Equine Osteopathy: Questions

[sparkygrace]

There are a few threads discussing equine osteopathy with plenty of different views and some skepticism. This alternative health care is becoming popular where I live and people I know are adding osteopathy to their regular vet care.

One issue that has come popular causes me some pause. A few practitioners are diagnosing horses with heavy worm loads and claiming that is causing stiffness or problems under saddle. They prescribe a complicated deworming protocol and will work on the horse only after that is completed. The people I know have been very careful to do fecals and deworm accordingly. These are high-end horse owners.

I’m skeptical and wanted to get some opinions or experiences with a diagnosis like this.

[FjordBCRF]

@sparkygrace

A few practitioners are diagnosing horses with heavy worm loads and claiming that is causing stiffness or problems under saddle.

Are fecals being done to verify the heavy worm load?

[JB]

@sparkygrace

One issue that has come popular causes me some pause. A few practitioners are diagnosing horses with heavy worm loads and claiming that is causing stiffness or problems under saddle.

this has been around a while, though thankfully not terribly common

@sparkygrace

They prescribe a complicated deworming protocol and will work on the horse only after that is completed.

Deworming even heavy burdens is rarely complicated. It only gets complicated if a horse has managed to attain a high load of highly resistant strongyles. That’s actually happened, some TBs that were imported from Ireland had strongyles who were highly resistant to moxidectin. IIRC, the farm (who is very religious about doing FECs, thankfully) worked with Dr Martin Nielson, parasite guru, to get things killed and under control. That’s an exception, not the rule, in terms of complicated deworming.

I’d be running far and fast from any one who siad any of what those practitioners are saying.

[Ghazzu]

I’m not a fan of “equine osteopaths” because they aren’t fully qualified IMHO.
Human osteopaths have a medical education as well as extensive training in osteopathic therapy. (My PCP is an osteopath and is fantastic.)

[sparkygrace]

Not as far as I know. It is diagnosed based on physical factors. I studied parasitology in college and have been a horse owner for eons and am quite well-versed in parasite control. That’s why I questioned the claims.

[sparkygrace]

My PCP is also an osteopath and an MD.

[sparkygrace]

What makes me wary is an experience my sister had with one of her horses. It did have a heavy worm load and she was not aware of what would happen when deworming caused a heavy die-off. The horse died after deworming.

I know there are other protocols for gradual deworming if there is a concern. I question whether a healthy horse is really carrying a heavy load of strongyles based on observation.

[JB]

@sparkygrace

It did have a heavy worm load and she was not aware of what would happen when deworming caused a heavy die-off. The horse died after deworming.

that’s so sad There are ways to mitigate the possibility of an impaction caused by enough dead/dying worms trying to pass through, or the toxins produced by enough dead/dying worms.

@sparkygrace

I question whether a healthy horse is really carrying a heavy load of strongyles based on observation.

Looks don’t tell you much of anything about a parasite load. I know quite a few “fat and shiny” horses who were outwardly the picture of health, who had enormous worm burdens based on FECs, or ending up on the operating table for an impaction of high numbers of tapeworms.

So it goes both ways - you can’t say a horse who is otherwise a picture of health doesn’t have a high burden, or a horse who looks sickly DOES have a high burden. And there’s no way putting hands on a horse in any way can tell you anything to the contrary.

[sparkygrace]

I have known horses heavily infested with tapeworms. They looked quite healthy. Tapes were not a problem in the PNW 30 years ago, but they are more common now. I check my horse’s manure for cysticerci and treat them spring and fall.

[FjordBCRF]

@sparkygrace

Not as far as I know. It is diagnosed based on physical factors. I studied parasitology in college and have been a horse owner for eons and am quite well-versed in parasite control. That’s why I questioned the claims.

I’d be steering clear of treatment from anyone who is just eyeballing. Especially when there are easy/cost effective ways to actually KNOW what to treat.

[sparkygrace]

You are right. Best to stick with a qualified vet.

[cilla1]

That sounds really weird to me. My equine osteopath (who is a human osteopath too) is very wary about deworming, she always suggests to run a fecal even before the routine deworming (that here - in Italy - is not a thing, many people deworm twice a year without running any fecal). I believe a serious osteopath, even if concerned about an heavy infestation, should suggest to the owner to get the horse checked by a vet. I’d stay away from an osteopath who tries to replace the vet

[sparkygrace]

As a follow-up, the vet did a fecal on my horse. She arrived here in late January from Canada. To my horror, she had a very high egg count, 1100/gram. The vet said to do the Panacur Power PAC and retest in six weeks.

This is my first experience with a positive fecal. My place is very clean. Stalls are cleaned twice daily, pastures every day if the horses poop out there. All manure goes to a compost bin and is hauled away.

The mare’s history is spotty and I have a feeling she was not regularly dewormed or always had a heavy worm load. We’ll come up with a deworming plan after the retest.

[JB]

@sparkygrace

To my horror, she had a very high egg count, 1100/gram.

that’s not horrible High, yes, needing deworming yes. I had one who was historically a low shedder, and for some weird reason one year he popped 1500. It happens.

@sparkygrace

The vet said to do the Panacur Power PAC and retest in six weeks.

Sorry, bad advice The PP isn’t a good choice to start with, but if you’ve done that, a repeat FEC NEEDS to be done 10-14 days later to see what good it did. Odds are quite high it won’t do much good. Maybe you’ll be lucky and he wasn’t carrying resistant strongyles and it got at least a 90%
reduction.

At 6 weeks, If she’s got a high count again, you have no idea if it’s from a low reduction from the PP, or she developed a new high count.

@sparkygrace

The mare’s history is spotty and I have a feeling she was not regularly dewormed or always had a heavy worm load.

not uncommon, unfortunately. Maybe she wasn’t really dewormed at all, maybe she only had ineffective products used, like fenbendazole (drug in a PP) and pyrantel pamoate, both of which have high and widespread resistance issues.

