Equine Insurance: Who needs it

 By: Katie Jones, CVT

We receive frequent calls regarding information on equine insurance. We do not represent or work for insurance companies. We also do not refer or suggest one over another. It is up to the individual horse owner to research and choose a company to best determine the type of coverage that fits their needs.

TurboI, myself, own a horse (Turbo) who is more of a weekend warrior out on the trail or at the occasional weekend show.   I went through most of my younger years dreaming and wishing for my own horse; however, I knew they were an investment difficult to have during college. The year I graduated from college I finally bought my horse and the investment into what I love began. Last year when I was faced with the question of, “would I take Turbo to colic surgery, if Banamine didn’t resolve his pain”, I didn’t know how to answer. Luckily for me he resolved his colic episode with a little amount of Banamine and time. As an Equine Technician, I see many situations not as simply resolved and surgical decisions become real. Sometimes the only thing separating a horse from euthanasia and a life-saving surgery is economics. A colic surgery base price starts around $3,500; however, overall medical care pre- and post-surgery can quickly reach $10,000. Would you be ready to front this cost in an emergency situation? If you have never had to answer this question, here are a few options to consider to help prepare you if the question ever arises.

Insurance

InsuranceWhen faced with a major medical expense, insurance is used to help soften the financial blow; so why couldn’t this work for your horse? Just like with human insurance, equine insurance has different types and levels of coverage. The two most frequently chosen insurance types are major medical and surgical. Major medical covers veterinary treatment, medications, and surgery due to an accident, injury, or illness on horses valued at a minimum of $7500. Surgical insurance only covers emergency or necessary surgeries performed under general anesthesia in a veterinary clinic, for any value horse.   To acquire either type of coverage, additional yearly mortality insurance is also required. Mortality insurance covers the horse’s value due to death from an accident, illness, or disease, and will typically cover loss due to theft. In the chance of an unexpected death, a mortality claim would require a necropsy report to determine the exact cause of death. (There are additional coverage options for individuals with equine businesses, such as loss of use or breeding coverages.)

The cost of equine insurance is based on the age, value, and use of the horse. Here is an example of what a quote would look like for an average trail horse (my horse, Turbo) from Blue Bridle Insurance.

sick horse

Great American Ins. Co.: (Turbo is categorized as a 7 yr. old Pleasure/Show Horse)
Plan 1: Only mortality: $2,000 (Value of Turbo) @ 3.6% = $200 Minimum/yr.
Plan 2: Surgical (ONLY surgical expenses included): $10,000 = $150/yr.

Total Annual Premium for Surgical Coverage: $350.00

+ An additional $10,000 limit can be added to the Surgical Coverage Plan to cover colic medical and/or surgical expenses for an additional $150/yr.

 

When considering purchasing equine insurance make sure to do plenty of research. It can become overwhelming when first looking into insurance due to the number of providing companies and the levels of coverage available. A company that specializes in equine insurance, or at least livestock, is highly recommended. By doing this, their overall understanding of the possible claims will heighten the ease of filling a claim. This will in turn result in less run around and a quicker response from a company with more equine claim experience compared to a typical Home-owners Insurance Company.

Finally, insurance coverage does have limitations. Limitations will be specific to the insuring company and are details to look into when considering equine insurance. Most insurance companies have an age limit on coverage, as well as restrictions regarding horses with preexisting conditions, specific to their policies. Make sure to compare coverage limitations, exclusions, and deductibles when considering different policies.

ColiCare – SmartPak

colic_care-379x121ColiCare is a wellness program supported by SmartPak. This program allows a small peace of mind by providing up to $7500 towards colic surgery (reimbursement will only cover the cost of the surgery not any medical treatment of the colic). To qualify for this wellness program, administration of an eligible ColiCare product daily to your horse is required. These supplements are designed to provide comprehensive hindgut support to lower the risk of digestive upset that can lead to colicky episodes with ingredients like prebiotics, yeast, and enzymes. An annual wellness exam with a veterinarian is also required. The veterinarian will verify vaccination history, perform a dental exam with recommendations, and perform a fecal test to set-up a deworming schedule. ColiCare is a wonderful compliment to any insurance policy. ColiCare will reimburse independently; therefore, additional financial coverage will be seen in addition to any initial insurance reimbursement.

