American Association of Equine Practitioners
American Association of Equine Practitioners

AAEP Position Statements HEADING_TITLE


Position Statement Protocol (2010)

The AAEP recognizes it is often a major source of information or expertise regarding the practice techniques, ethics and client relations of the equine veterinarian, as well as in defining humane and ethical treatment of horses. Therefore, the following protocol will be used in the development or adoption of a position statement by AAEP.

• Issues or areas of concern must be introduced in writing for consideration by the board. A concise, complete background of the situation, current status and anticipated outcome must be provided. A length of no more than one page is preferred.

• A notice announcing the board’s discussion of the proposed position may appear in either Equine Veterinary Education or Spur, AAEP’s electronic newsletter. If the board notifies the membership using one of these methods, members will be given an opportunity to comment at least 30 days prior to consideration by the board. No public comment will be allowed during the board meeting, but written comment may be provided for review by the board and must be received at least 30 days prior to the board meeting.

• If it is determined that on-site inspection is required in order to develop a statement, AAEP will conduct the inspection at its
own expense. 

• No position statement may be used as an endorsement or approval of any particular breed, sport, discipline or any other use of the horse, nor as an endorsement or approval of any pharmaceutical brand or instrument, and must specifically address the actual management, care or use of the horse in a specific activity or treatment regimen. 

As a matter of policy, the AAEP does not provide endorsements of continuing education programs developed and conducted by other organizations or individuals. Furthermore, the AAEP logo and name
can only be used in a co-branding situation where the AAEP has influence or direct involvement with the scientific program content or meeting and only after having undergone review by AAEP.

• Position statements must be first reviewed and approved by the appropriate committee, prior to review and approval by a quorum of the board. Opinions, not position statements, may be rendered by the board in an emergency situation. These will not become policy statements unless the above protocol is met. 

Revised by AAEP board of directors in 2010.

  • Compliance with Officials (1998)Click to Expand


    Members of AAEP will be guided and abide by all legally established rules developed by the states, provinces and organizations under whose jurisdictions they practice. The rules and regulations of the local jurisdiction supersede all other guidelines if they do not contradict state statutes.

    Competitions should be governed by rules established within the industry regarding therapeutic administration of medications and all matters pertaining to the health and well-being of the competitive
    horse. The use of stimulant, depressant, narcotic, tranquilizer, local anesthetic or any substance that affects normal performance of the horse should be prohibited.

    Reviewed by AAEP board of directors in 2010.

  • AAEP Statement on Genetic Defects (2009)Click to Expand

     

    Introduction and Definitions

    A. Congenital Defects: Congenital defects include all undesirable traits and pathologic conditions present at birth whether they are genetic or due to intra-uterine events that results from extra-uterine influences. Congenital defects do not necessarily indicate inheritance; they simply indicate that the defect was present at birth.

    B. Inherited Tendencies: There are characteristics in horses that are influenced by a wide variety of genes, whose pattern of inheritance is complex and whose expression has strong environmental influences. Horses have been selectively bred for centuries to promote or discourage these characteristics. The selection for or against these inherited tendencies is the basis for our current breed registries. Size, power, color, speed, conformation and many other characteristics that are genetically influenced are selected for or against by certain breed registries. Variations from ideal may be
    undesirable but they are not deemed to be genetic defects.

    C. Genetic Defects: Genetic defects are pathologic conditions of proven genetic origin. These may be the result of a mutation in a gene of major effect or mutations in multiple genes (polygenic) whose effects combine to produce a deleterious or undesirable result. The degree to which some traits are expressed in horses carrying particular mutations can be influenced by environmental factors. This is called incomplete penetrance. 

    D. Undesirable Traits: An undesirable trait, as designated by certain breed registries, is a condition or behavior which may or may not be present at birth, may develop over time, may or may not be a genetic defect, but precludes registration of that animal. A variation in color is an example of a characteristic that may be considered by a breed to be undesirable. Concealment of such undesirable traits by any means, including surgery, is prohibited by breed registry. It is therefore unethical for a veterinarian to perform such treatments, except when the treatment is intended to improve the health of the horse, and when the veterinarian reports the treatment to the breed registry.

    Genetic Tests Available for Horses

    As of February 2012, tests for mutations in single genes are currently available for 12 diseases. 

    Autosomal Dominant
    Hyperkalemic Periodic Paralysis (HYPP) in the Quarter Horse
    Type 1 Polysaccharide Storage Myopathy (PSSM) in numerous breeds
    Malignant Hyperthermia (MH) in Quarter Horse related breeds

    Autosomal Recessive
    Overo Lethal White Syndrome (OLWS) in the Paint Horse
    Severe Combined immunodeficiency (SCID) in Arabian Horses
    Glycogen Branching Enzyme Deficiency (GBED) in Quarter Horse related breeds
    Junctional Epidermolysis Bullosa (JEB) in Belgians
    JEB in Saddlebred horses
    Hereditary Equine Regional Dermal Asthenia (HERDA) in Quarter Horse-related breeds
    Lavender Foal Syndrome in Arabians
    Cerebellar Abiotrophy (CA) in Arabians
    Fell Pony Syndrome

    New information in equine genetics is being generated very quickly and this list will be updated as it becomes available.

    Surgical Correction of Undesirable Traits and Genetic Defects

    According to the American Veterinary Medical Association, surgical correction of “genetic defects” for the purposes of concealing the defect is unethical. If surgical correction is undertaken for the purpose of improving the health of the individual, then it should be accompanied by sterilization to prevent the perpetuation of the genetic defect. The AAEP agrees with the intent of this position. Further, surgical correction of any characteristic specifically named by the breed organization as being prohibited, for the purpose of concealing the characteristic for obtaining registration, would be considered fraudulent and unethical. Such procedures offer no benefit to the horse and are intended only to deceive the breed organization. The AAEP does support surgical correction of conditions that are in the best interest of individual horses.

