Veterinarian-Client Relations Articles

Referring A Horse
Is Your Horse Enrolled in a Wellness Program?
A New Paradigm for Equine Euthanasia
Back to chool
Who !wns Radiogra"hs?
When hould I #all the $et?

Referring A Horse
by Written by: Christina Cable, DVM, DACVS
Referral centers are those clinics or hos"itals that offer diagnostic and thera"eutic o"tions
not readil% a&aila'le or "ossi'le in a field ('arn) t%"e situation* +hese can include diagnostic
modalities such as endosco"% with or without a treadmill, ultrasound, scintigra"h% and
radiogra"h%, -ust to name a few* Referral centers can also offer a wide range of surgical care (on
an electi&e or emergenc% 'asis), such as colic surger%, soft tissue surger% and ortho"edic surger%
(such as fracture re"air or arthrosco"%)* .urthermore, most referral centers are staffed with
multi"le s"ecialists* +hese "eo"le are highl% trained in their areas of interest, such as
re"roduction, medicine, surger%, radiolog%, etc* +he% can "erform "rocedures man% &eterinarians
are not comforta'le "erforming, or the% ha&e seen man% more /rare0 diseases than an a&erage
general "ractitioner* Referral centers can also offer around1the1clock care for animals requiring
frequent administration of drugs and2or intra&enous fluids, or for horses that require multi"le
diagnostic tests or intensi&e management* Referral centers can also offer "eace of mind if a
second o"inion is needed, es"eciall% to confirm a terminal disease*
+he initial con&ersation 'etween a &eterinarian and a horse owner a'out "otentiall% sending a
horse to a referral center2equine clinic ho"efull% will not 'e in a rushed manner, 'ut too often it is*
I "refer to ha&e this con&ersation well 'efore there is an actual emergenc%* I think all horse
owners should decide ahead of time, 'efore there is a crisis, if the% want 3 or financiall% can 3
send a horse to a referral center for colic surger%, for e4am"le* +oo often, when emotions are
running high, the wrong decision is made for the wrong reasons and the end result sometimes is
not a ha""% one*
In a "erfect world, all horses could recei&e the 'est medical or surgical care and cost would not
'e a "ro'lem* 5nfortunatel%, we don6t li&e in a "erfect world* o, for man% horse owners, the cost
of the needed "rocedure 'ecomes an issue* It is ne&er an eas% decision, 'ut some "eo"le might
ha&e to decide 'etween feeding their famil% and 'u%ing colic surger% for the horse* +he costs of
medical and surgical "rocedures &ar% greatl% '% region, so I won6t e&en attem"t to offer ranges*
Your &eterinarian should 'e aware of the costs of common emergenc% "rocedures at %our nearest
referral center, so ask him2her for this information*
Electi&e medical or surgical "rocedures are o'&iousl% not "erformed on an emergenc% (middle of
the night) 'asis, so there is more time to research not onl% costs, 'ut risks, success rates and
"otential la%1u" time*
+went% %ears ago, there were &er% few equine referral centers not affiliated with a uni&ersit%
teaching hos"ital* Now, with man% more &eterinarians 'ecoming 'oarded s"ecialists in a &ariet%
of areas, there are equine referral centers staffed with s"ecialists in more areas of the countr%
than e&er 'efore* In most areas of this countr%, a good equine referral center is often no more
than a few hours dri&e awa%* We are &er% fortunate in this countr% to ha&e such eas% access to
equine care*
While tra&eling with the 5nited tates Equestrian +eam in western Euro"e, we were sometimes
faced with ha&ing to dri&e u" to 78 hours to get to an equine referral center* !ne referral center in
"ain would not take after1hours cases (this was a aturda% night and we would not 'e seen until
9onda% morning, e&en though we had a horse with a &er% "ainful colic)* o, 'e glad we ha&e
such good medical care here 3 not -ust for humans, 'ut also for our 'elo&ed horses*
+alk to %our &eterinarian a'out the "ossi'ilit% of referring %our horse to a uni&ersit% or clinic and
what o"tions might 'e a&aila'le in %our area should the need arise*
Article originated in the AAEP .!R59 section of +he Horse (9a% 8::;)*
ke%words< referral ser&ices *
"osted< =28828::;* >ast u"dated< =28828::;*