Program Requirements

Annual Wellness Requirements, which include:

  • Physical exam performed by your veterinarian
  • Dental exam performed by your veterinarian
  • Vaccinations administered by a veterinarian
  • Deworming program developed with your veterinarian that includes at least one fecal test and two deworming administrations per year

For more information on the products or to get signed up for the ColiCare program, please visit the SmartPak website: https://www.smartpakequine.com/colicare. Anoka Equine Veterinary serves does currently have clients that are on this program.

 

EQCO Coverage – Platinum Performance

eqco-program-slidePlatinum Performance has its own wellness program similar to the one offered by SmartPak. The coverage that Platinum Performance offers is up to $8,000-$10,000 towards colic surgery. To qualify for this coverage you have to administer eligible supplements to your horse on a daily bases, as well as complete an annual wellness exam with your local veterinarian. Platinum Performance supplements are formulated to provide omega-3 fatty acids, antioxidants, vitamins and trace minerals to support total body heath.

For more information and for a detailed list of available supplements, please visit Platinum Performance’s website http://www.platinumperformance.com/EQCO/.

**Please note: any previous colic/abdominal surgery, history of chronic colic, or an incidence of colic in the past twelve months will mark the horse unqualified for the both programs.

Who needs equine insurance? No one. Is this for everyone? No. Ultimately these questions come down to anyone who can not easily afford the unexpected cost of extensive treatments or surgery can benefit from having it. However, there is still an expense associated with either the ColiCare Program or insurance and it is a cost to be economically comfortable with. If this annual expense is something you may be willing to invest into, then these two program options provide a peace of mind if an emergency situation were to occur and life-saving-options will be more easily funded.

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What is involved in colic surgery?

By: Dr. J.C. Thieke

Colic Surgery

Doctors examining the intestines.

Colic is the catch-all term used to describe abdominal pain. In many cases, it is a problem with the horse’s intestinal tract. While most colic cases can be treated and resolved with medical therapy such as pain management, IV fluids and stomach tubes; sometimes surgical intervention is required.

The cases that require surgery are those with unrelenting pain that cannot be managed medically and/or have pre-surgical diagnostics such as a rectal exam, ultrasound exam, or belly tap that suggest a surgical problem. In surgical cases, it is always considered an abdominal exploratory. While the pre-surgical diagnostics and blood work can help shed some light on the cause of the colic, they cannot answer all the questions prior to surgery.

Before colic surgery, the patient will have an IV catheter placed in the jugular neck vein. This provides venous access to easily deliver medications and IV fluids during surgery and post-op. A naso-gastric (stomach) tube will be placed and taped in place so any fluid (reflux) that comes up out of the stomach can be controlled and kept out of the horse’s lungs. His mouth will also be rinsed out and antibiotics and pain medication will be given. The hair on the abdomen will be clipped either prior to anesthesia induction, or after the horse has been positioned on the surgery table.

Anesthesia is induced with injectable medications and the horse, as he becomes unconscious, is guided down to the floor. At this point an endotracheal tube will be placed into his trachea so that he can be connected to the gas anesthesia machine. Once the tube is placed, the horse is lifted with a hoist by the legs and positioned on the surgery table. The anesthesia is maintained using an anesthetic gas just like in humans. An EKG monitors heart rate and rhythm, and an arterial catheter directly measures blood pressure.

Once the final clip of his abdomen is completed, the area is scrubbed with a surgical scrub that typically takes 7-10 minutes. The abdomen is sterilely draped, making the surgical preparation complete.

Colic1

Small intestines showing healthy pink tissue on the left and red dying small intestines on the right.

A 1 4 to 16 inch length-wise incision is made along the ventral abdomen (the bottom of the belly in a standing horse). The exploratory begins by first palpating the abdomen for the inciting cause. In some cases the intestine is so gas distended that a suction unit and needle are used to pull the gas out of the intestine. This allows the two surgeons ample room to sort through the different parts of the intestine. Ideally the cecum, which is similar to the appendix in humans, is the first part of the intestine to be exposed through the incision. If it is not easily exteriorized, then a large intestinal torsion may be the cause of the colic. The large colon is lifted up and out of the abdomen with care to not tear the colon wall as it is manipulated. In the case of a torsion, the twist is reduced by rotating the colon in the correct direction until the cecum comes free, indicating it is now in the correct position. In most large colon surgeries, the contents of the colon need to be removed to either relieve an impaction or remove accumulated toxins from the twisted colon as a result of decreased blood flow due to the torsion. To remove the intestinal contents (an enterotomy) the colon is positioned on a tray and an incision is made to allow the contents to be flushed out; meanwhile, the inside lining of the affected bowel is assessed to provide important information regarding the horse’s prognosis. The incision in the bowel wall is closed in two layers, thoroughly rinsed, and placed back into the abdomen in the correct position.

