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Dr. Jeff Hall on Equine Sedation: What Horse Owners Should Know

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Pegasus Co-Founder Jen Tankel is joined by Dr. Jeff Hall, DVM, Managing Equine Technical Services Veterinarian with Zoetis. 

Dr. Hall explains what sedation is, how different types of sedatives work and what questions to ask your vet before various procedures. 

This episode is brought to you by Zoetis.

Need a helping hand to care for your horse? Prescription Dormosedan Gel® by Zoetis is easily administered under your horse’s tongue. Speak with your veterinarian to see if Dormosedan Gel is right for your horse. For more veterinary-informed solutions, visit ZoetisEquine.com or follow along on Instagram and Facebook @ZoetisEquine for horse care tips and resources. 

IMPORTANT SAFETY INFORMATION 

IMPORTANT SAFETY INFORMATION: Do not use Dormosedan Gel in anesthetized or sedated horses, or in conditions of shock, severe debilitation, or stress due to extreme heat, cold, fatigue or high altitude. Handle gel-dosing syringes with caution to avoid direct exposure to skin, eyes, or mouth. See full Prescribing Information at www.DormGel.com/PI.

All trademarks are the property of Zoetis Services LLC or a related company or a licensor unless otherwise noted. Dormosedan is a registered trademark of Orion Corporation, distributed by Zoetis under license. 
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SPEAKER_02

Need a helping hand to care for your horse? Prescription dormosidin gel detomidine hydrochloride by Zoetis is easily administered under your horse's tongue. Speak with your veterinarian to see if dermosetin gel is right for your horse. For more veterinarian form solutions, visit zoettisequine.com or follow along on Instagram and Facebook at Zoetis Equine for horse care tips and resources. Important safety information. Do not use dermosidin gel detomidine hydrochloride in anesthetized or sedated horses or in conditions of shock, severe debilitation, or stress due to extreme heat, cold, fatigue, or high altitude. Handle gel dosing syringes with caution to avoid direct exposure to skin, eyes, or mouth. See full prescribing information at www.dormgel.com slash PI. All trademarks are the property of Zoetis Services LLC or a related company or a licensor unless otherwise noted. Dormosidan is a registered trademark of Orion Corporation distributed by Zoetis under license. So today's episode is one that everyone's going to want to turn into, whether you're a competitive rider or you're a casual horse owner. We're diving to a topic that isn't talked about enough. It's one that most of us have encountered in the barn or at the vet clinic, and that is equine sedation. So for nervous horses who need a little extra support, staying calm during routine procedures at home, such as first aid or body clipping, to standing medical procedures done by a vet, sedation can be a game changer for the safety and welfare of both horses and handlers. But not all sedatives are the same, and it's important to note the difference. So to walk us through everything horse owners should know about equine sedation, we're joined by Dr. Jeff Hall, managing Equine Technical Services Veterinarian with SOETIS. So he's here to explain what sedation is, how different types of sedatives work, and what questions to ask your vet before various procedures. So thank you so much again for joining us, Dr. Hall. Where are you joining us from, by the way?

SPEAKER_00

I'm joining you from San Luis Obispo, California.

SPEAKER_02

Nice. Okay. Sun sunny and 75.

SPEAKER_00

Actually, we had a rainstorm that came through this morning. So that's uh that's nice. But yes, we do have very nice weather. It's one of the perks of uh living on the central coast of California.

Meet Dr. Jeff Hall

SPEAKER_02

Well, you say West Coast is the best coast. So all right. So Dr. Hall, can you give us a bit of more background about who you are, how you're working with Zoetis, your background experience, and all that good stuff.

SPEAKER_00

Yeah, sure. So so I guess we could start with Zoetis. So my current job, I'm I'm um a managing veterinarian for the Equine Technical Service team, Zoetis. So for horse owners who aren't familiar with that, Zoetis is a global animal health company that makes pharmaceuticals and diagnostics and a lot of different things for your pets across the board. I mean, we for dogs and cats and cattle and livestock and horses, it's it's an incredible company. And so the company has for each of those individual animal divisions, they have groups of veterinarians that um that work directly with the teams. The equine specialists is what we call them on our side of the business. And so those are the specialists that work directly with veterinarians in the field and support their practices. So you're as a horse owner, your veterinarian works very closely with these equine specialists in the field. And then I support those equine specialists, and so the team of veterinarians that I'm on does the same. And so we, from a technical standpoint, we use our expertise from being in practice or academia or advanced degrees or whatever many of my teammates have that are there to support uh those equine specialists in the field and support your veterinarian directly at their practices. So I've been doing that for um a little over, well, I think this 13 years now. Um and so uh prior to that, I was in practice in Oregon in uh equine practice uh that was uh ambulatory and a hospital practice and did a little bit of everything from surgery to medicine to routine care, wellness, all of that. Um I did my schooling and my training out east in North Carolina. So North Carolina State Veterinary School is where I got my veterinary degree there, and then I also did a one-year internship in equine medicine and surgery at that university. And I met my lovely wife who was in the class behind me, and she had family in Oregon. So as soon as we finished school, we moved to the West Coast, and we've been here uh ever since. Now, I think for anybody um young out there that's thinking about the veterinary profession as a career, you know, I may be a little bit biased, but I think it's it's the best, most amazing career or um a profession that you could have. My advice to anyone who's interested in that is is first and foremost, you know, spend some time with veterinarians that are in in the area that you're interested in, whether that be if you're interested in horses and spending time with your equine veterinarian or small animals and small animal practice. Then there's so many different things with this profession that I mean you can do wildlife, you can do general practice, you can do research, you can do, you can go and teach at a university, you can work with industry, you can work with nonprofits. I mean, there are so many different things that the profession opens up that I think are is is pretty pretty incredible for for people who are needing. And and, you know, we need more veterinarians now, more than we ever have. So the advantage of that is that it opens up a lot of opportunities for new veterinarians or or students who are coming out of school, is that there's a lot of a lot of opportunities out there because um we we need more veterinarians. And so, you know, it's not all rainbows and unicorns like like anything. I mean, it's it's a tough profession. You know, it you have to deal with life and death sometimes on a daily basis with pets and and pet owners. And emotionally that can be very challenging and and difficult for um veterinarians in in the profession. But there's now more and more support for veterinarians uh in in those areas, and I think you know the um the pet population um will continue to grow and we people you know love their pets like their family, and so um we're always gonna need veterinarians that are there to take care of them and help them. And so um if you're interested in, you know, seek out seek out your veterinarian and talk to them about it and uh take the steps from there. So and get good grades. Yeah, I mean it's it's you know, and and but don't let that discourage you. I mean, they're some of the best veterinarians that I know out there were not straight A students, right? And they weren't the they weren't the top of the classes, you know, and so grades are not everything. I mean, to to be a good veterinarian, you know, you need to be compassionate, you need to be empathetic, you need to be able to connect with the owners and the pets, and and so those aren't those aren't measured by how you know if you got an A or a B in a particular class. And and so there's there's more to it, as you can imagine, and your bedside manner is so critical to being able to take care of your patients and be able to be happy in the profession that you do. So if you're not, you're not school's not your your biggest strength, don't be discouraged. It might be a little bit more work for you and more time with the books, but um but some of the best veterinarians are are are those that I described.