Is Your Horse nrolle! in a Wellness "rogra#$
by %regory C& S#ith, DVM

A wellness "rogram for %our horse will sa&e %ou time, mone% and, most of all, the headache of
worr%ing if %ou6re doing the right things at the right time* But with all the sources of horse health
care information a&aila'le toda%, how do %ou decide what6s right for %our horse? Books,
maga?ines, the internet, %our farrier, the feed store o"erator and other resources can make %ou
unsure of what "ractical horse care is an%more*
.ortunatel%, %ou "ro'a'l% alread% know someone who has the education and e4"erience to sift
through the latest information in horse health care, coordinate with the other "rofessionals
in&ol&ed in the u"kee" of %our horse, and de&elo" a customi?ed health "lan -ust for %ou< %our
equine &eterinarian*
A wellness "rogram for horses is not a new idea, 'ut new ideas are what make them so
'eneficial* +he &eterinar% communit% is among the first in the industr% to learn a'out
ad&ancements in health care as well as disease out'reaks, "roduct com"laints and other
information that ma% affect how %ou care for %our horse* B% de&elo"ing a closer working
relationshi" with %our equine "ractitioner, %ou take ad&antage of this /inside scoo"0 as the two of
%ou work together to design a com"rehensi&e health care "lan for %our horse*
A wellness "rogram should ha&e &accinations, dewormers, dentistr% and nutritional consultation
as the cornerstone "rocedures* While that sounds sim"le and o'&ious, there is much contro&ers%
and change in each of these 'asic areas*
.or e4am"le, &eterinarians not too long ago were recommending that e&en foals from &accinated
mares 'egin recei&ing their own &accinations within the first few months of 'irth* !n1going
research has shown that anti'odies from the mare6s milk for some diseases (such as influen?a)
last much longer than originall% thought* +herefore, the foal6s first &accinations can 'e gi&en much
later (at eight or nine months of age for influen?a if the mare was &accinated)* !ther research has
"roduced a new &accine com'ining influen?a and rhino"neumonitis which can 'e gi&en either
through the intramuscular or intranasal routes*
With the introduction of more effecti&e dewormers, it is e&en more critical to "lan for "arasite
control* Issues such as resistance, whether to use a dail% dewormer or a "urge dewormer, and
the increasing im"ortance of enc%sted small strong%les need to 'e considered as %ou and %our
&eterinarian select "roducts, schedule fecal e4aminations, and set u" en&ironmental control
measures*
@entistr% in the horse has 'een transformed in the last decade or so to a science that hel"s kee"
%our horse in good weight and good "erformance* +his has 'ecome es"eciall% im"ortant as
horses are li&ing longer and longer* +he da%s of hand1floating e&er% horse in the 'arn on one &isit
ha&e gi&en wa% to oral e4aminations and scheduling "re&enti&e and correcti&e dental "rocedures
a""ro"riate for %our horse6s age and use*
E&en if %our horse is at his ideal weight for what %ou6re doing with him, there6s still a 'enefit to
showing %our &eterinarian what and how %ou6re feeding %our horse* Not onl% will %ou ha&e the
o""ortunit% to ask questions a'out nutrition and other to"ics during a tour of the feed shed and
"asture, 'ut %ou ma% also end u" reducing the num'er of su""lements %ou gi&e %our horse,
there'% reducing %our feed costs*
While all wellness "rograms also include a 'asic "h%sical e4amination in addition to the ser&ices
a'o&e, some &eterinarians include other "rocedures and consultations with their "ackages 'ased
on the needs of the indi&idual owner and horse* 9an% &eterinarians will alert %ou to the need for a
&isit or for a "roduct to 'e administered, relie&ing %ou of detailed record1kee"ing* 9ost
im"ortantl%, %ou can hel" kee" the information highwa% from 'ecoming 'um"er1to1'um"er with
confusion '% de&elo"ing a "artnershi" with %our local equine &eterinarian*
@r* Aregor% #* mith, owner of East #ount% >arge Animal Practice in El #a-on, #alifornia, a
three1doctor Practice of E4cellence as awarded '% $eterinar% Economics maga?ine, with @r*
>%dia .* 9iller, AAEP !wner Education #onsultant


7) title Is Your Horse Enrolled in a Wellness Program?
8) author Aregor% #* mith
B) +itle @$9
;) ource .orum
C) @ate 9arch 8::7
D) 9enu categor% Parasites $accination $eterinarian1#lient Relations
"osted< D27E28::8* >ast u"dated< D27E28::8*