    Identification of Genetic Traits

    AAEP supports the use of genetic testing by veterinarians or breed associations to identify genetic mutations in animals so that owners can make informed decisions about breeding, purchase and specific
    treatments. Breed associations should be contacted to determine if  there are any restrictions on registration of horses with genetic defects. Licensed laboratories should be used for genetic testing.
    More information on equine genetic diseases is available at these websites:

    http://www.cvm.umn.edu/umec/lab/home.html
    http://www.vdl.umn.edu/vdl/ourservices/equineneuromuscular/home.html
    http://www.vgl.ucdavis.edu/services/horse.php
    http://www.ca.uky.edu/gluck/ServEPVL.asp
    http://www.uky.edu/Ag/Horsemap/

  • Equine WelfareClick to Expand

    AAEP Principles of Equine Welfare (2006)

    As a voice for equids on issues affecting their well-being, the AAEP believes: 

    1. The responsible use of animals for human purposes, such as companionship, food, fiber, recreation, work, education, exhibition, and research conducted for the benefit of both humans and animals, is consistent with the Veterinarian's Oath.¹

     2. Equids must be provided water, food, proper handling, health care and an environment appropriate to their use, with thoughtful consideration for their species-typical biology and behavior.¹

     3. Equids should be cared for in ways that minimize fear, pain, stress and suffering.¹

     4. Equids should be provided with protection from injurious heat or cold and harmful adverse weather conditions.

     5. Equids used in competition, spectator events, shows, exhibitions, motion pictures and television should not be subjected to the fraudulent use of drugs, non-nutritive agents, equipment or procedures intended to alter performance, conformation or appearance.²

     6. Events and activities involving equids should continually strive to put the horse first above all other interests.

     7. Equine industry organizations should identify areas where equids are being subjected to adverse procedures or training methods and work to eliminate any inhumane acts.

     8. Equids should be transported in a manner which minimizes the potential for  infirmity, illness, injury, fatigue or other undue suffering during the journey.

     9. Equids shall be treated with respect and dignity throughout their lives and, when necessary and at the appropriate time, be provided a humane death.¹

     10. The veterinary profession shall continually strive to improve equine health and welfare through scientific research, education, collaboration, advocacy and the proposal or support of appropriate legislation and regulations that promote the humane existence of equids.¹

     
    ¹Adapted from AVMA Animal Welfare Principles, 2006.

    ²Adapted from AVMA Policy on Animals Used In Entertainment, Shows, and for Exhibition, 2007.

    Revised/Reviewed by AAEP board of directors in 2016.



    Position on Equids Used in Entertainment, Shows and for Exhibition (2014)

    The AAEP supports the humane and ethical use of equids in spectator events, competitions, exhibitions, and entertainment in accordance with existing federal, state and local animal protection laws. Examples include but are not limited to racing, horse shows, polo, rodeo, and audiovisual media such as movies and television. The AAEP encourages all organizations and individuals involved in such events to develop and abide by stringent standardized rules, policies and procedures that ensure equids shall at all times be treated humanely and with dignity, respect and compassion. This should also include proper housing, transportation, nutrition, restraint, management oversight and veterinary care before, during and after use.

    The AAEP opposes tripping, injuring or causing the death of horses, mules and donkeys for any entertainment purpose or during the training of such equids for any entertainment purpose and recommends that all equine welfare guidelines or standards be adhered to. Similarly, the AAEP believes that equids used in competition, spectator events, shows, exhibitions, motion pictures and television
    should not be subjected to the fraudulent use of drugs, non-nutritive agents, equipment or procedures intended to alter performance, conformation, appearance or function.

    The AAEP encourages quality, standardized drug testing to ensure equity, fairness and the appropriate use of therapeutic medications.

    Certain events involving equids are prohibited in some jurisdictions. The organizers of any kind of competition, spectator event, show, exhibition, motion picture or television production should contact the local and state authorities prior to scheduling such an event to be sure they are acting in accordance with local laws and regulations.

    Approved by AAEP board of directors in 2014.


    Position on the Practice of Hemi-Castration (2009)

    Removal of a retained testicle, while leaving the descended testicle within the scrotum and without permanent identification of the horse as a hemi-castrate, may expose that horse to unnecessary additional invasive surgical procedures. Subsequent efforts to locate and excise the previously removed retained testicle may require extensive abdominal exploration with increasing risk of post-operative complications. As it is in the best interest of the horse, the AAEP advocates the development of a permanent identification system of hemi-castrates that is acceptable to breed associations, owners and veterinarians.

    Reviewed by the AAEP board of directors in 2016.


    Position on Stewardship of the Horse (2002)

    The American Association of Equine Practitioners advocates respect for the dignity and the welfare of all horses and recognizes their specialized needs. It is the responsibility of AAEP members to serve as stewards of the horse and to follow practices that promote the health and welfare of the horse.

    The American Association of Equine Practitioners champions and fosters: research towards understanding and reducing injuries and illnesses, education to inform and support owners, trainers, event organizers and veterinarians regarding preventive medicine, responsible training and the humane treatment of horses; modern and progressive horse care as insured by periodic examination and disease prevention implemented by licensed veterinarians in partnership with horse owners, breeders and managers, euthanasia when justified by thorough and expedient diagnostic procedures to end inhumane suffering.

    Regarding the horse in competition, the American Association of Equine Practitioners advocates: ethical and humane conditions and handling which includes proper housing, transportation and nutrition in the training and care of the competitive horse; standardization of rules, policies and procedures for all equine events to insure maximum safety, health and welfare for all participants; and quality drug testing to assure equity and fairness regarding the regulation and use of appropriate therapeutic medications as they affect the competitive horse.

    Reviewed/revised by the AAEP Board of Directors 2016.

     

    Position on Transportation and Processing of Horses (2002)

    The AAEP advocates the humane treatment of all horses and believes the equine industry and horse owners have a responsibility to provide humane care throughout the life of the horse. However, a small percentage of horses are ultimately unwanted because they are no longer serviceable, are infirm, dangerous, or their owners are no longer able to care for them. 

