A Veterinary Outreach Tradition

The view from the top

What November means to me: turkey (of course), warm days and cool nights (usually), northern wave swells and a cooling ocean (freezing already), the end of pelagic fishing (it never really started this year), and an annual trip to the Havasupai Reservation in the bottom of the Grand Canyon. VCF (Veterinary Christian Foundation) led by Dr. Rick Marshall has been providing annual veterinary services to the Supai Tribe for 27 years. Traditionally, we travel to Peach Springs, Arizona, on the Saturday before Thanksgiving and overnight at the Hualapai Lodge on Route 66. Sunday morning finds us motoring to Hilltop, 60 miles to the north, readying ourselves for the eight mile, 2000 foot drop from the Canyon rim. Monday and Tuesday are work days and Wednesday, the day before Thanksgiving, we helicopter out so all can be home for the holiday. This year we flew out in a snow storm.

Supai

The valley floor

The mailman is packed and leaving for Hilltop

Packing his own feed

Supai, Arizona, is the only town in America still served by the US Postal service on horseback. There are no roads. There are no cars or trucks. One walks or rides on horseback or takes the helicopter (when it is running) to get down. Once in Supai, one walks or rides on horseback. A few have a golf cart. There are several tractors and back-hoes for maintenance of the trails and paths and campgrounds at the magnificent Falls. The first of three, Navajo Falls, is located about 1.5 miles further down the Canyon from Supai. The majority of the commerce is based on horse transportation of goods, services, and tourists. All the horse feed (bags of pellets) is imported into the canyon on horseback. The pack trains haul the majority of the Tribal needs down the hill daily with the helicopter supplying the rest on the two days it routinely flies. 

The Havasupai people have inhabited this spot for the last 800 years and until the reservation system was forced upon them. Traditionally, Winters were spent on the plains above the canyon where they hunted wildlife,  gathered pine nuts and traded with other Tribes. In the Spring, they returned to the Canyon, living in the cracks of the walls and farmed the small river valley. They have never been known to be a militant people but rather shy.

Dr. Chandler always enjoys his work in Supai.

My first trip was in 1994 along with my wife of three weeks, Rhonda. That experience has had a prolonged and profound impact on my family. All of our kids (3) have made multiple trips with us since and I have had the pleasure of both Dr. Chandler's and Dr. Oman's company on trips as well. I've met dozens of dedicated people willing to donate their time, expertise, and resources to the Supai community for nothing more than the satisfaction of "loving thy neighbor as you love yourself". 

This past November, there were 34 in the VCF group: 10 veterinarians, 4 junior veterinary students, several medical technicians, a couple of contractors, family members, a fireman, and the remainder were from various churches from California and Nevada. After arriving in Supai on Sunday afternoon, we participated in a huge turkey dinner for the community in the church where over 100 people were served. There are approximately 600 inhabitants. Several hundred live outside the reservation in Phoenix, Flagstaff, Kingman etc. Those people always miss their home in the Canyon.

Havasupai Bible Church (and Veterinary Clinic)

For two days, the veterinarians provide their services. Neutering (spays and castrations) dogs and cats is paramount for animal population control. All that are brought to the church based improvised veterinary clinic are vaccinated and wormed and health issues are attended to. Rabies is a problem for the community so it is essential the dogs and horses receive rabies vaccinations. Last year, one of our veterinarians ended up having to take the rabies prophylaxis treatment when he was bitten and the dog died later the next day! On the large animal side, we vaccinated (West Nile, 5 way, and Rabies) and wormed about 250 horses/mules; a small number since many animals were turned out on the new grass above the Canyon. Dr. White, from northern California, floated teeth and used the opportunity to teach the vet students proper dentistry. I castrated horses and performed other surgeries deemed necessary while students and "horse people" did the vaccinations and wormings. All in all, the process becomes an efficient machine after the first few hours of "cluster". The rest of the VCF group have their own activities: construction, children's outreach, women's outreach, and making acquaintances providing encouragement and prayer when asked.

Small animal surgery recovery room

Pack horses on the way down.

Over the last two years, the Supai village has been the victim of flooding. Rain falling miles away washed down the Canyon floor, through the lower extent of the village and over the Falls into the campground. They have been economically devastated as a result. The campground is closed and once again they are attempting to resurrect it so tourism can return. The village of Supai is closed to outsiders at this time. The Lodge and the restaurant closed down. More jobs lost. Packers have no work without tourists (normally 60K people a year) and commerce.