A 'e( "ara!ig# for )uine uthanasia
by Carolyn *utler, MS


February 2001
A horse owner develops a relationship with his or her horse that is
marked by mutual trust, respect, and affection, much as would be
encountered in a relationship between two people who spend several
hours every day together doing something enjoyable for both. verall,
the levels of attachment shown by horse owners seem to be increasing.
!t is highly probable, however, that owners" attachment levels have not
really changed over the years. !nstead, an increase in their outward
e#pressions of feelings might be attributed to society"s increased
awareness of the significance of the human$animal bond and to an
increasing tolerance for emotional reactions to loss. !n veterinary
medicine, many professionals are more perceptive about what their
clients are feeling and thus are more comfortable indicating to them
that e#pressions of grief are acceptable.
Euthanasia With Owner Present
%uthanasia is being viewed more fre&uently by veterinary professionals
and animal owners alike as both a privilege and a gift that can be
lovingly bestowed on ill or injured animals.
'he term (euthanasia( is derived from two )reek words$$(eu( meaning
good( and (thanatos( meaning death. 'hese words &ualify euthanasia
as (good death.( *ords such as easy, humane, painless, and loving also
are associated with euthanasia. +et, putting these positive attributes
aside, euthanasia remains the purposeful act of taking a life. 'herefore,
euthanasia of an animal often affects the individual involved in
intensely emotional ways.
*ith this in mind, concerned veterinarians, animal health technicians,
and grief counselors from across the country have worked together
during the last decade to create and perfect euthanasia protocols that
have both the patient"s and the client"s comfort and well$being in mind.
'hese teams of professionals have considered many variables,
including the attitudes of those involved in the euthanasia process, the
physical surroundings and aesthetics of the euthanasia site, and the
combination of drugs and methods used to induce peaceful and
painless death. 'he ways to prepare a client for an animal"s death and
to help the owner plan the circumstances surrounding the euthanasia
procedure also have been studied.
A New Paradigm
!n the new model of euthanasia, it is becoming more common for
veterinarians and clients to discuss euthanasia directly and at length. !t
also is common to allow as much time for the procedure as is needed
and possible, to involve an owner in the process as much as possible
,without being directly involved with the procedure-, and to
acknowledge the animal"s death, talking openly about it afterward. 'he
new paradigm is much more congruent with what research has told us
about healthy grief resolution.
'he key word when conducting euthanasia within the new paradigm is
choice. 'his means that for an owner to make wise and timely
decisions when faced with an animal"s death, he or she must be
provided with information and choices by the veterinarian. !n the new
paradigm, an owner is given choices about as many details as possible.
'he emotional burdens are shared, and, as a team, veterinarian and
client decide when, why, how, and where an animal should die.
.ome well$meaning veterinarians discourage owners from witnessing
their animal"s euthanasia, believing that it is best to shield owners from
the e#perience. /eterinarians also might discourage client presence
because they feel that it upsets dying animals, or because they fear that
during the procedure the client will become upset. 0lient safety is
another legitimate concern, given the unpredictability of large animal
euthanasia.
*ithout &uestion, it is emotionally painful for an owner to watch a
dearly loved animal die1 however, clinical e#perience with owners has
shown that being absent when an animal dies might increase the
client"s feelings of pain and distress. *ith honest and detailed
preparation from a veterinarian, an owner can decide what to or not to
witness regarding the animal"s death. 'hen, as long as the methods
used are humane, client presence does not need to be the veterinarian"s
choice $$ it can be the client"s choice.
Adapted from the chapter "Helping during Large-Animal Euthanasia"
from the book 'he 2uman$Animal 3ond and )rief, by Laurel Lagoni,
MS; arolyn !utler, MS; and Su"anne Hetts, #h$, from the Argus
%nstitute, olorado State &ni'ersity (eterinary )eaching Hospital, *ith
Lydia Miller, $(M
7* +itle A New Paradigm for Equine Euthanasia 8* Author #arol%n Butler B* +itle2Bio 9 ;* ource
+he .orum C* @ate .e'ruar% 8::7 D* 9enu categor% $eterinarian1#lient Relations 9iscellaneous
"osted< D27E28::8* >ast u"dated< D28:28::B*