    The AAEP recognizes that the processing of unwanted horses is currently a necessary aspect of the equine industry, and provides a humane alternative to allowing the horse to continue a life of discomfort and pain, and possibly inadequate care or abandonment. The AAEP encourages, fosters and provides education regarding responsible ownership and management that will reduce the number of unwanted horses. In addition, the AAEP supports and commends the efforts of equine retirement facilities and adoption groups. 

    Regarding the care of horses destined for processing, the AAEP’s position is that these horses should be: 

    • Treated humanely and with dignity;
    • Transported to the production facility in accordance with the United States Department of Agriculture regulations;
    • Euthanized in a humane manner in accordance with the guidelines established by the American Veterinary Medical Association (AVMA). 

    In addition, the AAEP recognizes that the human consumption of horsemeat is a cultural and personal issue and does not fall within the purview of the association, whose mission is to improve the health and welfare of the horse. 

    Reviewed/revised by the AAEP board of directors in 2016.


    Position on the Management of Mares Utilized in the Pregnant Mare Urine (PMU) Collection Industry (1996)

    Through on-site investigations and peer review of ongoing research, the AAEP believes the collection of urine from pregnant mares and care of their offspring as prescribed by the recommended “Code of Practice,” represents responsible management of horses to produce a commodity for the benefit of man. These practices should not result in abuse, neglect or inhumane treatment of horses. 

    The recommended Code of Practice is accessible at www.naeric.org/about.asp?strNav=5&

    Reviewed by AAEP board of directors in 2010.

    Position on the Use of Horses in Urban Environments (2014)

    The AAEP supports the humane and ethical use of horses in urban environments, such as mounted patrols, tourist carriages and taxi/limousine services, in accordance with federal, state and local animal protection laws. Horses engaged in these activities require that special working and living conditions and precautions be taken for their safety and well-being. Urban environments present potential health and welfare hazards that may preclude their use, such as extremes of pollution, concussion, climate and load. 

    Provisions concerning work hours, workloads and living conditions, standards of driver training and passenger safety should be prepared for each jurisdiction and reviewed by an equine veterinarian. To ensure the health and welfare of horses in urban environments, they should be examined at least annually by competent equine veterinarians for body condition, freedom from lameness and disease, and appropriateness of living conditions and transport, with all findings recorded. Appropriate licensing standards should be established and adhered to by local authorities.

    The equine veterinarian is the most qualified individual to manage the health care needs of the horse. The owners and caregivers of horses working in urban settings should have a professional relationship with a veterinary practice with equine expertise that can respond appropriately to all emergencies, including those in which humane euthanasia is required. In the absence of a veterinarian in such a situation, the AAEP acknowledges that it may be necessary for licensed, qualified animal control or trained law enforcement personnel to perform euthanasia using the established guidelines of the American Veterinary Medical Association.

    Revised by AAEP board of directors in 2014.

    Position on the Use of Vesicants (2010)

    The use of vesicants (therapeutic counter-irritation) may be useful in the management of selected musculoskeletal disorders providing the induced tissue reaction is controlled, precautions are taken for the well-being of the animal and effective pain management is provided. Use of vesicants for therapeutic purposes should be applied under veterinary supervision.

    Reviewed/revised by AAEP board of directors in 2016.

     

    Position on the Practice of Soring (2002)

    The AAEP condemns the practice of “soring,” as legally defined in the Horse Protection Act of 1970 (HPA), to accentuate a horse’s gait for training or show purposes.

    The AAEP supports the efforts of APHIS in the application and enforcement of the HPA as outlined in the APHIS Horse Protection Operating Plan and strongly recommends imposing sufficient sanctions to prevent these practices.

    As legally defined in the HPA, “soring” refers to:

    1. An irritating or blistering agent has been applied, internally or externally, by a person to any limb of a horse;
    2. Any burn, cut or laceration has been inflicted by a person on any limb of a horse;
    3. Any tack, nail, screw or chemical agent has been injected by a person or used by a person on any limb of a horse; or
    4. Any other substance or device has been used by a person on any limb of a horse or a person has engaged in a practice involving a horse, and, as a result of such application, infliction, injection, use or  practice, such a horse suffers, or can reasonably be expected to suffer, physical pain or distress, inflammation or lameness when walking, trotting or otherwise moving, except that such term does not  include such an application, infliction, injection, use or practice in connection with the therapeutic treatment of a horse by or under the supervision of a person licensed to practice veterinary medicine in the State in which such a treatment was given.

    For additional information on this issue, please read the AAEP’s white paper “Putting the Horse First: Veterinary Recommendations for Ending the Soring of Tennessee Walking Horses” (2008), available at www.aaep.org/custdocs/AAEPWhitePaperonTWHSoring.pdf.

    Reviewed by AAEP board of directors in 2016.


    Position on Tail Alteration in Horses
     

    The American Association of Equine Practitioners condemns the alteration of the tail of the horse for cosmetic or competitive purposes. This includes, but is not limited to, docking, nicking (i.e., cutting) and blocking. When performed for cosmetic purposes, these procedures do not contribute to the health or welfare of the horse and are primarily used for gain in the show ring (nicking/cutting, blocking and docking) or because of historical custom (docking). If a horse’s tail becomes injured or diseased and requires medical or surgical intervention such care should be provided by a licensed veterinarian. 

    The AAEP urges all breed associations and disciplines to establish and enforce guidelines to eliminate these practices and to educate their membership on the horse health risks they may create. Members of the AAEP should educate their clients about the potential health risks, welfare concerns, legal and/or regulatory ramifications regarding these procedures based on the relevant jurisdiction and/or association rules. 

    Approved by AAEP board of directors:  5/1/2015




    Position on Thermocautery or Pin Firing (2006)

    Thermocautery may have therapeutic value for certain conditions in the horse. When applied judiciously and in conjunction with appropriate analgesia and aftercare, the AAEP considers the modality an acceptable form of therapy in cases that have proven refractory to conventional treatment. The application of this therapy should be based upon an accurate diagnosis and performed only by a veterinarian. 

