The 2018 AAEP Meeting – A Summary (blog)
Above is the Marriott at the San Fransisco 2018 AAEP meeting. I was on the 35th floor overlooking all of downtown.
Veterinarians are smart people and well-educated scientists. They may love horses and have compassion for their health and care. Unfortunately, they have been trained to fix things without really understanding why they have occurred. Let’s look at what I have seen so far in the 2 days here.
The first egregious lectures were presented at 6:45 in the morning by manufacturers and had no educational credits associated with them because they were agenda-driven. The two I attended were given by international feed companies (Cargill and Purina) and each had a Ph.D. nutritionist as their presenter. They knew their stuff well and smoothly presented to the 50 to 70 veterinarians who ate the free food as they listened. Many took the slick material and several either took notes or photographed the slides on the screen. Few saw the gaping holes in their story.
Cargill’s talk was on the repair of a poor top line which involved feeding their feeds including Top Line Extreme and ProAdd. They discussed amino acids and the quality of protein being fed. What they never discussed was the reason for the chronic protein loss showing as loss of the top line muscle. Adding their feed was said to resolve top lines. They didn’t say that they change the formulations of their feed this year to include inflammatory ingredients nor did they talk about medications that prevent the absorption of proteins.
Purina’s talk was about their new ulcer-preventing additive to their feed called Outcome. Their research trials created more questions than answers which is a sure sign that the research is agenda driven. For example, this presentation only focused on gastric (stomach) ulcers and ignored colon (hindgut) ulcers. In fact, at the very end, they gave a blanket statement that these colon ulcers are “poorly understood” which is not true. It was never mentioned that ulcers in humans are now associated with dysbiosis (abnormal gut bacteria). Worse, the whole purpose of their additive is to increase the pH of the stomach (less acidic) which is very disruptive to the bacteria normally living in the stomach. Further, an acid environment in the stomach kills bad bacteria and dissolves proteins into absorbable peptides and amino acids – both essential to the good health of the horse.
What shocks me the most is that the attending veterinarians allowed the spoon-feeding of unchallenged information. Both of these companies are huge supporters of the AAEP. Way too many complications for my comfort level.
The keynote speaker was a human physician who now writes books (and gives talks) about doctors (and veterinarians) who spend more time on lab results and diagnostic tests and far less time listening to the patient. He used the famous painting of the late 1600s of an obviously dying child in a blanket laying on cushioned chairs in the living room of a house. To the right of the child and in the shadows were the parents, the mother with her head down in prayer and the father assuring her with his hand but gazing upon the doctor on the other side of the child. The doctor sitting in a chair by the window with sunlight was in deep thought and focused on the child. There are no diagnostic tools in the painting such as a stethoscope and thermometer and this was done on purpose. The painting resonated with viewers wherever it was displayed and crowds formed around it because it represented the faith of people in doctors and their compassion for healing.
I wrote about this doctor-patient connection many years ago and included two photos of paintings celebrating 100 years of veterinarians caring for horses for 100 years. The first painting was of a barn scene 100 years ago and all eyes of the people and the dog were on the veterinarian who was focused on the horse. The second painting depicts veterinary care today and it had all the people looking at the ultrasound screen while no one, not even the dog, was looking at the horse.
Is anyone seeing this disconnect with the patient at their barn? Maybe you have experienced it personally as I did when my son was in the hospital with a life-threatening illness. Few doctors and nurses had a connection with him as he lay there scared and confused with few answers coming from the experts. He was given numbers they read from their computers. I am grateful that the AAEP is addressing this concern of owners that veterinarians are not connecting with their patients. But cynically I don’t think it will make a difference because the selection of students for vet school excludes most horsemen while focusing on diagnostics.
The main speaker today was Dr. Virginia Reef (Univ of Penn), the world’s expert on heart disease in horses. Last year it was Dr. Paddy Dixon (Edinburgh Univ) on dentistry and the evolution of the horse. Before that, it was Dr. Norm Ducharme (Cornell) on laryngeal function and Dr. Tom Divers (Cornell) on liver function. These speakers are worth the price of admission as the in-depth discussion is very fascinating.
In the case presentations on heart disease given today, there was again no mention of root causes or any epidemiological studies (looking at factors that may cause the disease) that would help horse owners prevent heart disease. Excluding congenital defects (birth defects), why do horses get disease of the heart muscle and valves? The primary answer was “age.”
I get confused. Is heart disease more prevalent now because we now have diagnostic tools able to discover these diseases? Or is it more evident because we are caring for them differently than 50 years ago? Are feeding programs to blame or is it the constant stress from shipping and competing? The Purina speaker said there was a study showing horses stabled with talk radio playing had a higher incidence of gastric ulcers than if music was played. They did not mention if these programs were political or educational.
All of this does give me the thought that what we are doing today may not be working as far as giving our horses optimal care. But as long as horses continue to get sick, veterinarians will have work and feed dealers and supplement makers will have a market. And as long as I have state licenses that need continuing education requirements I will attend these meetings. It gives me perspective and on occasion, I meet another like-minded veterinarian. That gives me hope.
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Thank you for sharing your thoughts about the convention. Those thoughts allow us the opportunity to see from your perspective. Lynne
Thanks for getting the facts told.