*ac+ to School

.or most of us, our formal education might ha&e ended u"on graduation from high school or
college* With our trust% shee"skin, we entered 'ra&el% into the world of the gainfull% em"lo%ed,
with onl% the occasional nightmare of imagining ha&ing enrolled in a class we ne&er attended or
showing u" clad onl% in 'ooks and 'o4ers reminding us of classroom da%s* .or %our equine
&eterinarian, howe&er, school is ne&er out*
#ase in "oint is the annual con&ention of the American Association of Equine Practitioners*
hould %ou attem"t to ring %our &eterinarian during @ecem'er, it is &er% likel% that %our
&eterinarian, or one of his or her associates, is attending this con&ention* Nearl% half of all
&eterinarians whose "ractices focus on the horse attend this continuing education meeting* +his
is -ust one of se&eral o""ortunities &eterinarians ha&e to recei&e required Fcontinuing educationF
credits*
In most states, %our &eterinarian is required to document these continuing education credits11
much like the hours "er semester %ou earned11to the state licensing agenc% in order to retain his
or her license and continue "erforming as a &eterinarian in that state* In some cases,
&eterinarians carr% licenses in multi"le states and are therefore required to fulfill each stateGs
licensing requirements*
While the 'enefit to the &eterinarian might 'e o'&ious, the 'enefit to %ou as a horse owner is e&en
greater* .or e4am"le, while attending the AAEP con&ention, %our &eterinarian will 'e a'le to learn
more a'out what makes a test for equine "roto?oal m%elitis (EP9) a Ffalse "ositi&eF or Ffalse
negati&eHF how new treatments for EP9 can 'e effecti&eH whether or not riding a horse while it
has the flu is a good ideaH whether or not foal &accinations are effecti&e and what kind of
&accinations work 'estH how to work with "ro'lem "regnanciesH and wa%s to 'etter handle
in-uries, like fractures or -oint "ro'lems, as well as a""ro4imatel% I: other choices*
Your &eterinarian also uses the time to mingle with other "ractitioners, sharing difficult cases, new
treatment ideas, and other information that further stimulates a greater wealth of knowledge in
%our &eterinarian*
Fo,F %ou might sa%, FshouldnGt the% ha&e learned all this stuff when the% were in school?F
Well, the fact is, either this FstuffF wasnGt e&en around when %our &eterinarian was in school, or the
information has 'ecome much more so"histicated and effecti&e* Either wa%, %ouGre still the
winner* With %our &eterinarian taking a few da%s awa% from his or her "ractice to attend one of
these meetings, %ou can 'e sure that %our horse is going to recei&e 'etter treatment in the long
run*
A#erican Association of )uine "ractitioners
,-./ Iron Wor+s "i+e
0e1ington, 2Y ,-/33
45-56 788--3,.
(((&aae9&org
"osted< D27E28::8* >ast u"dated< =27E28::C*