    Recommendation for below position: The Council have a brief discussion regarding AAEP continued interest in the development of a permanent ID system.  Nothing has occurred on this since 2009’s position development.  The subcommittee did reach out to Dr. Embertson, Chair of ACVS, and he said ACVS has not developed such a system.


    Reviewed/revised by AAEP board of directors in 2016.

  • Horse ShowClick to Expand

     

    Horse Show Official Veterinarian (1971)

    The responsibilities of the official veterinarian for horse shows and other equestrian events are as follows:

    • He or she shall serve as a professional consultant on veterinary matters to the show management, the stewards and the judges.

    • He or she shall advise the management and cooperating persons and agencies about the health care of the horses present at the event and shall administer to them if the
    need arises.

    • He or she shall do everything within his or her power and training to aid the sport in general and the event in particular.

    • He or she shall not assume or be expected to assume the role, responsibilities or privileges of the management, judges, stewards or other officials or agencies at the event.

    • He or she shall not assume or be expected to assume a dual role in conjunction with that of Official Veterinarian.

    Reviewed by AAEP board of directors in 2010.

  • MedicationClick to Expand

    Position on Endurance Horse Medications (1975)

    Endurance rides and competitive trail rides differ from racing in that horses competing in these events are judged primarily on their endurance, physical fitness and ability to withstand the stress of sustained hard work on long trails. Speed and time are considerations, but not the determining factors.

    AAEP policy recommends that the use of any medication in horses participating in competitive trail or endurance rides is prohibited. Medications for this purpose are defined as injectable, oral or topical administered substances other than oral electrolytes and vitamins. 

    Reviewed by AAEP board of directors in 2010.

    Position on Therapeutic Medications in Racehorses (2009)

    The AAEP policy on medication in pari-mutuel racing is driven by our mission to improve the health and welfare of the horse. The AAEP policy is aimed at providing the best health care possible for the racehorses competing while ensuring the integrity of the sport. The AAEP expects its members to abide by the rules of all jurisdictions
    where they practice. The AAEP condemns the administration of non-therapeutic or unprescribed medications to racehorses by anyone. The AAEP believes that all therapeutic medication should be administered to racehorses by or under the direction of a licensed veterinarian. Health care decisions on individual horses should involve the veterinarian, the trainer and owner with the best interests of the horse as the primary objective. The AAEP strongly encourages continued research in determining the therapeutic levels and appropriate withdrawal times that represent responsible use of medication in the racehorse. The AAEP is aware of the dynamics of the development of new products, as well as the continuing evaluation of current medications, and will continue to evaluate its policy based upon available scientific research and the best interests of the horse.

    In order to provide the best health care possible for the racehorse, veterinarians should utilize the most modern diagnostic and therapeutic modalities available in accordance with medication guidelines designed to ensure the integrity of the sport. To this end, the following are the essential elements of AAEP policy concerning
    veterinary care of the racehorse:

    • All racing jurisdictions should adopt the uniform medication guidelines set forth by the Racing and Medication Testing Consortium Inc. (RMTC). Including the RMTC testing
    procedures with strict quality controls and penalty schedules, these guidelines and procedures strive to protect the integrity of racing as well as the health and well-being of the horse.

    • Race day medication must be in accordance with current RMTC guidelines. In the absence of a more effective treatment/preventative for exercise-induced pulmonary hemorrhage (EIPH), the AAEP supports the use of furosemide as a day-of-the-race medication to control EIPH. The AAEP advocates the research and development of new treatments to help prevent and/or control EIPH.

    • The AAEP encourages proactive and constructive communication between regulatory bodies and practicing veterinarians and other industry stakeholders.

    • The AAEP believes that all veterinarians should use judicious, prudent and ethical decisions in all treatments to ensure the health and welfare of the horse.

    • The AAEP strongly endorses increased surveillance and enforcement of the above-mentioned regulations. 

    For more information regarding RMTC guidelines, please visit www.rmtcnet.com.

    Reviewed by AAEP board of directors in 2010.

    Position on Therapeutic Medications in Non-Racing Performance Horses (2002)

    The AAEP policy on medication in non-racing performance horses is driven by our mission to improve the health and welfare of the horse. It is aimed at providing the best health care possible for horses competing under the current rules in various disciplines while ensuring the integrity of the sport. The AAEP expects its members to abide by the rules of all jurisdictions where they practice. The AAEP condemns the administration of nontherapeutic or unprescribed medications to performance horses by anyone. The AAEP believes that all therapeutic medication should be administered to performance horses by or under the direction of a licensed veterinarian. Health care decisions on individual horses involve the veterinarian, the trainer and the owner with the best interests of the horse as the primary objective.

    The AAEP strongly encourages continued research in determining the therapeutic levels and appropriate withdrawal times that represent responsible use of medication in the competing horse. The AAEP is aware of the dynamics of the development of new products, as well as the continuing evaluation of current medications, and will continue to evaluate its policy based upon available scientific research and the best interests of the horse.

    In order to provide the best health care possible for the performance horse, veterinarians should utilize the most appropriate diagnostic and therapeutic modalities in accordance with medication guidelines of the sport. To this end, the following are the essential elements of the AAEP policy concerning veterinary care of the performance horse:

    • It is recognized that various performance horse disciplines have differing regulations concerning medication guidelines. The AAEP urges members to abide by these regulations and to work with the governing bodies to develop and enforce such regulations.  The establishment of guidelines backed by testing procedures with strict quality controls should be the goal to protect the well-being of the horse and the integrity of the sport.

    • The AAEP encourages proactive and constructive communication between regulatory bodies, practicing veterinarians and other industry stakeholders.

    • The AAEP offers its expertise to all performance horse organizations for assistance in establishing medication guidelines for their respective disciplines.

    • The use of medications for the purpose of stimulating, depressing or numbing a horse at the time of competition should be forbidden. It is recognized that some governing bodies allow
    for the emergency use of local anesthetics for strictly medical purposes within the normal withdrawal time for such agents. Such procedures must be very closely controlled.