BTW AAEP is pro horse slaughter and against our wild horses IMO.
Thank you for a thoughtful and important commentary on your experiences at the AAEP conference. The pictures and comments about the veterinarians/horses (1875 & 2005) remind me of comments & advice a former equine vet of mine gave me – 1) he said he attended a veterinarian conference in another country years ago and the seminar he was referring to was on how to determine if a horse was lame. All sorts of diagnostic equipment was showcased and lauded. My vet said something to the effect of – you don’t need all that diagnostic equipment, just watch the horse walk and move and you can tell that he’s lame. 2) One of my horses had some sand in his gut (I didn’t know what was wrong so called Dr. Dan) – instead of telling me to put my horse on psyllium, expensive other remedies, he told me to trot him everyday about 20 minutes for two weeks and that would get rid of the sand. It did. Very simple. Your comments about not paying attention to what the patient presents (symptoms, behaviors, etc.) and looking for a root cause, instead running expensive diagnostic tests & looking at those results, hits the nail on the head of what is wrong with medicine – human and animal – today. I have a thyroid condition, which if you dose me according to my blood tests, makes me hypothyroid. So, I’ve come up with a dosage, based on what works for me, that’s about 1/3 to 1/2 of what the labs say it should be and have no symptoms. Fortunately, my doctor values my opinion and is OK with my assessment. Keep up the good fight Doc T! There are more veterinarians and horse owners out there like you, but we are in the minority! I am doing my part (by example) to change perceptions by feeding and keeping my horses as naturally as possible in the city. My horses (and dogs) are almost never sick, don’t have behavioral problems and enjoy living in herds & packs. Yay!
Thanks Lorraine! On many levels your comment is very helpful. At my vet school we were taught by a great and older mentor the art of “physical diagnosis.” By the way, when I drove tractor trailers (18 wheelers) for a living my more experienced driving partner trained me to use my ears, eyes, nose and touch to recognize when something isn’t right with the truck. The Same applies to the horse as well as all animals and even vegetation. Becoming aware and being in the moment…. oops, sounding “fru-fru” and far out. It’s not “normal” to be a man and to be in touch with the senses….. I digress. Thanks again
most horses and people have zero access to pasture grass
Limited pasture is a huge problem in modern day keeping of horses. It becomes incumbent on people to try to feed horses like horses. Hay is preserved summer grass from earlier in the year. It is an adequate substitute for pasture but not as good as pasture. Adding a broad source of amino acids plus decreasing the availability of carbohydrates (sugar, starch) during the winter months will help keep the horse healthy.
More information on horse nutrition can be found in my nutrition blogs or my nutrition course. If we all started to feed our horses as they should be fed we could eliminate a bunch of ailments in them.
Just a thought, but if you could rest your horses for 2 to 3 months in a pasture it would be well worth the effort to transport them to it.
Your current day picture is right on. My horse wasn’t feeling well and one day she froze in place and couldn’t move so I had my vet come out and I noticed she didn’t really look at the horse but suggested blood testing. She didn’t even notice the tricep muscle loss that I had noticed . She had no Cushing’s, vitamin E was okay. We may have done other testing but I just can’t remember . When I had an acupuncturist come out, she said to test for Lyme. I did and she tested chronic. Sometimes I wonder if my vet thought it may have been Lyme but tested for other things first to make money. Once these horses and other pets pass on, I won’t be acquiring anymore. I just can’t stand depending on other people like this vet, undependable hay sellers, an “equine dentist” who destroyed my other horse’s mouth with an electric tool to a point he couldn’t chew hay from that day and even has trouble chewing chopped hay. He survives on alfalfa cubes and various pellets.
Thank you so much for the work you are doing and the wealth of knowledge you are sharing. My horses are so much better since they have been totally off any sugar etc. Now that the weather is cooler in Fl they are galloping and playing. What a difference! I’m so grateful!!!
Thank you for the great article. It is frustrating that the vets like Doctors don’t find the cause. Just fork out meds. It is a bit scary.
Thanking you for being our advocate and caring so much. I feel like I’m alone in my world with my horses. I have caring vets but I don’t feel like they “get it”, my horses are struggling with issues and right now they are just pasture pets, have been for quite some time and I cannot figure out the reason. From obesity to abcesses and laminitis, cushings symptoms, head shaking and high anxiety, A recent dental visit that resulted pulling 2 teeth and talk of pulling teeth on a 12 year old mare….what?! I’m at my wits end. I have implemented your ideas and I do see improvements and I thank you for that. I also have your courses that I need to complete. Thank you.
Thanks Kim. If all horse owners started to keep horses as they should be, the vets would be out of business. Same with doctors, the health care system, health insurance, food stores, farmers, supplement makers, magazines supported by the industry, and on and on if humans did it too. Thanks for reading, enrolling and taking the time to comment.
As always, well written and thought out. I like your candor and honesty. The research behind the “why” is so very important, and so often forgotten in the “lets sell it” state of mind.
Thanks for reading (and sharing…).
Thank for sharing. I know there are caring people and animal doctors out there. I just think they a few. Most time it’s about the money, instead of the patient.