SPEAKER_02

I imagine you learn so much on the job too. Like I studied engineering and s and of course I'm no longer in engineering, but when I did work at engineering firms, what I learned in school was was just so different from what was what what it was like, you know, on the ground. And so I imagine there's a bit of that too. Of course, you need to know the foundations and know the technical jargon and how to administer, you know, Dordocidin gel and gin anesthesia. Like they're not gonna not gonna just throw you out there day one and you're gonna be doing that. You need to learn that in school. But I imagine so much of what you're learning actually comes from on the ground. So and that that wisdom and in practice.

SPEAKER_00

Yeah, it's um, you know, I've been doing this for 25 years and I still learn something every time I work on a horse in different situations. And so we're we're as veterinarians, we're constantly learning and improving, and there's so much new information and research and data and new products and for horses and for pets, and that the future's really bright.

SPEAKER_02

Totally. You both have horses, is that right? Or or are you are you both riders?

SPEAKER_00

Yes, yes. We both we have three horses um at our ranch in California, uh or it's I call it a ranch. It's it's probably more of a petting zoo than a ranch. So we have many donkeys and goats and llamas and chickens and go and turkeys and a little bit of everything. But yes, we have two three amazing horses uh that uh um uh two quarter horses and a uh Rocky Mountain uh horse that uh we just use for pleasure. So just trail riding and weekend camping and and that kind of stuff.

SPEAKER_02

So that's so awesome. Do you guys have kids?

SPEAKER_00

Uh we do. Yep. We have two boys that are uh uh now they're off and doing their thing now. My youngest just uh just uh went to college about a week ago. So uh it's an exciting time for them and for us.

SPEAKER_02

So are they are they feature vets too? I mean you parents parents are vets, horses, have they got the genus well, or are they like soccer? No pets.

SPEAKER_00

Where are they on the Yeah, no, it's a good question. My oldest, no. He's he's he I don't think he wants to be a veterinarian. Uh my youngest is pre-vet officially, it is now what, his second week of college. So so we'll see. It's uh it it it I think is the greatest profession on the planet because of what we get to do and all the variety and the things that we experience. But it it is a lot of time in school, and uh you have to you have to be able to either like or endure that much school. And I think my youngest is I'm not sure that he would wants to do that. So we'll see. Time will tell. He would make an incredible veterinarian. He's got he's got the right personality, and and obviously both my boys you know have an incredible love for animals because that's what they grew up around. So I think they both would be great vets. And we definitely need more vets. So fingers crossed, maybe it'll happen.

How Sedation Helps Safety

SPEAKER_02

The Hall veterinarian empire will continue out west. Absolutely. Getting it right into kind of the foundations of equine sedation, if you will. So we'll start with the basics. How do you typically describe equine sedation to horse owners?

SPEAKER_00

Yeah, well, thank you first for for doing this and setting this up because I think it's such an important topic. And we, as veterinarians, get a lot of questions about sedation from horse owners, and it's something that a lot of them are very anxious about for good reason because you know they're seeing their horses under sedation, and it may make them a little bit nervous. So asking questions about it is something that's pretty common. So so when I describe sedation to a horse owner, I mean, I think the most important thing is any of us who own horses or around horses know that horses have a really strong fight or flight response, which is natural. I mean, that's built into their instincts and their genetics, and it's what kept them alive in the wild. And so their first response to anything that's painful or scary or they don't feel comfortable is to get away as quickly as they possibly can. And so obviously, in a situation where we're there trying to help them, it may be an emergency situation, um, it may be something we're doing routine that might be a little bit scary to them, sedation allows us to basically calm them. It basically just make them comfortable in the situation that they're in, make them a little less stimulated by other things that are happening around them, and provide a situation in which they feel safe, which makes us feel safe when we're handling them and taking care of them, so that we can get things done that are sometimes life-saving for them that without sedation, I mean, it's such a vital component to veterinary practice. And without that, if you think back to the years prior when we didn't have these sedatives in practice, um, we're kind of relying on physical restraint, which is never something that's very good or comfortable for the horses. And so we are very blessed now to have some amazing, very safe, very effective sedatives that can help horses in these situations.

Routine And Emergency Use Cases

SPEAKER_02

Yeah, absolutely. Uh so why might a horse need to be sedated? Like what are the most common situations where it is used?