    • Products present in a horse at the time of performance that have been proven to interfere with accurate and effective postperformance testing should be strictly forbidden.

    • The AAEP endorses the use of quality-controlled testing procedures by all performance horse organizations. Detection of pharmacologically insignificant levels of therapeutic medications
    should not constitute a violation of medication rules.

    • Governing organizations have developed guidelines for the use of nonsteroidal anti-inflammatory agents in their sports. It is the opinion of the AAEP that the use of multiple NSAID agents is not in the best interest of the health and welfare of the horse. Performance horse governing bodies are encouraged to regularly reevaluate their regulations in light of this recommendation.

    • The AAEP believes that all veterinarians should follow a judicious, prudent and ethical decision-making process. 

    • The AAEP endorses increased surveillance and enforcement of the above-mentioned regulations. 

    Reviewed by AAEP board of directors in 2010.


    Position on the Use of Anabolic Steroids (2007)

    Definition and Mode of Action
    Anabolic steroids are a group of naturally occurring and/or synthetic hormones including androgens (testosterone and its derivatives), estrogen and progestins. The action of these substances is to increase protein synthesis, particularly in skeletal muscle. Anabolic steroids have specific indications in the therapeutic treatment of medical conditions of horses.

    Indications for Use
    Indications for use: Anabolic steroids are primarily effective when the objective is to improve appetite, repair tissue, promote weight gain and accelerate recovery from disease. In horses, anabolic steroids may stimulate appetite and increase muscle mass, particularly when there has been marked tissue breakdown associated with disease, prolonged anorexia, stress, or surgery.

    Potential side effects of anabolic therapy: Anabolic steroids may cause aggressive or male-like behavior in mares or geldings. Of greater concern are the potentially adverse effects of anabolic steroids on the reproductive function of both mares and stallions. Although these effects are not thought to be permanent, consideration must be given to this possibility.

    Additionally, anabolic steroids, like other drugs, should only be prescribed where a doctor/client/patient relationship exists and only for the therapeutic treatment of specific medical conditions. In adherence with its medication policies related to competition horses, the AAEP recommends that practitioners abide by the rules governing the jurisdiction or competition in which they practice. Veterinarians must exercise extreme caution in prescribing anabolic steroids to prevent their acquisition for human use.

    Reviewed by AAEP board of directors in 2010.



    Position on the Use of Corticosteroids (2007)

    Definition and Mode of Action
    Corticosteroids occur naturally or may be synthesized. The most useful and desired effect of these compounds is to control inflammation. Corticosteroids have specific indications in the therapeutic treatment of medical conditions of horses. 

    Indications for Use
    Indications for use: Corticosteroids act and are indicated in a wide variety of conditions that require anti-inflammatory therapy, such as joint inflammation, allergic conditions and skin disease.

    Potential side effects of corticosteroid therapy: Some corticosteroids, when used excessively or too frequently, may have a negative effect on the body’s natural immune response. Locally injected, corticosteroids may weaken support tissues such as the cartilage and ligaments of a damaged joint if used excessively or indiscriminately. The frequent systemic use of corticosteroids may suppress the ability of the adrenal gland to produce naturally occurring corticosteroids and other hormones, thus creating a hormonal imbalance. Some corticosteroids have been implicated anecdotally as a cause of laminitis. 

    Additionally, corticosteroids, like other drugs, should only be prescribed where a doctor/client/patient relationship exists and only for the therapeutic treatment of specific medical conditions. In adherence with its medication policies related to competition horses, the AAEP recommends that practitioners abide by the rules governing the jurisdiction or competition in which they practice.

    Reviewed by AAEP board of directors in 2010.






     

  • RacingClick to Expand

    Private Practice by Regulatory Veterinarians (1993)

    The AAEP views as a conflict of interest the participation in private practice by a “Regulatory Veterinarian” at the track where he or she serves in an official capacity.

    (Regulatory Veterinarian means track veterinarian, examining veterinarian, commission veterinarian, identifier or any other official capacity in the racing department.)

    For the purposes of this policy, the associates in private practice of a regulatory veterinarian are similarly excluded from practice at the track where the regulatory veterinarian is employed.

    This interpretation implies no intent to impugn any members who serve in dual capacities; but such conflicts of interest have invited misunderstanding, challenge and untoward public reaction.

    Many states outlaw private practice by regulatory veterinarians. In those states where no regulation exists, professional ethics preclude such
    conflicts of interest.

    Effective January 1, 1969, the AAEP will regard participation in private practice by a regulatory veterinarian at the track where he or she is employed as a serious breach of ethics and may be the cause for termination of membership or other disciplinary action.

    A regulatory veterinarian may administer emergency first aid in the absence of a private practitioner, but such emergency treatment will be administered without fee and the case referred to a private practitioner for further care.

    Reviewed by AAEP board of directors in 2010.

  • ReproductionClick to Expand

    Veterinary Management of Broodmares (1994)

    It is the opinion of the AAEP that the commonly used diagnostic and therapeutic procedures are important in the proper management of broodmares for optimum reproductive efficiency.

    These procedures include, but are not limited to: palpation per rectum, ultrasound examination, visual and endoscopic examination of the internal reproductive organs, endometrial culture, endometrial cytology, endometrial biopsy, hormone assays, intrauterine therapy, urogenital surgery, embryo and gamete retrieval, manipulation
    and transfer, and artificial insemination (AI).

    AI should be performed under the direction of a licensed veterinarian pursuant to a valid VCPR. All other above named procedures should only be performed by a licensed veterinarian.

    Revised by AAEP board of directors in 2013.


    Recommendations for Transported Semen as it Relates to Equine Viral Arteritis (EVA) (1992)

    Equine Viral Arteritis (EVA) with respect to stallions from which semen is collected and transported from the premises in the fresh cooled or frozen state:

    1. Breeding stallions unvaccinated for EVA should be tested for evidence of equine viral arteritis infection using the serum neutralization test. No stallion should be vaccinated for the first time without its prevaccination titer first being established.