@sparkygrace

We’ll come up with a deworming plan after the retest.

See above. You really need that 10-14 day post-deworming FEC reduction test (FECRT) to see how effective it was. If not very effective, then she needs moxidectin or ivermectin. And, since a PP won’t address bots or tapeworms, she needs to be treated for those. This means Equimax or Quest Plus **

Even if you find the PP was 90%+ effective, the bot/tapeworm issue still exists, so you still need Equimax or Quest Plus, which I’d do about 2 weeks after the last dose of the PP, just so you get on a Spring/Fall schedule

And honestly I’m not sure I’d take a deworming schedule from this particular vet

**I won’t ever recommend Zimecterin Gold, the other US product with ivermectin + praziquantel, because of the not insignificant risk of causing contact ulcers.

[sparkygrace]

@JB

Sorry, bad advice The PP isn’t a good choice to start with, but if you’ve done that, a repeat FEC NEEDS to be done 10-14 days later to see what good it did. Odds are quite high it won’t do much good. Maybe you’ll be lucky and he wasn’t carrying resistant strongyles and it got at least a 90%
reduction.

This is a very good vet. I was worried about Panacur because of the historical resistance. However, there is literature that goes deeper into the issue and Panacur is still widely used. I did text the vet office to tell them I got the vet’s message and asked if there was another protocol. Didn’t hear back.

Of course, being the anal horse owner I am, I’ll follow up with Quest Plus to get any tapes or bots. My mare is in perfect weight with a shiny coat. The only thing I notice is laziness under saddle. Whether it is from a large parasite load or just her nature, I’m not sure. She is a new horse.

[JB]

@sparkygrace

This is a very good vet.

there are a lot of vets who are excellent in general, and even excellent in their deworming advice, but not realizing that advice is based on information that’s now 30 years old.

@sparkygrace

I was worried about Panacur because of the historical resistance. However, there is literature that goes deeper into the issue and Panacur is still widely used.

Yes, it’s still widely used, but often for the wrong reasons. The science and data over decades of research proves the current resistance issues. It’s still needed to treat ascarids in foals, given the resistance with ivermectin. It’s still valuable in a lot of cases to deal with pinworms - again, resistance to ivermectin. For strongyles, it has to be assumed to be ineffective until you prove it’s effective enough on your farm. In your case, this horse can from another farm, so “on your farm” doesn’t apply as he’s bringing in an entirely different colony of strongyles. What’s most important now is to clean him up, and at this point that means a FEC at the 10-14 day mark after the last Power Pack dose.

@sparkygrace

Of course, being the anal horse owner I am, I’ll follow up with Quest Plus to get any tapes or bots.

This really is the best course of action And, since you’re not in the position to see if fenbendazole is effective on your farm (because the parasite load isn’t from your farm) then you don’t even really need to do a FECRT - just follow-up with QP at 4 weeks post-PP. 2-4 weeks.

At that point, you can assume it was effective, or, you can do a FECRT at 10-14 days to make sure

[trubandloki]

@sparkygrace

This is a very good vet. I was worried about Panacur because of the historical resistance. However, there is literature that goes deeper into the issue and Panacur is still widely used.

My vet explained that they like to do the panacur first in these situations because it does not kill everything and it allows some die off with less risk of large die off issues.
They had me do the PP and then test shortly after and we moved forward after that test result showed what we had left to deal with.
They said these results also gave them an idea of how resistant the worms were to the PP.

It seemed like a very logical and safe approach to me when dealing with a high FEC.

[JB]

@trubandloki

My vet explained that they like to do the panacur first in these situations because it does not kill everything and it allows some die off with less risk of large die off issues.

In theory that’s a good thought, but if it’s very INeffective, which is likely the case here, then you’re still left with a large load. If it was quite effective, then you did what you didn’t want to do and aren’t prepared for a potential issue. You just can’t know that it’s going to be only, say, 40% effective.

It’s also compounded by the fact that the vet didn’t recommend another FEC for 6 weeks. It needs to be at the 10-14 day mark so if you find it was too ineffective, then you go with something known to be effective.

@trubandloki

They had me do the PP and then test shortly after and we moved forward after that test result showed what we had left to deal with.
They said these results also gave them an idea of how resistant the worms were to the PP.

Yes, that’s the better protocol. It’s not entirely unreasonable for horses who have been on the farm for long enough so you can see if you have effective alternatives to ivermectin/moxidectin. I did FECRT on one of mine when he was 2. Fenbendazole was utterly ineffective against strongyles.
I hadn’t used fen on the farm for 8 years, other than to deworm that same horse for ascarids, and prior to that 8 years it had been empty for 10 years and was a cow pasture before then. But I did bring 2 horses in who clearly carried resistant strongyles

At that point I used pyrantel pamoate, and found it’s quite effective here, so that gives me an alternative to iver/moxidectin if needed

TBH, 1100 isn’t high enough to be concerned about a large die-off, unless maybe the horse was already compromised in some way (not the case with the OP).

[Ghazzu]

From the AAEP:

Internal-Parasite-Guidelines_Updated.pdf

[sparkygrace]

Thanks, this is helpful. Without knowing my mare’s history, it’s hard to say if she has developed a resistance to certain classes of drugs because I don’t know her deworming history. I also don’t know about the history of places where she lived and if the drug resistance was widespread among all horses. I do know she came from a large ranch with lots of horses, went to breeder as a recipient mare, and then to a trainer to be sold. From what I know, she spent most of her life out on pastures, large and small.

As I said before, I’ll discuss the issue with my vet.

Edited to add: the mare came from northern Canada, but there would no difference in species of parasites.