SPEAKER_00

Yeah, sure. Well, that's we can kind of break it down into two groups, you know, kind of routine care and medical care, I think is a great way to look at it. So from a routine standpoint, you know, there are things such as dentistry that where we're working on horses' teeth. Horses have teeth that continue to grow their entire life, which is different than our teeth. And so they require regular dental work to be able to keep them as healthy as possible. And so to be able to do an exam properly to look into your horse's mouth and know exactly what's going on so that we can make a correct treatment plan. It's very difficult to do that properly, as you can imagine. They can't just open up and say, ah, and just stand there for us to look at. So they don't love to have their mouth looked at. And so sedation is critical for those. So it just relaxes them and allows us to take a good look in there. We often can put what's called a speculum in their mouth, which just allows us to open up their mouth so we can see all the way in the back. And then, you know, the dentistry procedure itself, where we're working on their teeth, also sedation is really important for that because it just makes them feel comfortable. Most of the sedatives that we use have pain relievers in it, also. So if they have uncomfortable teeth or they have an abscess or some sores or something like that, the sedation will help kind of relieve that. We use a lot of sedation routinely for horses if we're doing partnering with the farrier to do farrier work on them. So if your horse is anxious or again, they have something that's painful with their foot and they're and we need to do something to the farrier needs to work or do some corrective shoeing, then sedation can be really important for those. Um, you know, probably the most common uses from a veterinary standpoint of sedation are for medical procedures and diagnostics. So you can imagine any emergency that your horse is going under, probably like a colache, a bellyache, lacerations, an injury or something like that, most of the time they're in quite a bit of pain and discomfort and they're very anxious. And so it's difficult sometimes to even do an exam or to be able to get move around them safely in those situations because it's an emergency. And so sedation allows us to have give them pain relief, but also sedate them and calm them down in those situations. Diagnostic-wise, most of horse owners have probably had some experience where maybe their horse had to have an x-ray or maybe an ultrasound or some type of procedure, maybe a scoping to look in their stomach for ulcers. All of those procedures we use sedation for so that they can just, the horse just stays very calm and quiet and is relaxed, and probably most importantly is still, because if they're moving during those procedures, especially x-rays or ultrasounds or things like that, it's very difficult for the veterinarian to be able to get a quality image or see what we're seeing and for them to be kind of really quiet and still is important. And, you know, that's those are the main ones. I mean, therapeutic-wise, if we're administering like joint injections or um, you know, some types of medications and some types of treatments, uh, it helps to have some sedation on board for them.

What To Ask Your Vet

SPEAKER_02

Yeah. No, that makes perfect sense. It's something where you're able to get in there very effectively, quickly, the horse is more comfortable, everyone is in a safer position. I'm sure they they don't mind this procedure as much when they are sedated, just thinking about a human too. I think that there are plenty of humans that might even require a little bit of sedation before they go to the dentist or to get some of these things done. So this all makes perfect sense. Um, definitely a win-win. And then and going into the types of sedation and exactly how they work. So, what are some questions that listeners could ask their veterinarian if their horse will undergo any type of sedation?

SPEAKER_00

Yeah, so it it's it's great for horse owners to ask about what procedures are being done or medications are being used or sedation, because I think it's it's always good because sometimes you're worrying about that and uh as a horse owner, and and you're probably thinking of things that are much worse than the reality of the situation is. So just asking good questions, I think, is important. So the most common questions that I think most horse owners ask uh about sedation is, you know, will my horse lay down? How long is it going to last? They may say, are, you know, are there any do you have any concerns or side effects that you're worried about with this particular sedation? You know, why are you using the particular sedation that you you have chosen? Because they may be familiar with some different sedations. And then, you know, how are you going to administer the sedation to my horse? Um, because there's there's lots of different routes. Most of the time, veterinarians are administered sedation through an intravenous injection, so an IV injection. Uh, but sometimes we'll use intramuscular injections. There are oral um administration routes through the mouth, um, even things on the skin. So there's lots of different um options when it comes to the different sedatives that we're using as well as the routes that we're using.

SPEAKER_02

That's actually a good question about them laying down. Is that possible? Has that ever happened?

SPEAKER_00

Sure. It has happened and it can happen. It's probably one of the more common concerns that horse owners have if they haven't seen their horses sedated before, if it's the first time that they're seeing their horse undergo sedation, because when we administer IV sedation to horses, it starts taking effect very quickly. So within a minute or two, you're going to start seeing effects of the sedation. The first things that you're noticing or the horse owner will see is that their head, the horse's head will stop to start to drop down. And then probably what's most makes them most nervous is that they start to get a little bit wobbly and a little bit unstable on their feet. And that is a very natural progression of the sedatives that we use. It's as they're taking effect, they're going to have a little bit of instability. It's an important part of how the sedative is working and it's attaching to the receptors and starting to have an effect on the horse's nervous system. And what we see is that by maybe four or five minutes post-sedation, the horses have just gotten into a very nice, comfortable plane of sedation, and they often are no longer wobbling or kind of looking like they want to lay down. And so it's very rare for horses to lay down with sedation. We do see it in some older horses. We do see it sometimes if they horses that have some arthritis and their joints are sore and they're just kind of, they're just like, actually, I feel good. I I kind of want to just lay down. But it's it's not our goal as veterinarians for the horses to lay down at all during sedation. We're always prepared for that. We always watch and we we we know what to do if if they lay down. But again, it's something that's um it's pretty uncommon. And once you've seen it a few times and your horse has kind of gone through that, you realize that's just a normal part of their process until they just get comfortable and and set into their level of plane of sedation.

SPEAKER_02

Yeah, it's interesting. Is there on that note, is there any correlation between horses that will typically like sleep on the ground to when they're actually sedated? Like this horse typically doesn't sleep while standing up. They they're always napping and falling asleep in their stall, like laying down, or is that completely unrelated?