    2. Seronegative stallions (titers of less than 1:4) should be vaccinated at least 28 days prior to breeding or semen collection and receive an annual booster. Vaccinated stallions should be isolated for 28 days post vaccination. Seronegative stallions that are vaccinated for EVA should be vaccinated at least 28 days prior to breeding or semen collection and receive an annual booster. Vaccinated stallions should be isolated 28 days post vaccination.

    3. Seropositive stallion’s (unvaccinated) shedding status should be determined every 12 months either by: Attempted virus isolation on semen or, testbreeding to at least two seronegative mares and monitoring for seroconversion at 14 and 28 days post breeding.

    4. Seropositive stallions (vaccinated) need not be tested for virus shedding if seronegative prior to initial vaccination.

    5. The serologic and shedding status of non-EVA vaccinated seropositive stallions should be made known to mare owners receiving the semen. This information should also be reported to state authorities where so required and to breed associations where so required.

    6. Stallions seropositive for EVA from natural exposure need not be
    vaccinated.

    Guidelines pertaining to mares which will be inseminated with transported fresh cooled or frozen semen.

    1. Seronegative mares to be inseminated with semen from an equine arteritis virus shedding stallion should be vaccinated against EVA at least 21 days prior to insemination. These vaccinated animals should be isolated for 21 days post vaccination.

    2. Mares seropositive for EVA from natural exposure need not be vaccinated.

    Reviewed by AAEP board of directors in 2010.


    Veterinary Management of the Breeding Stallion (1996)

    It is the opinion of the AAEP that proper management of the breeding stallion is paramount in obtaining optimum breeding efficiency. Proper management requires close cooperation between the licensed veterinarian and stallion manager. The licensed veterinarian can contribute various diagnostic and therapeutic procedures to this partnership.

    These procedures include, but are not limited to, the following: visual, tactile, endoscopic and sonographic examination of the reproductive organs; collection and evaluation of semen (i.e.
    assessment of spermatozoal number, initial spermatozoal motility, longevity of spermatozoal motility and spermatozoal morphology);evaluation of spermatozoal responsiveness to cooling and freezing techniques; evaluation of extender compatibility with semen; reproductive tract culture; reproductive tract biopsy; adjunctive diagnostic techniques (e.g. hormonal assays, sperm chromatin structure assay, antisperm antibody assay and transmission electronic microscopy);medical therapeutic strategies; and urogenital surgery.

    A reproduction examination should be carried out by a licensed veterinarian prior to entry of a stallion into a breeding program and periodically during his breeding career in order to manage the stallion to his maximum efficiency. Semen collections should be performed by a licensed veterinarian or qualified reproductive technician in association with a veterinarian. Diagnostic tests, medical treatments and urogenital surgery should be conducted only by a licensed veterinarian.

    Reviewed by AAEP board of directors in 2010.

     

     

    Recommendations Regarding Equine Viral Arteritis (EVA)

    Please visit the Biosecurity Guidelines for Control of Venereally Transmitted Diseases at here


    Breeding Terminology (2010)

    In providing written reports to interested parties, the AAEP encourages all equine practitioners to use the following terms when conducting reproductive examinations:

    Pregnant: Any filly or mare shall be characterized as “pregnant” if and only if a licensed veterinarian has made such a determination. Any such report should include the method of diagnosis (i.e. palpation per rectum, transrectal ultrasound, etc.) and the approximate length of gestation. A statement regarding whether or not the examining veterinarian has determined that the pregnancy appears normal for the gestational age should also be included. Knowledge of any adjunct method(s) used to aid in the maintenance of said pregnancy should be disclosed.

    Aborted: Any filly or mare that is not pregnant at the time of examination by a licensed veterinarian should be reported as “aborted” rather than “not pregnant” if the person rendering the report is actually aware that (a) an aborted fetus was observed or (b) the mare had been previously declared “pregnant” based on an examination by a licensed veterinarian at 42 days or more post mating.

    Not Pregnant: Any filly or mare that has been examined for pregnancy by a licensed veterinarian, and found not to be pregnant at the time of that examination shall be characterized as “not pregnant” unless there is evidence that the filly or mare has “aborted” as defined above. Any such report shall include the method of determination.

    Suitable for Mating: Any filly or mare that is not pregnant shall be characterized as “suitable for mating” if examination by a licensed veterinarian does not reveal any obvious abnormalities that would impair the animal’s ability to have a reasonable chance of becoming pregnant and carrying a foal to term. The examination of the reproductive tract (ovaries, uterus, cervix, vagina, vestibule and perineum) should include palpation per rectum and where practical, transrectal ultrasonography as well as visual and manual examination of the vagina and
    cervix. While other tests and criteria can be used to further evaluate the animal’s potential fertility, employment of such techniques shall be at the discretion of the examiner or their client. A filly or mare may be characterized as “suitable for mating” based on only one examination even though additional examinations may enhance the likelihood of discovering reproductive abnormalities.

    Mating: The physical act of a stallion mounting a filly or mare with intromission of the penis. Artificial insemination qualifies as mating for breeds that permit artificial insemination.

    Mated: Any filly or mare that has undergone the physical act of mating but whose pregnancy status has not been determined.

    Stillborn: Any foal, after at least 320 days of gestation, that is dead at the time of delivery.

    Neonatal Death: Any foal that dies within 14 days of foaling from a medical condition determined to be existing at or dating from birth. 

    Foal Died: Any foal that stands and nurses unassisted and subsequently dies from a condition not determined to be existing at or dating from birth.

    Revised by AAEP board of directors in 2010.

  • Sales IssuesClick to Expand

     

    Position on Medication in Horses Presented for Sale at Public Auction (2005)

    The following recommendations were developed by the AAEP’s Task Force on Medication Issues at Public Auction. The charge to the Task Force was to study and address the issues surrounding
    medication in the public sales horse.