The Havasupai Lodge at the bottom

I'm not asking for anything from you, our cherished clients. I wanted you to know about the Havasupai people and the efforts made to serve them. If you have interest, you should plan on visiting Supai this Summer. You can trailer your horses to hilltop, ride down to the campground and spend some relaxing time with your family and friends. The packers will deliver pellets to you and there is water everywhere (the river). Otherwise,you could walk down and stay in the Lodge and take day hikes to the Falls, explore the old living quarters in the cracks of the walls and there are wall paintings from the "Old Ones" to explore. But, I will warn you, it is as close to third world as you can get in the continental US. You won't be pampered but you will be contributing to a society that needs your visit and consumerism.

I am certainly happy to answer any questions. Try "Google-ing" Havasupai Tribe. There is quite a bit of information available.           Greg Smith, DVM

Narrow path, tall walls

Sunday night after the community dinner

Nice elk rack

On the top of Navajo Falls 

Dr's Cuadras, Smith, and Oman on the chopper out

Equine Holiday Cheering

The pictures are of an aged mare that was rescued by a rescue facility. One of our clients re-rescued the mare. To be sure the rescue facility was giving good and proper care but had her for a relatively short time before our good hearted human made "Honey Bunny" her own. She has made a wonderful transformation, I hope you agree.

In the near future, you will be hearing more from the San Diego Equine Safety Net Coalition of which ECLAP is one of four equine veterinary practices to be on the Board along with horse rescue facility owners and county officials. Our aim is to "Keep the horse in its home" by offering material, educational and veterinary help to horse owners struggling to do so. The Coalition is on the brink of findings ways to identify horses and their owners that have a TRUE need of a temporary helping hand. We will be providing several educational opportunities to the horse owning community in 2011 and asking your help in identifying animals in need.

To Blanket or Not to Blanket (Does my horse need one?)

Deciding when to blanket your horse can be  challenging, especially in San Diego.  When your friends in Minnesota are laughing at you because you blanket your horse, just explain to them how you actually had frost on your car in late November.  The northerners just can't believe that it can actually freeze here in sunny SoCal.  Cold winter nights combined with thin coats (developed after multiple 100 plus degree summer days) can produce some easily chilled horses. 

Blanketing needs will vary from horse to horse based on their coat condition and tolerance for the cold weather.  You will find that horses that have moved to San Diego from colder climates, will develop much thicker winter coats.  

Here are some simple yes or no questions that can help you determine if your horse should be blanketed. A "yes" answer to any one means your horse would appreciate a little extra insulation.

1. Is it below 50 degrees Fahrenheit? Even if your horse has a natural (unclipped) haircoat, he may appreciate a blanket at this temperature. This is just a general rule of thumb, since other factors (such as wind, humidity and/or precipitation) may call for a blanket when it's warmer. On the other hand, some horses acclimate to colder temperatures, especially those with thick haircoats.
2. Is his coat clipped? If so, your horse may need a blanket (or at least a sheet) when the mercury drops|}below 60 degrees F.
3. Does he usually live indoors? If your horse lives even part of the time in a warm barn, he'll feel the cold more than a horse that lives outside full time.
4. Does he live in an open pasture? A full-time outdoor horse will grow a heavy coat to ward off the elements, but wind and rain can destroy that insulating effect. If there's no shelter in his pasture, he may need wind- and water-resistant horse clothing to stay warm.
5. Is his stall drafty? Drafts in your barn may have the same effect as outside breezes--they blow away that layer of warm air next to your horse's skin, making him feel colder.
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6. Is he shivering? Don't go by formulas--check your horse to see whether he's too cold. If he's shivering, blanket him (or add blankets) and get him to a shelter. (To see if your horse is too warm, slide your hand under his blanket; if he's sweaty, he needs a lighter covering, or none at all.)

It is important to remember to remove blankets in the morning as temperatures can get really high on many San Diego winter days.  
These question have been adapted from an article written by Dr. Hower-Moritz that was published in horse and rider magazine.

What's Your Diagnosis: The Foot Problem

So the answer is.... "Canker"  

Brenda Nellums is the winner.  She got the question correct. Valerie and Mary were actually very close as Canker can be secondary to a bad case of deep central frog thrush. 