SPEAKER_00

Yeah, I don't think there's a direct connection between those commonly. If your horse loves to lay down and sleep, that they'll do that when they're sedated. I haven't had that experience in my practice. You know, there are we when we look at sedation, and your veterinarian is going through a lot of different decisions when they're choosing the sedatives when they're looking at a horse. We're looking at the horse's weight, we're looking at the horse's age, we're looking at the horse's health, we're looking at the horse's why we're doing the sedation, um, we're looking at their breed. So, for example, you know, there are certain breeds that often need more sedations. To provide a procedure. So let's say, for example, like a Mustang or an Arab breed or an Appaloosa, you know, those breeds which we we tend to use more sedation. And then the opposite side of that is though if we're working on like draft horses or we're working on saddlebred horses, those breeds we tend to use less sedation because we know that it just doesn't take as much for those particular horses to get them into the same plane of sedation. So you might just see your veterinarian reach for a bottle, draw up a sedative into a syringe and administer it to a horse. But before any of that has happened, they've already gone through all of these different thoughts and processes and relied on their expertise to decide, okay, this is the dose that I want to use on the horse based on their weight and based on all those other factors. And this is the route that I want to use that I think is safest for the horse and to be able to achieve what we're trying to do for them. And then, you know, the nice thing about sedatives for horses is that, you know, often if they if we're if we're giving a sedative to them and they reach kind of a plane of sedation where we feel like we need to give them a little bit more, it's it's very safe for us to have to give additional doses. We're prepared for that as veterinarians. We we know what doses to use if we need more. So our goal is to try to get the ideal sedation for them the first time. But it's not uncommon for your veterinarian to say, you know, this horse is still a little anxious, or we're still not able to do what we want. So we're gonna go ahead and give another dose to be able to achieve what we want. And so don't be don't be concerned if you see that. That's that's very common.

Common Sedative Drug Classes

SPEAKER_02

Just a little little top off is all. Yeah. That makes that makes perfect sense. Okay, and I I didn't realize that about the different breeds, but that also makes perfect sense too. I imagine a giraffe who's already very calm and chill and potentially already quite sedated naturally, doesn't require quite as much as an Arabian. But um Okay, very cool. All right, so going on to the next question I have. So since you know not all sedatives are created equal, can you explain the difference between the common equine sedatives on the market?

SPEAKER_00

Yeah, it's a great question. So probably the most common group or class of sedatives that we use in horses are what are called alpha-2 agonists. And that just alpha-2 just is the type of receptor that the sedatives work on. So common names horse owners might be familiar with are dermosidan or datomidine, xylazine, romifidine. Those are probably the three most common types of alpha-2 sedatives that we give to horses. And that's probably the most common class that we use. They're very safe, they're very effective, predictable as far as what we can expect from those. And then the other classes of sedatives that we use commonly in horses are opioids, which are kind of like morphine, but we use betorphenol in horses. Um, great medications that have very good pain medication as or pain effects or pain relieving effects as well as sedation. And then most owners are probably familiar with ACE bromazine, um, which is a phenothiazine. That's the class of drug that it's in. It's actually we consider it a tranquilizer instead of a sedative. So it it's it works by um working on receptors to reduce their anxiety. So it's kind of an anti-anxiety medication, a little bit different than like the sedative classes, but still something very common that we use for horses. You know, it's not uncommon. You might see your veterinarian using a combination of these together. And that's very common for us to do that. So we'll look at the particular situation, we'll look at you know what level of sedation we need, what level of pain medication we need, and it's common for us to kind of combine maybe two or three of those together to achieve what we're trying to do.

SPEAKER_02

This is a bit off topic from kind of just like the typical types, but on the note of ace, I haven't competed in several years. And um I started off in the hunter jumper world and then I moved to like I'm I'm an inventor now. But I remember in the Hunter Jumper world, it was very common to hear about trainers giving their students horses a bit of ace. Is that something that is still quite prevalent today in the horse show world, or is that something and I know different um types of shows might regulate that more, but are you able to speak to a little bit more of how ACE is administered in the competition world and or if that's something that's just outright banned at the moment?

SPEAKER_00

Yeah, USCF and FEI have very strict regulations about what can be used and when it can be used, and if it can even be used at all for any performance horse situation. And so I always point horse owners to those websites and to those guidelines to get the most updated and most specific uh rules and regulations as to what's safe. Because we we have to follow those rules. They're there, they're set for a reason, they're set for the safety of the horse, for the safety of the rider. You know, the last thing you want is to have a um, you know, a rider or horse that's injured because somebody administered one of these, you know, either um tranquilizers or sedatives in a situation that uh um created that type of accident or something. And so um so I I think it's it's very important that horse owners are aware of those rules and speak directly to their veterinarian if they are even considering using something like this. You know, the training obviously is a is a such a critical component of our horses and their performance and their behavior. And unfortunately, because we have these medications and sedations and tranquilizers, sometimes they're relied on in the absence of good training, right? And and I think all of us that have horses ride horses and are around them, there are a lot of things that the horses can just be worked through with good training and good management. And you shouldn't have to use these. We have them as veterinarians to be able to do the things that we talked about, but it makes me uncomfortable to think about having to use those in a performance setting or something like that because you're just trying to get through that particular event or show where it could put the rider and horse at risk.

SPEAKER_02

100%. Yeah, no, very well said. And I mean, as an inventor, I can't even imagine having your horse even a bit sedated, like on the cross-country course. Okay, that's that's really great intel. So if needed, how do horse owners work with their vet to determine if a prescription gel formula is indeed right for their horse?

Dormosedan Gel For Home Use

SPEAKER_00

Yeah, so we are and horse owners and veterinarians, we're very, very lucky to have a product called Dormosidan gel, which is a gel formulation of a ditomidine, which is a common alpha-2 agonist that we as veterinarians inject horses with for sedation. But years ago it was created into a gel that horse owners then can get from their veterinarian as a prescription and then be able to administer it orally to their own horse so that they can either, you know, for just routine husbandry, things that need a little bit of sedation, so back to kind of the farrier work, or maybe you're doing some grooming work, or you know, they're you know they're going to be anxious in a particular situation, such as, you know, fireworks or you know, a new environment or something where you would like to have the horse owner would like to have some sedation on board. And so we now have this formulation that comes in a tube like a dewormering medication that horse owners can administer. One of the most important things to remember about this as far as its administration rate or how it's administered is that it's actually administered under the tongue and not on the back on the tongue and the back of the mouth like we would a dewormer. So when we administer dewormers to horses, we want them to swallow it, go into their intestinal tract, and that's how the medication works. Dermosidangel, we actually want it to stay in the mouth and it's absorbed through the mucous membranes inside the mouth. And so when you read the instructions on it, it'll say administer under the horse's tongue. And it's very easy. It's a gel formulation that's very smooth, it dissolves almost instantaneously in the mouth. It really has no taste, so most horses don't object to it at all, other than just having something put in their mouth. And then, you know, because it's a little different route of administration, right? Remember, we talked about giving horses intravenous injections where we see effects within a few minutes. Um, when we give the oral gel to horses, it takes 40 or 45 minutes for it to take effect because it just it's a different route. It has to be absorbed into their system. So we have horse owners administer that to them, and then they're just put in a quiet place, like a nice safe stall or a quiet area where they don't have any food or water as they're just kind of starting to let the sedation affect. And then at 40 or 45 minutes in, you should have a really good idea as kind of how the sedation has affected them. And it's it's we're really blessed to have something like this.