    The goals set by the Task Force were:

    1. To protect the health and welfare of the horse.

    2. To facilitate the presentation of a healthy, well-cared-for animal for public auction.

    3. To facilitate a fair and uncomplicated evaluation of the potential sales animal for the mutual benefit of the purchaser and consignor.

    To conceptually evaluate the interaction of medication used in the sales horse, its health care and public auction implications, the committee evaluated the peri-sales timeframe in three time periods and assessed the effect of medication as a part of the horse’s health care in each time period.

    Time Period I: Pre-sale. This is the time prior to presentation at the sales ground. The principal stakeholder in this time period is the owner and/or consignor of the horse to public auction. They should be allowed to care for the horse in the best possible manner to maximize their return at public auction, but should do so without deceiving the potential purchaser about the true status of the horse.

    Time Period II: The Sales Period. This is the time that the horse is on the sales ground at the auction site. The stakeholders in this time period become expanded. The owner and consignor have a continued stake in the horse, but also the auction company, potential buyers and agents for potential buyers become stakeholders. Medication issues must be evaluated to take into consideration all parties and the horse.

    Time Period III: The Post-sales Period. The purchaser is the stakeholder. It is the purview of the purchaser to ensure that they have bought a fairly represented sales horse, but it is not under the purview of the purchaser to return the horse for anything other than a definitive violation of the principles outlined.

    Medication Recommendations
    As a general recommendation for medication of sales horses, it would be desirable to have no medication given within 24 hours of the start of the sales session, except in such situations as noted. Certain medications will facilitate a fair and safe sale for both parties’ benefit. These medications would be allowable at therapeutic doses. The common medications given to horses intended for sales have been divided into categories. The categories are listed as generic classes of medication, and medication actions, to prevent the need for continually updating an exhaustive list of specific compounds. 

    Category 1: Allowable at Therapeutic Levels. The horse can be given these medications on the sales grounds, but the medication should not be present at more than the maximum therapeutic levels, as would be recommended by the manufacturer’s dosing recommendations.

    Allowable at therapeutic levels:
    • One non-steroidal anti-inflammatory drug, with no detectable level of a second non-steroidal anti-inflammatory drug. The primary non-steroidal anti-inflammatory drug must be present at less than the maximum expected level when given at manufactures’ recommended dosage.

    • One cortico-steroid, excluding methyl-prednisolone acetate (Depo-medrol), which must not be present at any detectable level. Any other cortico-steroid would be allowable, however they must be present at less than the maximum therapeutic level recommended by the manufacturer’s dosing regimens, and no detectable level of a second cortico-steroid is allowed to be present.

    • Medications labeled for ongoing therapy of gastric ulcers

    • Tranquilizers

    • Oral anti-arthritic medications, such as proteoglycan supplements (Steroidal and non-steroidal medications would be governed by the recommendations above.) 


    • Progestins

    Category 2: Not Allowable on the Sales Ground. These would be medications whose use can be therapeutic, and which could be part of the normal health care of a horse presented for sale. These medications would be allowable at trace levels, but would not be allowable above the level to be expected from administration of the lowest therapeutic dose, as described by the manufacturer in the dosing recommendations, when this lowest therapeutic dose was given prior to the horse arriving at the sales ground.

    Not allowable on the sales ground:
    • Treatments commonly recognized as therapeutic for equine protozoal myelitis
    • Bronchodilators, such as clenbuterol
    • Vaso-active drugs, such as aspirin, isoxsuprine or pentoxifylline
    • Parenteral anti-arthritics such as injectable proteoglycan supplements (These would not include non-steroidal antiinflammatory and cortico-steroid anti-arthritics as they would be governed by the guidelines outlined above when given by any method oral or parenteral.)

    Category 3: No Detectable Level. These medications may be therapeutic for normal health care, but should have cleared the horse’s system and should have no detectable level at the time of sale.

    No detectable levels:
    • Stimulants
    • Muscle relaxants
    • Diuretics
    • Anabolic steroids

    Category 4: Allowable at Therapeutic Levels, but Must Be Declared in the Repository or Announced by the Auctioneer. These medications would be allowable if given as part of the horse’s normal health care, but may affect the purchaser’s decision as to the suitability of the horse, and therefore must be declared for assessment by the purchaser.

    Allowable if declared:
    • Cyproheptadine
    • Pergolide
    • Antibiotics


    Enforcement
    Neither the Task Force nor the AAEP has power of enforcement. The principal enforcer must be the sales company, and the principal action should be the rescinding of the sale and return of the horse to the consignor. It is the desire of the AAEP Task Force to discourage legal action by any parties. It is hoped that the sales companies will make a concerted effort to be the power of dispute resolution for the fair and equitable protection of the purchaser and the seller. This may be done through a panel of experienced veterinarians or some other means outlined by the sales company. But, the sales company must take an active role in promoting the fair and equitable transaction, as indicated by their taking of a commission for
    facilitating the sale of the horse.

    The ultimate goal of the task force, and their recommendations presented in this document, would be to serve as a deterrent. It would be ideal to establish what is acceptable, and what is not acceptable, for presentation of a horse at public auction and to have all consignors abide by those “best practices” in “good faith.” And, to have any disputes resolved without litigation. 

    The Task Force fully recognizes that not all of the recommendations are fully enforceable, because not all medications are capable of being examined for via forensic testing. We present these guidelines as a best practice for the mutual establishment of a fair value of horses at public auction. Forensic testing will continue to progress with time.

    For the situations where medications are to be assessed via testing, the sampling of the horse’s blood and/or urine must take place on the sales ground, by or under the direction of a licensed veterinarian. The sampling would preferably take place at the consignor’s barn, after the sale, with an agent of the consignor as a witness. The blood and/or urine sample must be submitted for testing within 5 working days of the start of the session in which the horse was purchased. The cost of testing would be the responsibility of the purchaser. It must be done at a recognized testing laboratory and the laboratory must maintain a split sample, available for confirmation testing should any discussion of the results result in a dispute. The consignor and sales company should be notified within 24 hours of the delivery of the laboratory report to the purchaser if a question is to be raised about the medication of the tested horse.

