and the GI system  is working and
in- balance - don't mess with it. How do I know for sure - the addition
of a medium that is suppose to keep the system balanced,  does not throw
it out of a 'natural' balance for THAT horse. 
The more I read about the horses' digestive system,  the more I
understand why they get into gastric problems in our sport.
The problem with OMNI was too much HCL. The PRO-BI did not or could not
manage that excessive volume. The product will help balance the pH,  but
at what level and how much would be needed. I am concerned that
pre-loading with this MAY help to push the balance out.
Many of us have seen  this product get a horse out of trouble- GI track
- during a race. That is, given to a horse that has a microflora problem
and they come out of it very fast. I have seen it work on horses that
were going to be pulled. I gave 60 cc and within  20 minutes the horse
is eating and drinking and ready to go on. I am questioning the use of
it BEFORE the race. I will continue to mix it with the electrolytes as I
done for years, but I will not pre-load or use before the race.

3. WORMS - WORMER -ENCYSTED 
As I have stated,  I use Strongid-C for at least 10 years- since it was
developed. NEVER a problem. The reported and un-proven problem caused by
this product is  ANTERIOR ENTERITIS. An irritation of the lining of the
small intestine at  the junction of the stomach.
 I asked the UT staff, 2 DVM one Ph.D. , 3 lab Tech and a number of
others, HAVE you ever heard of this OR any other performance issue with
Strongid. They at UT had no idea what I was talking about. One vet said
they heard of this 'story' BUT all the scopings and colic and other GI
issues they deal with - they could not attribute ANY problem to
Strongid-C. Dr Crandle concurs.

So we went into Omni's SI and they were just fine. Not one indication of
a problem. So he is back on Strongid-c.

We need to go one step further. I called the FDA. I wanted to report the
problems with Ft Dodge QUEST and ask about STRONGID-C.
First - The Pd.- DVM - who was from Texas A/M - you know those Aggies
are NEVER wrong-
Said that QUEST is DEADLY - it should be off the market and NOT to use
it. They have MANY reports.
Next Strongid -C , or sure they heard that issue, UNFOUNDED, never
proven, no study to ever show it caused any problem.  NO known law suits
against PFIZER.

ENCYSTED STRONGYLES. This THEORY cannot be proven as a cause or a
pre-exsisting situation that could be associated with the Biltmore
Colic's. But I throw it out to think about it. As we have read, the
encysted strongyles will stay dormate UNTIL the weather is conducive to
the continued life cycle. That is they come out in the spring and early
fall. Now a horse on Strongid SHOULD not have this problem. However, If
I miss a few days of feeding - as occurs when we go on the road, or I
just don't feed today, the strongyles can get ingested and thus setup
shop. The Biltmore is the time of year they come out. 
So I took some fecal samples of Omni and a few of the others. Sure
enough I found small immature worms. I take a number of samples and make
up the float-mix and look at many slides to verify what I see. I have
pictures, so I know what to look for. I saw NO eggs, just bodies. Under
400x you can see the mouth- so gross.
I decided to give everyone BUT OMNI the Safeguard 2x dose for 5 days.
On advice, I only gave Omni a one time 2x dose. No need to stress his
digestive system any more - but I wanted to clean out some of the load
that was there.
Sure enough- additional fecal samples showed a high amount of worms
about 4 days after I started. 
It appears in my application on 6 horses, there were no reactions or
problems. I was amazed at the change I saw after the treatment. The
older horse's winter coats came off  in about 3 days, they all came up
in weight very fast and had great appetites. I was impressed. Now I know
this was poison - but per the 'experts' it is very safe and gentle. I do
however feed a dose of ABC DETOX every day during the treatment and for
the week after. Just in case there may be some toxic issues with the
horse. 


WHITE CLOVER  While there is adequate studies to prove there MAY be a
problem with some horses that are feed white clove. The probability this
had any thing to do with this problems is limited. We do not have any
white clove in our  pasture. He did ingest and inordinate amount at the
ride site. I walked him about quite a number of times on Thursday and
Friday. However the final analysis indicates there was not enough to
cause any problems. The main fact was he failed to eat enough hay.


OVER-RIDDEN. Depends.
 Over ridden for his physical condition. No. His working level HR  was
correct for him. He recovered on trail and at the VC very fast.
 Weather- same as we have here, NO.  Trail - The trail is not as
difficult as what I condition on at home, except Drucker Mtn - and we
walked in hand over that part.
Over-Ridden for current fuel load - YES, that is he ran out of gas,
because he was " half full".  A slower pace and longer time at VC would
or MAY have prevented the problem. Let him fill his gut back when he was
ready to eat.
WHAT'S NEXT- 
Liberty Run 50 this weekend. Can you say HUMID and HOT. This is going to
be a tough one. 

Plan - 
Pre-Race- normal electrolytes - 1/2 dose a few times during the day
before. Mix with Maalox and babyfood carrots. No pro-bi. Listen to gut
sounds. Monitor what he eats better. He will have his buddy along on
this trip. I also have feedbag to feed his grain- if it is in front of
him he will eat it
Give full dose electrolytes night before and in the AM
Use PRO-BI only at VC

Go slower - relative -no race -most likely about 7 to mph. Will be very
difficult to hold him back- get off and walk.  This is a very flat and
fast trail. 
Spend extra time in VC. If he wants to eat more - let him.
Electrolyte and pro-bi mid way on each loop - 1/2 dose to full dose -
depending on weather and speed.  Loops are 15/15/20 (10/10)

Since it is very easy - I do not plan on using any carbo supplementation
- other then feed ( he gets rolled oats and beetpulp. I will be taking
Glucose reading at each VC.


Off to Liberty Run


Roger