SPEAKER_02

Yeah. No, that makes perfect sense. And is that something where the horse owner will apply that before the veterinarian or the farrier arrives, or is that oftentimes the case where a veteran or a farrier might administer it upon their arrival and it just kind of waited out?

SPEAKER_00

Yeah. So I think for the farrier and the veterinarian, so the example where you might use it with a veterinarian is let's say your horse is just really anxious about getting vaccines or injections of any type. And they just really dislike needles. And it's really stressful for them, stressful for the owner, and difficult sometimes for the veterinarian to safely administer them. So that's a very common example where the owner, 45 minutes or an hour before their appointment with the veterinarian, will give it to them. And so then when the horse, or when the veterinarian arrives, and the horse is already relaxed, it's not anxious, and and that procedure can go very smoothly. Same for the farrier. If you have communicated with the farrier and this is a horse that the gel would really help the farrier be able to do a better job and a safer job for working on their feet, then giving it, you know, 40, 45 minutes before the farrier arrives is very common. Um, you know, for the other things that we talked about, usually if the veterinarian's there, you know, as veterinarians, we're not going to use the gel at the time because we have the injectable forms, we have the ability to administer that, and it works pretty quickly. So it'd be pretty rare that we would wait around for the oral administration. So it takes a little bit of planning. You know, one of the recommendations, you know, if this is something new to your horse or something that you're doing this as far as a scheduled appointment that's coming ahead, it's not a bad idea to talk to your veterinarian, get a tube of dormosedan gel, and go ahead and do kind of a test or a trial run with your horse. The gel is administered to the horse based on their weight. So make sure you talk to your veterinarian about the weight or have a weight tape or a scale or something that you can accurately calculate that weight, and then go ahead and give it to your horse and then see the effect it is, because some horses will get lightly sedated and it may not be enough, and some horses will be just right for the procedure that you're doing. But it's kind of nice to do that um ahead of time so you kind of know what to expect so that for future routine events that are happening, you can go ahead and plan for those.

SPEAKER_02

Yeah, and those are really helpful tips. And um and you talked about how you want to administer it under the tongue and it dissolves, it's tasteless. Are there other key considerations that horse owners should keep in mind when it comes to administering it into the mouth? Like are there, you know, with gloves or just the any any other considerations that um horse owners should be cognizant of.

SPEAKER_00

Yeah, yeah. It's something that we recommend and it's on the label to wear gloves when you're administering that. We recommend always using gloves during the time of administration and then just disposing of the gloves afterwards. If for some reason you got it on your hand or your arm or something like that, it's nothing to panic about. You just wash it off with soap and water and and everything will be fine.

SPEAKER_02

You won't get sleepy.

SPEAKER_00

Yeah, you won't. And then, you know, it we we always want to be safe of any medication when we're finished using it to make sure we discard of it properly, right? There's a cap that comes with it. So you put the cap back on, you make sure it goes into a safe trash can where, you know, a dog or you know, a child or somebody couldn't get a hold of that medication. So that's just common sense in kind of handling that uh uh that medication as you as you would with any other medication that that you're doing. Um I think we talked about this already, but kind of the key is when when they're getting sedated, we want to make sure we pull all food and water away. And that's very important because horses will still, we know most of them love to eat, and any opportunity they will, they'll take advantage of that. And so if a sedated horse tries to eat, often they can potentially choke from that. And that's something that obviously we want to avoid. By taking away their food right at the time we do the administration while they're getting sedated, we don't have to worry about that. And then we don't allow them to have any access to the food or water until they're awake after uh the gel wears off. The gel in general lasts about 90 to 180 minutes or so, sometimes a little bit longer for individual horses. But taking away the food and water keeps them safe. And it actually what we found from some horses when we would just take away their food and not their water, they'd go into the stall and they'd have the gel in their mouth, and it felt kind of weird, so they just go and they'd rinse their mouth. And then you come back 45 minutes later and they'd be wide awake looking at you, and you're like, this stuff doesn't work at all. And it's just because they rinsed it out of their mouth before it had effect. So the water is important to take away too during that time so that they don't uh they don't do that.

SPEAKER_02

Okay. Yeah, that's really good advice. And and we talked about this a little bit before where we were talking about how when the horse might lay down. And so you can see if their their knees are getting wobbly and then you know their head starts to droop. What are some of the other signals that a horse will show to indicate that the gel is indeed working?

SPEAKER_00

Yeah, so probably the first things that you'll start noticing when it takes effect is that their head will lower down. And so they'll just just like you would expect, they're starting to get a little bit sleepy. So the head will lower down. You know, sometimes they, you know, we don't see this as much with the gel as we do with the injectables, but sometimes they'll get a little sweaty. That's very common for them. Um they may, you know, jewel a little bit if their head's kind of hanging down slightly. Um, but the nice thing about the gel is that it it's it's a very mild sedative. Uh and so it just kind of takes the edge off, relaxes them. Um it's not something, you know, when when we're doing an emergency procedure or the veterinarian is administering IV sedation, you know, those sedations are are um um uh a deeper level of sedation because of what we're trying to do and what we need. Um and so um the gel is nice because it's just just enough to usually take the edge off to get done what you need done.

SPEAKER_02

It's like a little margarita before you guys arrive. Just a couple couple of shots of tequila. That's all that said. Okay, so then what about post-sedation? Do you have any advice for what happens, you know, after they've they've had this gel and just like you know, uh basically any advice post-sedation.