Colic

Round worms in the small intestines of a weanling causing an impaction.

A small intestinal problem is typically evident immediately once the abdomen is opened.  Stretched out and gas distended small intestine indicates a small intestinal obstruction. This can be caused by the small intestine getting stuck in an abnormal location, twisting on itself, or having a tumor wrap around a section of it. If the blood flow to a section of small intestine is compromised, that section may die and need removal. This procedure (an anastamosis) requires tying off the blood supply to the affected section, cutting the section out, and reconnecting healthy intestine to healthy intestine. Once complete the repaired intestine is placed back into the abdomen.  A thorough final exam is performed on the remainder of the abdomen. This includes: the liver, small colon, spleen, kidneys, and the ovaries and uterus in mares. A special solution (carboxymethylcellulose or belly jelly) is placed in the abdomen to help minimize the risk of adhesions between the abdominal contents.

Finally, the large initial abdominal incision is closed in 3 layers: the body wall and layer below the skin (subcutaneous) with suture, and the skin with staples. A bandage is sutured onto the skin and the horse is removed from gas anesthesia to recover. We ask a lot from them post anesthesia. They will stand on their own, which usually takes around 30 minutes. Once the horse is stable enough to walk and back in the stall, they will be hooked back up to IV fluids and medication will be given to stimulate intestinal motility. The normal recovery from colic surgery will include 5-7 days in the hospital on fluids, antibiotics, and pain management. In many cases, acupuncture is used to stimulate intestinal function and for additional pain management. If all proceeds as planned, food will be re-introduced over the next several days. Once the horse is off all medications and on full feed, they can be discharged.

Recovery at home is 6 weeks of stall rest with the skin staples being removed 2 weeks post-op. Stall rest is followed by six weeks in a small pen and then a gradual return to work and pasture turnout. Success rate varies on the type of colic surgery performed but on average about 75% of horses that have colic surgery survive and go back to their normal activity.

colic_care-379x121

Equine Osteochondrosis

Megan Slamka, DVM

What is Osteochondrosis?

Osteochondrosis (OC) is a common developmental bone abnormality that can result in lameness in horses. In a growing horse, the end of the long bones start as cartilage and then converts into bone as the horse grows. OCs occurs when there is a disruption in the cartilage converting into bone, (endochondral ossification) most commonly near a joint surface, see figure 1. The cause of OC is thought to be due to lack of nutrition to the developing bone. Initially, nutrients are brought to the developing cartilage through small vessels, however, as the cartilage begins to turn to born, vessels diminish and the joint synovial fluid becomes the sole source of nutrition to the cartilage. This can lead to areas of retained cartilage which then die and split off. The term osteochondritis dissecans (OCD) is used when a flap of cartilage or a joint mouse is present. Alternatively, Osteochondrosis(OC) is used when there is a defect in the cartilage, but there is no free edge. The most common joints affected are in the stifles, hocks, and the fetlocks.

OC Image 1

Figure 1: Disruption in endochondral ossification due to poor blood supply leads to defects in the subchondral bone and retention of cartilage. Adams Lameness 2011, pg 2633.

 What factors contribute?

Many factors contribute to the cause of OC. Although, the exact inciting factor is unknown; genetics, rapid growth, conformation, trauma and dietary imbalances have all been implicated. Studies have shown animals fed a high energy diet and diets low in copper or high in phosphorus may predispose horses to development of OC. Thoroughbreds and Quarter Horses are overrepresented in breed prevalence; however, a variety of breeds can be affected. Horses tend to be around one year of age when clinical signs manifest, but OCs can manifest later in slow growing breeds such as Warmbloods.

Diagnosis

Diagnosis is mostly based on presenting clinical signs, signalment and radiographic evidence. Presenting clinical signs often include acute onset of joint swelling that may correlate with a recent increase in level of exercise. Horses tend to have a very stiff gait which is exacerbated by flexion tests. Diagnosis can be confounded in that horses may show both radiographic and clinical signs, clinical signs without radiographic abnormalities (but arthroscopic abnormalities), and radiographic abnormalities with no clinical signs. Radiographic signs include areas in the bone that appear dark or borders that are irregular.