Who :(ns Ra!iogra9hs$
by 'or#an W& Rantanen, DVM

My ;et too+ so#e < rays of #y horse=s legs& I 9ai! the bill in full, but (hen I as+e! for the
< rays, he sai! they belonge! to hi# an! not #e& Is this correct$ If I=# charge! for the <
rays, (hy can=t I ha;e the#$
9an% &eterinarians run into this situation, not onl% equine &eterinarians* +o the client, it makes
sense that he or she would own the radiogra"hs (J ra%s) since, in the clientGs o"inion, he or she
"aid for them* Howe&er, the images themsel&es (the film or other medium) remain the "ro"ert% of
the &eterinarian who ordered or took the radiogra"hs* +he diagnosis which is the result of the
radiogra"hs is the ser&ice the client has "aid for* +he notion that FI "aid for them and the%Gre
mineF -ust is not a &alid argument either legall% or "rofessionall% when it comes to o'taining
original co"ies of radiogra"hs* +he reason the radiogra"hs are ke"t '% the &eterinarian is so there
is a com"lete medical histor% of the horse on record* 9aintaining com"lete records is not
e4clusi&e to equine medicineH it works the same wa% in human medicine* Also, it is required '%
law that &eterinarians kee" radiogra"hs on file for a s"ecific "eriod of time, which will &ar% '%
state*
!wners, trainers, or other "arties concerned with the radiogra"hs are entitled to co"ies, "rints, or
other du"lication documents, if the% are granted "ermission '% the "art% res"onsi'le for ordering
the radiogra"hs to 'e taken* +his is true for not onl% radiogra"hs, 'ut an% medical records on the
horse*
!wners and trainers often ha&e 'een gi&en the originals '% their &eterinarians* +his is a ha'it that
is hard to 'reak* 9an% owners or trainers think that recei&ing the originals is normal 'usiness
"ractice since that is what the% are accustomed to* $eterinarians need to kee" the original
radiogra"hs so a com"lete medical histor% of the horseGs medical records, including images, is
a&aila'le for future use* !n the "ositi&e side, with the increased use of digital images, some of
these "ro'lems with original radiogra"h ownershi" are im"ro&ing*
A concern man% horse owners and trainers ha&e is that if the% do not o'tain the original
radiogra"hs, disclosure of a horseGs *"ro'lems might 'e re&ealed to those who are in the "osition
to 'u% the horse* You must remem'er, &eterinarians are not allowed to disclose an% health
information a'out a horse without the ownerGs "ermission*
As with most contro&ersial issues, communication (usuall% the &eterinarianGs res"onsi'ilit%) with
the owner or trainer can alle&iate the "ro'lem* Also remem'er, am"le time and "re"aration
should 'e allowed for sufficient image du"lication to satisf% all "arties in&ol&ed*
!ne discouraging "art of the radiogra"h "ro'lem comes into "la% when a &eterinarian, or for that
matter an owner or trainer, requests that radiogra"hs 'e sent to him2her '% the &eterinarian or
equine hos"ital that has taken the films* If the second &eterinarian then gi&es the radiogra"hs to
the owner or trainer either 'ecause the owner or trainer demands them or it is that &eterinarianGs
"ractice to hand o&er the originals, the situation re1sults in a more com"licated "rofessional
dilemma*
>egall%, the &eterinarian who took or ordered the radio1gra"hs owns them* In this da% of eas%
du"lication or mani"ulation of images, there is little reason wh% a client, agent, owner, etc* canGt
ha&e the information he or she needs or requires while the &eterinarian u"holds his2her
"rofessional requirements for maintaining a com"lete medical histor% of the horse*
As I mentioned earlier, this is not a "ro'lem that is unique to equine &eterinarians or &eterinarians
in general* It also occurs in human medicine, where a great effort is "laced on the maintenance of
com"lete medical records* Images are frequentl% Flost,F Fmis"laced,F Fmisfiled,F or gi&en out to
"atients without adequate documentation or safeguards to ensure the% will 'e returned*
Norman W* Rantanen, @$9, is a 'oard certified radiologist with an equine s"ecialt%* Rantanen
"ractices at an >uis Re% Equine Hos"ital in Bonsall, #alif*
"osted< D27E28::8* >ast u"dated< D27E28::8*