SPEAKER_00

Yeah, so um so a couple things that are important for for horse owners to remember from a safety standpoint. So anytime a horse is sedated at any point, including when they're kind of post-sedating or they're recovering from this, we just want to be really aware of our working around them, right? Because, you know, even though they are sedated, they still can sometimes be startled. And it doesn't prevent them from being able to kick. So for any horses waking up from sedation, again, you're just being very quiet and calm and working around them. You're just taking the precautions to not walk behind them, to not startle them, to not spook them. It's important to keep them in a safe spot, right? So you want to make sure they're in an area where they couldn't potentially stumble into something that would injure them and that they're they feel comfortable. There's not another horse that's bothering them or, you know, one of their dominant pasture mates that's starting to try to push them around or something like that when they're trying to wake up from sedation. And then just allowing enough time for that to take effect. And depending on the dose and depending on the route of administration of the sedation, that time is gonna vary. But you want to make sure that they're basically bright and alert and awake and aware of the surroundings before you would potentially take them somewhere or load them on a trailer or turn them out or feed them. So we want to make sure that they basically are back to normal before we go back to any of the routine things that you do with them.

When Not To Sedate

SPEAKER_02

Yeah. And then just on that note, too, so just to really hit this home for anyone that's listening, but like when is it most appropriate for for horse owners to give that sedation at home? And when should it always be done by a veterinarian?

SPEAKER_00

Yeah, so the at-home sedation, I mean, think about that as just something that you need for just kind of husbandry procedures that you're doing. So it it wouldn't be something that you know you would want to do if the horse is in pain or going through an emergency situation or a colic or something like that. Those are just not appropriate uses of the gel. The gel is just there to design to just kind of provide some light sedation for them to be able to kind of get those uh those general, you know, routine husbandry things done. Um if they're experiencing any of those other things that we talked about, an injury, a laceration, a colic, an emergency, um, you know, those types of things, then you know it's much more um appropriate for them to wait for the veterinarian to get there to make a determination of them. Because if if the gel is administered um ahead of time and then START takes effect, and then the veterinarian is called out to come see the horse, then all of those things are changing what your veterinarian is seeing when they get there. And and our the ability of a veterinarian to do a physical exam at the time of arrival of seeing your horse in an emergency situation is so critical and so important because we use those parameters, the heart rate, their respiratory rate, their behavior, their pain signs, all of those are telling the veterinarian exactly what we think is potentially going on and how we're going to proceed with treatment for that emergency. And if those physical signs or or parameters are changed by something like the gel that you gave ahead of time and good intentions to try to help the horse, it makes it much more difficult for the veterinarian to proceed through that emergency. If you're ever questioning it at all under any circumstances, always talk to your veterinarian first before you administer it. Always call them and get them on the phone to discuss it and they'll tell you, yes, I think it's a good time to do it, or no, we need to wait.

SPEAKER_02

It's really good advice. And so on that note, too, of just making sure that you're, you know, doing the right thing at the right time. What are some of the common mistakes or misunderstandings that you have seen when it comes to sedation? It would be great to know what is the difference between sedation and general anesthesia. There might be some people who are lifelong riders, they're very experienced, but a lot of people that listen to the podcast are the parents of kids and they're just now getting into the horse show world and have their first pony. So if you could talk a little bit more about that, that'd be great.

Sedation Versus General Anesthesia

SPEAKER_00

Yeah, sure. So yeah, it is important to kind of know the difference between sedation and general anesthesia. And so when we when we talk about general anesthesia, that's a procedure in which we're the horses will actually be unconscious. And so probably the most common example for that would be a surgical procedure. No different than if us as humans went into the hospital and we had to have surgery or had to have some type of procedure. Um general anesthesia is very common for us. And very same for the horses. The advantages for for general anesthesia, of course, are that because they're unconscious, that they have uh there's no response to any stimulus at all, right? So they're perfectly still, they don't feel any pain. The surgery can be performed under very controlled circumstances, and we don't have to worry about them moving or you know, you know, being awake. And so that's the difference with sedation, right? Sedation is we're not they're not unconscious, they're awake and they're just quieter and more calm. And general anesthesia is a critical part of what we do as veterinarians. If we can do a procedure standing or under sedation, we will always try to do that if at all possible. Um, because general anesthesia, while very safe in horses, um probably the biggest risk that we worry about for anesthesian horses is when they recover and they're waking up from that. You can imagine, you know, for us as humans, you're in a nice hospital bed, you're quiet, you're just gonna kind of take it easy and just kind of slowly wake up. For a horse, you know, they they wake up um sometimes and they're obviously not sure where they are. They're still a little the anesthetics are still having some effects. Um, and so sometimes they can injure themselves when they're recovering from. From anesthesia. So we're very well at that as veterinarians. There's lots of precautions that we take to keep them as safe as possible. And it's an it's an important part of what we do in veterinary medicine. However, if if we have the ability, and then the exciting thing now is that we are doing more and more procedures understanding sedation that used to be under anesthesia, that now with technology and new equipment and new diagnostics, we can do those standing, which eliminates the risk of them having to recover from general anesthesia. So that's pretty exciting that that those advancements have taken place and we don't always have to do the general anesthesia.

SPEAKER_02

Yeah, absolutely. I think that's something that you typically want to avoid. Human, horse, any animal. You want to be able to go the sedation route when you can. And that's great to hear that there are new developments and technology and innovation that enable you to not have to go through the general anesthesia every single time. And they can just have maybe this type of sedation. So very good to know.

SPEAKER_00

Yeah. I mean, if have you ever seen a horse recovering from anesthesia before?

SPEAKER_02

Yeah, my horse, um, my old mare, she's since passed away, but um, she was an advanced level mayor and she had bone chips on her knee and she had to have surgery to get them removed. And so yeah, I mean, it was at the University of Florida um that I can't remember the the full name, but it was up in Oka up in Gainesville and um Florida. And yeah, she was there was a lot of precaution and padding and things that went into making sure that she woke up comfortably.

SPEAKER_00

Yeah. Yeah, it's it's something that, you know, no matter how many times you do it, we always get pretty nervous during that process. Um most of the time everything goes well, but you know, there's things can happen and it's can be pretty dramatic. So Yeah.