OC image 2

Treatment

In mild cases, such as small lesions in very young horses, a more conservative approach can be taken. A reduction in feed intake is recommended to slow growth rate along with rest. Intra-articular corticosteroids and hyaluronic acid may be helpful as well in reducing swelling and associated synovitis. More often, surgical intervention via arthroscopy (see figure 3) is needed when lameness is a factor and the horse is over 8 months of age. The arthroscope is inserted into the joint and the cartilage flap or the bone fragment is removed. The bone underlying the defect is smoothed out to reveal healthy bone to ensure optimal healing.

OC Image 3

Prognosis

Overall, the prognosis for a return athletic function is good post surgery, with more severe lesions and those in the shoulder joint having a worse prognosis. Success rates have ranged from 75 to 90% depending on the affected site.

 

Managing Equine Leg Wounds with a Cast

Managing Equine Leg Wounds with a Cast

J.C. Thieke, DVM

Proud FleashFrom an anatomical standpoint, everything below a horse’s hock on their hind leg or the carpus (knee) of their front leg is just tendons, ligaments, joints, bone, and skin. As a result, there is less blood supplying nutrition to heal the wounds that occur on this part of a horse’s leg. The structures that are integral to a horse’s soundness, the joints, tendon, ligaments and bone, can become easily exposed with lower leg wounds. It is extremely important to manage these wounds effectively, so as to ensure optimal healing and minimal scaring.

After a horse has sustained a large wound to this area of their body, our first step is to evaluate which structures are involved and to what degree. If a joint is involved, that joint will need to be flushed and have antibiotics placed into it. If flexor tendons (on the back of the leg) are severed, they will need to be sutured back together. Other instances, if it is an extensor tendon (on the front of the leg) that is severed, it may be able to heal without the aid of sutures. Damage to the flexor tendons is much more serious than injury to the extensor tendons. In fact, significant damage to the flexor tendon can be career ending. In contrast, completely severed extensor tendons will heal and the horse can return to full athletic function in most cases.

Exposed or damaged bone will need to be scraped and debrided to expose healthy bone. If bone is exposed, the development of a dead piece of bone will occur. This is called a sequestrum. Usually taking 6 weeks to develop, it will need to be removed. Fortunately, most leg wounds do not develop this.

The assessment of the wound allows us to develop a plan to treat the wound as well as determine the likely prognosis for the horse. Most horse owners know lower leg wounds are susceptible to the development of exuberant granulation tissue, often called proud flesh. This development can be minimized if the tissues involved in the wound are immobilized during the healing process. One way to do this is with a good bandage, although a cast is preferable. The same fiberglass casts that are often applied to people can be used on horses. If the wound is below the fetlock, a short pastern cast that incorporates the foot can be used, and it can be applied while the horse is standing under sedation. If the wound involves the canon bone region, it will require a cast that incorporates the foot and extends up the leg to either the bottom of the carpus (knee) on a front leg or the hock on a hind leg. This cast can only be applied while the horse is under anesthesia.

Buttercup CastGeneral anesthesia is needed for any wounds that involve bones, joints, tendons or ligaments. These wounds usually require surgical debridement, joint flushes, or tendon repair. It is best if this is done with the horse anesthetized. In conjunction with these procedures, we often do a regional limb perfusion with antibiotics. This involves putting a tourniquet above the wound and placing a catheter into a vessel below the tourniquet for injecting the antibiotics. This allows us to get a very high concentration of antibiotics into the injured tissues.

Once the wound is cleaned, flushed, perfused, and sutured back together, it is time to apply the cast. The limb is padded well and held in the position desired for the casting. The horse is allowed to recover from anesthesia, then treated with antibiotics and anti-inflammatory medications based on the severity of the wound and the level of contamination present when the wound first occurred. Most horses will wear the cast for 4 to 6 weeks. The horse must be stall confined during this period and the cast is usually removed with the horse standing, unless the initial wound makes a second cast necessary.

The mobilization of the wound in a cast provides a better healing environment than that of a bandage. The cost of the cast itself over the course of the healing process is often cheaper than the bandage costs over the same amount of time, given the number of bandage changes that would occur over the same time frame. Typically, the wounds will also heal faster in a cast then in a bandage due to the amount of motion present at the wound site when it is bandaged. Cast treated wounds heal with a healthy flat granulation bed, rather than the raised proud flesh tissue that occurs with a bandage. The granulation bed will usually stay flat as the skin cells migrate across the wound to finish the healing.