When Shoul! I Call the Vet$
by Roberta D(yer, DVM, MS

I=# a #e#ber of an online horse !iscussion grou9& So#eti#es (e as+ each
other about training or ail#ents our horses ha;e, an! (e tra!e i!eas, ti9s,
an! a!;ice& So#e health con!itions soun! ;ery serious& Ho( !o I +no(
(hen a 9roble# is serious enough to call the ;et$
I also ha&e read some of the "ostings to these discussion grou"s, and ha&e read la% "eo"le
diagnosing ra'ies and man% other diseases after a 'rief and (usuall%) incom"lete descri"tion of
the "ro'lem* E&en &eterinarians ha&e to e4amine an animal11or 'e &er% familiar with its medical
histor%11to diagnose or "rescri'e medications to a clientGs horse* We are 'ound '% the
F&eterinarian1client1"atient relationshi"F for the diagnosis and treatment of animals*
+here is no wa% to make an entire list of situations of Fwhen to call the &eterinarianF in this short
s"ace* Howe&er, here are some general guidelines*
+he "resence of uncontrolla'le 'leeding, foreign o'-ects "rotruding from the 'od% (do not remo&e
themK), lacerations, in-ur% to the e%e or e%elids, a'dominal "ain or diarrhea, aggressi&e or unusual
'eha&ior, neurologic signs, se&ere or chronic lameness, mares which are acti&el% in la'or for
more than 8: minutes without "rogress, and difficult% in 'reathing are onl% some of the o'&ious
times to call %our &eterinarian* Perha"s the 'est rule is, when in dou't, callK
All horse owners should know how to take their horseGs tem"erature, "ulse, res"iration, ca"illar%
refill time, and deh%dration status* When these 'asic health "arameters are a'normal for an
unknown reason, a call to the &eterinarian is warranted* When %ou ha&e o'ser&ed %our animals
o&er a "eriod of time, %ou should know immediatel% when something is out of the ordinar%,
'esides o'&ious clinical signs such as lameness or nasal discharge*
9ulti"le animals getting sick at once should raise a red flag* %m"toms in se&eral animals could
indicate such dangers as infectious diseases or a to4in in the horsesG "asture, water, or feed*
A good rule of thum' is, if a child were e4hi'iting the same s%m"toms as %our horse, would %ou
call the "ediatrician? If %our child had "rofuse diarrhea, chances are %ouGre not going let him2her
go untreated for a week without seeking a medical o"inion* Pro"er treatment and diagnosis of a
sick horse requires a &eterinar%2"atient interaction* +his generall% is not the case o&er the
Internet* .or a la% "erson to suggest a diagnosis or treatment for a horse is not sound ad&ice*
Part of our training to 'ecome &eterinar% "ractitioners is to check multi"le organ s%stems, as
there are man% diseases with com"licated s%m"toms* omeone who has a horse with a'normal
'eha&ior might not notice or re"ort o&er the Internet that the horse has a %ellowish color to its
gums* +o a &eterinarian finding this in a "h%sical e4amination, this would likel% lead to 'lood work
to e&aluate the condition of the li&er* >i&er disease can cause the 'uild1u" of su'stances in the
'loodstream causing neurologic s%m"toms* A la% "erson might suggest treatment for EP9,
ke%ing in onl% on the neurologic nature of the descri'ed case*
+he Internet is a wonderful tool, 'ut readers must remain critical in their reading, and not 'elie&e
e&er%thing in "rint* #onsider the source* Information made a&aila'le through the #enters for
@isease #ontrol and Pre&ention (www*cdc*go&), the American Association of Equine Practitioners
(www*aae"*com), and man% other sites are closel% scrutini?ed for accurac%* If %our &eterinarian
diagnoses #ushingGs disease in %our horse, and %ou want to read more information on the
disease, do a search at www*thehorse*com, or, for more scientific information, www*medline*com,
which searches for scientific "a"ers* Remem'er, though, that this is general information on the
disease, and not ad&ice on how to treat your horse 'eing fed your feed, drinking your creek water,
etc* +hose decisions need to 'e discussed with a &eterinarian who knows %our horseGs situation*
!n the other hand, %ou might ha&e Neil from W%oming "ro&iding %ou ad&ice 'ased on the
treatment of his horse for #ushingGs disease &ia the Internet chat room* Neil might not mention
that his horse is 8: %ears older than %ours, also has kidne% failure, and is on multi"le medications
for chronic laminitis* Are %ou reall% "re"ared to change %our horseGs treatment on NeilGs sa%1so?
IGm not sa%ing that chat rooms and ad&ice columns are 'ad, -ust that readers should ha&e a
qualified &eterinarian diagnose and treat their animals* Additional information gleaned from other
sources should 'e closel% scrutini?ed* If %ou still are not comforta'le with %our &eterinarianGs
o"inion, get a second &eterinarian to e4amine %our horse, or ask %our &eterinarian to consult a
uni&ersit% &eterinar% teaching hos"ital*
Internet ad&ice for 'asic training issues is fine* .or e4am"le, someone might write FHow do I ask
m% horse to "ick u" a left lead?F In shar" contrast, the "erson who writes, F9% horse has 'een
la%ing down in the "asture for the "ast si4 hours* What do I do now?F should not 'e on the
com"uter, 'ut on the tele"hone to his or her &eterinarian*
When a diagnosis has 'een made '% a &eterinarian, then it is good to get on the Internet and
research the disease and treatments* We' research can hel" owners make intelligent decisions
regarding their animals* Howe&er, taking medical ad&ice from a total stranger, as in a discussion
grou", is not ad&isa'le*
+he sa%ing often fits, FYou get what %ou "a% for*F
Roberta Dwyer, DVM, MS, is Board Certified by the American College of Veterinary Preventive
Medicine She is an associate !rofessor at the Ma"well # $luc% &'uine Research Center,
(niversity of )entuc%y, where she is involved in e'uine !reventive medicine, teaching, research,
and !re*veterinary advising
"osted< D27E28::8* >ast u"dated< D27E28::8*