AI Advice And Vet Shortage

SPEAKER_02

I I couldn't even see I she was on the operating table and we could watch. I don't know. There's something about seeing your horse on a table being operated on. It's like I I saw it for a couple minutes and I I just kinda I still haven't burned in my memory though, but um But it's incredible what what can be done. And she was right. I mean, I couldn't compete at that level with her ever again, but she was comfortable, she could do some lower level jumping and it's just amazing. I was actually thinking too on the note of chat GPT, something that I wonder w if vets in general will get into is if you guys were to create I don't know how familiar you are with with you know AI and LLMs and whatnot, but I was almost thinking like if vet practices were to create their own GPT essentially that has all of your information, all of your learnings, just all everything that you would convey, which I'm sure is like thousands of papers worth of documents, you can essentially upload that to your own GPT. And then if someone has a question, instead of Googling on the internet or going to chat GPT, they're basically only going to what's it's it's like your own private chat GPT that is only trained on your information. So I wonder if people are going to adopt that. Like I mean, and to put in perspective, like we have that on I'm not sure how familiar you are with Pegasus, but yeah, we it's a it's our company is a horse show software company, hence some of my questions on the horse show stuff, but we have our own internal GPT that's trained on everything about our software in our company. So we can basically just ask it something and it spits off the question and it's trained on what we fed it. So I wonder if the veterinarians will be able to or if they're going to be interested in implementing something like that for their, you know, for their patients.

SPEAKER_00

Yeah, I mean it and I think it's a great idea. You know, there there have been, you know, apps and things like that prior to AIGT GPT that kind of tried to do the same thing. And the problem is, is that you can imagine is that you know the the work to maintain them and set them up and the expenses and all that are are pretty are pretty significant. But you know, it it's you know, it I think we probably all as veterinarians have done this, but I've asked them questions, you know, veterinary questions on Chat GPT and and when you read them from a professional standpoint, like I kind of put myself in the horse owner's, you know, you know, mind or or situation, and it sounds amazing and it sounds correct. And you know, there are things that have been blatantly wrong. The confidence, yeah, and it but it just it sounds and it just the way it's put, and you're like, yeah, that's that's right. And and you don't they you just can't pick that things out. And I think the same for, you know, if we asked, you know, a medical question about us, you know, it's I I'm always cautious. I like to learn from those things, but you know, then yeah, we have to lean on the experts to make sure that that those things are accurate.

SPEAKER_02

Yeah. And with um because that that's basically using open source internet, but when it's your own, you're essentially just uploading only your documents. But to your point, that would be you know, every new year when things come out and things change, you're gonna have to essentially remove all of the outdated information. So I can see that becoming burdensome, but um yeah, and that's that's super interesting. Yeah.

SPEAKER_00

When we describe equine practice, you'll you'll you'll hear some veterinarians or many veterinarians kind of refer to it as it's it's a life culture that we're that we do. I mean, it's not it's not a job, it's not an eight to five that we kind of go in and go out kind of thing. It's it's a it's part of our lifestyle, right? Most of the equine veterinarians that have been doing it for a long time. And then I think that I think that brings a lot to patient care and just connecting with pet owners and horse owners and and those kind of things. And so but that also the flip side of that coin is it's it's it's very it's been more and more challenging to get younger than the next generation to want to do that. To to, you know, because a lot of the veterinarians that are have been in their career for many years have made a lot of sacrifices to have that practice and have that culture and lifestyle. Not everybody wants to do that. And so that's that's a challenge that we're facing on the equine veterinary side is is what what happens is the attrition rate is in from equine practice to small animal is incredible. I mean most most veterinarians within three to five years have left equine practice and have gone to small animal. That that started out as equine. And there's a whole variety of reasons for that. Culture and work um hours and safety and wanting to have a lifestyle that's different and paid too. So all of those things sometimes, you know, and and the horse lovers that are that you know were or could be continue to be great veterinarians would be like, well, I'd rather work four hours a week in a small animal practice and then ride my horses on the weekend versus be an equine practitioner and not have enough time to enjoy my horses and stuff. And so there's a balance with that. And I think the profession is making some great strides to solve that issue. We're just honestly, we're 20 years behind, right? We should have been doing this, you know, two decades ago. So we'll get there and it it is improving, but it's one of the hardest things we face right now is that the shortage of, you know, I do emergency relief practice and and it's you know, because you know, the horse owners can't find a veterinarian for their emergencies sometimes. And and so it's it's just it's really, really stressful like you know, to be in the middle of the night or something to have something happening to your horse and you call four or five veterinarians and and you can't get somebody there to help you. Um that uh that makes it really tough. So Yeah.

SPEAKER_02

Gosh, and you're in a you're in a large city as well. So the fact that there's that you're experiencing that too. You know, it's not like you're in this tiny town that's everywhere, yeah.

SPEAKER_00

It really is. It's and it's getting it's getting worse, obviously, as as others leave the area or leave leave the practice. So I think it it's important important to take good care of your veterinarian. Uh because they uh last thing you want to do is have them be away. Nowadays with complaints and social media and all of that, it's just it's made, you know, things more difficult and more highlighted as far as those those pain points.

SPEAKER_02

Well on the on a positive note, you're married to a vet, so she gets it. She gets it. And that lets like it's like my co-founder and I were actually married as well. So you know when you have a customer support that's happening at like 9 p.m. on a Saturday, it's not like someone who's not in the industry is like, why are you on your phone talking? So at least you've got the support at home, and hopefully you'll you might have two more vets in the family too. Might be increase increase the vets there.

SPEAKER_00

But um, it's important you you may get rec recommended from someone else to give XYZ to your horse at a certain particular time, or they'll say, you know, this is perfect, or this worked great on my horse. Let's try this for your particular horse or something. And so, you know, I really caution horse owners on doing that um without talking to their veterinarian first, because each horse is an individual, each is different. The last thing you would want to do is, you know, have something happen that would be negative from that situation. So I just I would say don't use sedatives if you're not directly directed from your veterinarian on your horse under any circumstance. I think that's that's important. And we talked about kind of the misconceptions of of you know the horses laying down uh during sedation. I think that's not something that we have to worry about uh in most cases. And sedatives, the sedatives we have that we use as veterinarians and the ones that are labeled for administration to your horse orally are extremely safe. If you're concerned about that or worried about that, ask your veterinarian and and they'll kind of walk you through it. But uh but we're we're very lucky to have very safe choices today.