 Equine canker is described as an infectious process that results in the development of a chronic hypertrophy of the horn-producing tissues.1 It generally originates in the frog; may remain focal, but has the capacity to become diffuse and invade the adjacent sole, bars and hoof wall. Canker can occur in one foot or multiple feet may be involved.  The etiology of canker remains elusive but wet environmental or moist unhygienic conditions have traditionally been thought to act as a stimulus, however, canker is commonly seen in horses that are well cared for and horses who receive regular hoof care.


http://www.thehorse.com/ViewArticle.aspx?ID=2782
Here is a link to a more in depth description of Canker found in "The Horse" magazine. 

November E Letter 2010

November 2010 ECLAP E-Letter Dear ECLAPers, "Spring is sprung, the grass is riz...."   But wait - this is the first week in November - usually the hills are still brown, dry and dusty.  Not this year.  The dust is down - the air is clear and there is "sprigs" of green everywhere - what great conditions for a ride.  Now if we could just get rid of those pesky flies things would be perfect!  There is lots of information to pass on to you so let's get on with the show. ANNUAL CHRISTMAS OPEN HOUSE Don't forget to mark your calendars for this year's Holiday Season Open House.  The venue is a great place for good food and fellowship - and an opportunity to swap stories with others in the large animal community - or to come by just to see how awkward the ECLAP vets look in dress clothes! Event Details: Saturday December 11, 2010 From 1pm to 4pm Food and Beverages will be served Location: 10312 Quail Canyon Road El Cajon, CA 92021 Please R.S.V.P. if possible by December 8 619-561-4661 or email info@eclap.org See you there Rain or Shine!!!!   EMAILS, WEBSITES, and DECALS....Oh my! First- We have changed our E Mail address to info@eclap.org - we will continue to respond to the old address through the first of the year - and then it will be discontinued. Secondly - If you haven't already - you should browse through our new web site at www.ECLAP.org.  There are many added features - which we will highlight in each of the E Letters. Here is a tip for this month. Many of you have called the office wanting information from a previous E Letter - well now you can retrieve that information in the searchable archives of all the previous  E letters.  Click on the "Client Education" tab on the top of the home page - and then click on "Newsletters" in the drop down menu.  At the top of the page you will find a search box where you can type in a key word from a previous E Letter and magically (since we don't really understand how this process works) - the article or reference that you are looking for will appear!  More tips next month (OOOhhh - we bet you can hardly wait). Thirdly- We look forward to the waves from all of you when we are on the road - it helps to keep us in the chipper and perky mood you have come to expect.  But the problem is there are so many white trucks on the road - that many of you look for the license plates to identify us - and that makes one more thing to do while driving along with fiddling with your blue tooth wireless earpiece.  So - in order to make us more noticeable - we are labeling the trucks with a small (smile) sign on the back.  So far we have 1 truck with the inconspicuous decal - but hopefully all the trucks will be done by the end of November.  Now that you can see us - don't forget to wave! Fourthly- Don't forget to follow us on Face Book and Twitter for articles, quizzes, photos and other fun info! And a Few More Items From the Office: Starting in December we no longer will be continuing the VetStreet Pet Portals. This service seemed to receive more complaints than praise regarding the automatic email reminders. We will now be emailing you vaccine reminders directly from our info@eclap.org email address. We hope this method will be more benefical to you.  Dormosodan Gel: We recieve many requests from clients for a sedative other than acepromazine to use for body clipping, trailering, the farrier, etc. Until now there was no good alternative. This new oral sedative comes in a gel form that we can perscribe for your horse with instructions and it is only $31.00 a tube/dose. EXERCISING OUR BRAINS In a continued attempt to provide your animal family member with the highest quality of care - we are constantly sending off ECLAP vets to continuing education seminars throughout the year (Comic Con does not count!).Dr's Smith and Chandler have both attended advanced equine dentistry seminars this past year - and Dr's Chandler and Oman will be attending the American Association of Equine Practitioner's Convention the first week in December.  This year's meeting will be in Baltimore, Maryland.  We hope to take excellent notes so we can share some pearls of wisdom in next month's E Letter. Only a Bunch of Christmas Shopping Days Left..... It seems as though the Holidays are all blending together!  Pretty soon we are all going to be confused - exchanging Pumpkins on December 25th, taking long stockings out to collect candy in October, and dressing up in costumes at the end of November!  But the reality is - at today's pace - the days can fly by.  And - there are always those people who seem to have everything and you rack you brain trying to find a gift that is unique and useful.  We can help!   