SPEAKER_02

Have you yet encountered a horse owner saying, but ChatGPT said to do this? So I didn't have you encountered that yet?

SPEAKER_00

Yeah, the ChatGPT is is the new term for it. I mean, Dr. Google um has been used for forever.

SPEAKER_01

There's a new doctor in the United States.

SPEAKER_00

And so, you know, I think we're all experiencing that world that we're living in and adjusting to right now, and and there can be some really good information that those AI search engines can provide from a medical standpoint. However, there can be things that are completely wrong and completely inaccurate. So that again, you know, your veterinarian spends a lot of time training for many, many years and going to school and and getting degrees, and we have to s keep up on our continuing education regularly to maintain our licenses. And so they're obviously should be your most trusted resource. It's it's okay to look and search and read about those and learn as long as you ask your veterinarian about what you read and what you're thinking about and doing rather than rather on then listening to that and then trying that and then seeing if it works, and then unfortunately getting into a really potentially worse situation for your horse and for you that it may be very difficult for the veterinarian to help. So always always ask first.

Training, Age, And Temperament

SPEAKER_02

Totally. Okay, and then um talking about the temperament. So how does a horse's behavior or training affect sedation needs?

SPEAKER_00

Yeah. Yeah, so it can have a profound effect on the sedation needs. Uh so horses that are very anxious or very worked up or already very excited prior to sedation, because the sedations, the way they work, they often bind to the same receptors that adrenaline binds to. And so if the horses are already very worked up and excited, the sedatives just don't have the same effect. They don't work as well. So, so, you know, how well your horse is trained, how calm they are, your ability to kind of work with them in those situations can really help make sure that the sedations that we're using are going to be as effective as they possibly can. So, back to kind of the training that we discussed earlier. I think it's so important if your horse has a particular anxiety issue or a particular um concern about anything that's done with them from a medical standpoint, working with your veterinarian and working with your trainer to say, okay, here's the problem. This is what we identify, what options do we have from a training aspect that we can kind of desensitize them right to the situation so that the next time it comes up, they're like, no big deal. They're not worried about it. And maybe if we have to use some sedation, it's just a light dose versus if they're very, very worried and very excited, then you know, the sedation um, you know, it just makes it a lot more challenging.

SPEAKER_02

Have you also noticed on that note any correlation between age and then the angst that they might have before a procedure?

SPEAKER_00

Aaron Powell Yeah, sure. I think in general our younger horses tend to be more anxious. They tend to often require a little bit more sedation than our 20-year-old gelding that's just kind of happy to be around and may not need any sedation at all, you know. And so your veterinarian is making that determination when they're doing their exam and talking to you and asking about the history of your horse, then all of those are going to come into the determination as far as what sedative is going to be used, what dose is going to be used to uh sedate them.

SPEAKER_02

Yeah, that 20-year-old mare is still a skeptic, but the 20-year-old gelding fine.

SPEAKER_00

Yeah, I have I am one of those, so yeah, he he doesn't require much, if any, sedation at all.

SPEAKER_01

Yeah, gotcha. Well, I mean, the of course they're the the horses of a veterinarian. They they don't need any. They're the perfect patients.

SPEAKER_00

I don't know. That's we sometimes adopt the problem child because we get them from situations and we all have big hearts, and so they end up uh sometimes coming home with us. So uh we don't we don't always have the perfect ones, but but we can handle that.

Myth Busting And Wrap Up

SPEAKER_02

Well to to wrap things up, the the big final question is what is the biggest myth that you would like to bust about sedation?

SPEAKER_00

Uh yeah, I think I think this the safety uh concerns that a horse owner might have is is probably the the biggest myth if uh or that a concern that they have. You know, your your your veterinarian is very well trained, well experienced, understands these sedatives and how they have uh how they take effect on your horses. And so, you know, if if if if you just don't want your horse sedated because of the safety issues, then I say, you know, talk to your veterinarian. And that conversation I think will go very well for them to be able to explain to you the safety profiles of our sedatives, why we use them, and why it's actually probably more unsafe, right, to do what we're trying to do for the horse, for the horse owner, for the handler and the veterinarian without the sedative than it is to actually use the sedative itself. And so that's uh that's probably one of the I don't know if that's a myth, but it's uh it's something that most horse owners are anxious about if they haven't seen sedation with their horses.

SPEAKER_02

No, this is all really great advice. And um, I really appreciate you coming on and breaking this out this all down so clearly. And I know I learned a lot. I have I have a bunch of just follow-up questions probably for another time, just with my own experience and and with competition and whatnot. But um, I know our listeners will also walk away with a better understanding of what sedation can do to help keep their horses calm, safe, and comfortable in a variety of scenarios as discussed. So for anyone looking to learn more, check out zoettiskequine.com and of course always talk with your veterinarian. And we will link all of the things that were discussed uh in the show notes at the end of this episode. So everyone can go there and learn more about Zoettis, Dramocogen gel, and just all those different components discussed. So thank you, Dr. Hall, very much for coming on and for sharing all of your wisdom and advice with our audience. And um, yeah, I appreciate it. So until next time.

SPEAKER_00

All right. Thank you very much. It was my pleasure.

SPEAKER_02

Important safety information. Do not use dermositative gelow to topidate hydrochloride in anesthetized or sedated forces, or in conditions of shock, severe debilitation, or stress, due to extreme heat, cold fatigue, or high altitude. Handle gel-dosing syringes with caution to avoid direct exposure to skin, eyes, or mouth. See full prescribing information at www.dormgel.com slash BI. All trademarks are the property of Zoetis Services LLC or related company or a licensor unless otherwise noted. Dormostative is a registered trademark of Orion Corporation distributed by Zoetis under licensed.