ECLAP CASH CARDS are a great solution - they can be used for veterinary services (give the gift of good health!) and at many local vendors (the list is on our website).  You can buy ECLAP Cash Cards at our office - or if the Holidays are going to put a crimp in your schedule - you can call the office - give us the name of who you would like to honor with some Cash Cards(and give us your credit card info of course) - and we will send them for you in a special gift envelope with a note inside.   How could shopping be easier!  Now you can sit back and enjoy the family and friends Thanksgiving event worry free. THE NEW DEWORMING APPROACH Strategic De-worming based on fecal egg counts is gaining speed - we are now running around 50 fecal egg counts per month - so many of you have made the conversion to the new approach.  We seem to all have a good grasp on how to imposed this program on adults(2 years of age and older) but there have been many questions concerning young horses.  And for those of you who asked - it is a very good question.  Here is the answer.  Young horses are treated differently for 2 reasons. The first is that they have not developed naturally immunity to the parasite world so parasite issues are more common.  Secondly -  and in concert with the first point - young horses have to deal with Ascarids - a parasite not common in adult horses because of the acquired immunity mentioned above.  Ascarids have a migratory phase through the lungs and can create permanent damage if not controlled.  For those reasons - the older style of De-worming every 2 months irregardless of fecal egg counts still applies.  We start at 2 months of age - using Pyrantel paste (Strongid for example) as the first de-wormer  - then Ivermectin at 4 months, and then Anthelcide at 6 months.  This rotation is continued for the first year - then during the second year - when ivermectin is due - use a product that has Prazyquantel in it - such as Ivermectin Gold, Ivermectin Plus or Equimax.     Another option would be to use a daily dewormer - such as Strongid C - starting at 2 months of age - still giving ivermectin paste at 6 months and 1 year - then an ivermectin plus prazyquantel at 18 months and 2 years - then start strategic deworming by doing a fecal egg count approximately 30 days after the last dewormer was used at 2 months of age. SUTURES OR NOT??? We get this comment frequently - "I don't know if it needs sutures or not".  Well here are some guidelines when a wound cannot be sutured: 1.  A wound cannot be sutured if the skin edges cannot easily be brought together without tension.  The picture below shows a laceration over the knee with some loss of skin.  On exam - the skin edges could not be brought together so this wound was treated with cleaning and bandaging. 2.  In general - wounds that are greater than 12 hours old are contaminated and are very difficult to get clean enough to suture - the exception to this are wounds to the head - these can be older and still possibly be sutured. 3.  Puncture wounds  are generally not sutured as these usually have bacteria that have been forced into deeper tissues and will need to be open to drain. 4.  Wounds that have been grossly contaminated with dirt, gravel and manure at the time of injury - these are very difficult to get clean enough to suture shut  as dirt and debris tends to  "stick" to exposed tissue. And to Make You Even More Popular At Parties..... Throw this one out at your next social events to dazzle your friends.  During exercise and increased oxygen demand horses can increase the number of red blood cells available to carry oxygen by contracting its unusually large spleen (a storage organ for red blood cells among other things).  This infusion of red cells causes the blood to actually get thicker - or more viscous.  Now if that in and of itself does not have enough "wow" factor - the equine heart valves are specially designed to tolerate these changes in viscosity.  You and I would effectively "sludge out" and "check out" under the same circumstances. We hope you have a wonderful Thanksgiving with your family and friends filled with fantastic food and great times! Sincerely, The Staff and Doctors at ECLAP Dr. Greg Smith, Dr. Craig Chandler, Dr. Daniel Oman, Dr. Carlisle Rand Feature Promotion Try phrases like: dramatic savings, clearance, overstocked, reduced rates, buy 1 get 1 free, treat yourself, you deserve it, and don't miss out. Add a "Learn More" link at the bottom of your promotion to drive traffic to your website. Our Price: $ List Price: $ S & H: $   $20 Fall Fecal Special For the month of November we are offering our Fecal Egg Count which is usually $27.00 for only $20.00. If you would like this test done for your horse simply collect a fresh "road apple" and put it in a ziploc bag and bring it over to our office and we will be happy to run it for you! For more information about why you would do this, read our article above about our Strategic De-Worming Program. Offer Expires: November 30, 2010

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Thrush- Prevention and treatment

Now that we have gotten our early rain storm and our horses are experiencing mud, for the first time in 6+ months, it is time for hoof problems.  Thrush is the most common problem the foot will experience as your horse stands in wet footing.  Attached is great article from the horse magazine on prevention and care of thrush.

http://www.thehorse.com/pdf/factsheets/thrush/thrush.pdf

ECLAP OCTOBER E-LETTER

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