    In sales where horses must sell after a timed performance, such as a “two-year-old in training” sale, such performances are normally governed by the rules of racing in the state of the sale. Those regulations supersede the recommendations outlined here. Likewise, in these sales where performance is part of the sales process, post-exercise medications are sometimes allowed after exercise, if disclosed on the treatment sheets on file with the sales company, and accessible to the purchaser or the purchaser’s agent. The recommendations outlined here would also be superseded by these regulations.

    It is the recommendation of the AAEP Task Force on Medication Issues at Public Auction that the guidelines outlined be recommended for common sales venues. These recommendations will be superseded by specific sales conditions and can be modified as needed for specific sale sites and situations. It is hoped that the sales company will take active roles in facilitating the use of these recommendations and that they will be edited and maintained in an ongoing fashion as required by changes in therapeutic medications and dosing schedules. The primary objective is to establish “best practices” to serve as guidelines for the presentation of horses at public auction for fair and equitable establishment of the horse’s value, and to deter the use of medication that may cloud the horse’s true status. 

    Reviewed by AAEP board of directors in 2010.


    Cryptorchid – Definition (1998)

    The AAEP has adopted the following definition of retained testicle or cryptorchid.

    Cryptorchid: Any animal that does not have two testes palpable in their entirety below the external inguinal rings. In the event of a dispute, the matter should be referred to a panel of veterinary arbitrators.

    Reviewed by AAEP board of directors in 2010.


    Dental Malocclusions (2009)

    Madibular brachygnathism (“parrot mouth” or MAL2) is the condition in which the upper incisors protrude more rostrally than the lower incisors resulting in no occlusal contact between upper
    and lower central incisor teeth. Mandibular prognathism (“sow mouth,” “monkey mouth” or MAL3) is the condition in which the lower incisors protrude more rostrally than the upper incisors
    resulting in no occlusal contact between upper and lower central incisor teeth. The AAEP (and many breed organizations) consider these conditions undesirable traits.

    Reviewed by AAEP board of directors in 2010.


    Recommended Guidelines for Post-Sale Examination of Horses Intended for Racing (1991)

    (Guidelines pertain only to the Upper Respiratory Tract)
    These guidelines are for post-sale examination and the reporting of upper respiratory endoscopy evaluations. For the purpose of this examination, “upper respiratory endoscopy” does not include the trachea.

    1. Endoscopy of subject horse will be done at rest in the stall.
    2. Restrain with a twitch or lip chain; if restraint is removed during the examination, make notation on certificate and document any differences in function observed.
    3. Pass the endoscope up either nostril.
    4. Stimulate a swallowing reflex and/or perform nasal occlusion to assist in evaluation of pharyngeal and laryngeal function.
    5. Observe for anatomical form and function of upper respiratory structures.
    6. If a chemical restraint is needed, document the drug and dosage. Re-examination of the horse is suggested if chemical restraint has been used or is suspected.
    7. Document endoscopic observations and other pertinent findings on an appropriate certificate or suitable reporting form. 

    Conditions which should be considered unacceptable and should constitute grounds for rejection on the day of examination include, but are not limited to:

    1. Laryngeal hemiplegia.
    2. Laryngeal hemiparesis with incomplete abductor function.
    3. Epiglottic entrapment.
    4. Persistent DDSP.
    5. Arytenoid chondritis.
    6. Subepiglottic cyst.
    7. Soft palate cyst.
    8. Rostral displacement of the palatopharyngeal arch.
    9. Nasopharyngeal cicatrix.
    10. Space occupying lesions or malformation which compromise the diameter of upper respiratory tract.
    11. Cleft palate. 

    In the event of a dispute between the buyer’s veterinarian and the consignor’s veterinarian, the AAEP recommends that three veterinarians without conflicts of interest be drawn from an arbitration panel to adjudicate such dispute. The arbitration panel should consist of a pool of eight or more veterinarians and could be established in specific geographic areas by local equine practitioner organizations or equine sales companies. Criteria for selection would be based upon experience and expertise. The three veterinarians mutually selected by the buyer and consignor would have no knowledge of either the horse, buyer, or consignor.

    Another acceptable method is to have five veterinarians selected from the pool; three examiners would then be picked from these five by a blind draw. They will examine the horse together and collectively determine the acceptance or rejection of the subject horse. Concurrence by two of the three examiners will be conclusive in such cases. Some conditions are generally considered an acceptable variation of normal, but at times may be viewed to affect the ability of the horse to perform its intended use.

    Conditions that may elicit concern regarding suitability for racing include the interpretation of:

    1. Intermittent DDSP.
    2. Hypoplastic epiglottis.
    3. Larygeneal hemiparesis with complete (full) abductor function.
    4. Variations of epiglottic contour.
    5. Pharyngeal lymphoid hyperplasia.
    6. Mucopurulent discharge from guttural pouch.
    7. Nasal septum deviation.

    Detailed diagrams and descriptive terms of the pathology noted should be a part of the examining veterinarian’s records only. The certificate issued by individuals or the arbitration team to the sales companies or owners should be a generalized statement of the condition without implied warranty for future athletic potential of the subject horse at the time of the examination and should be prefaced by the phrase “In my opinion.” 

    Other recommendations from the AAEP include:

    1. That sales companies obtain a consent form signed by both consignors and buyers to agree to the consent of an arbitration panel and their binding conclusion thereof. 
    2. That sales companies attempt to institute a uniform agreement among consignors regarding pre-sale examinations on the sales grounds. It was the consensus of the subcommittee that either pre-sale examinations be uniformly allowed or
    disallowed, so as to establish conformity for consignors and buyers without allowing a selective advantage in the sales process to selected individuals.

    Reviewed by AAEP board of directors in 2010.



    Guidelines for Reporting Purchase Examinations (2009)

    The AAEP has approved the following guidelines for reporting equine purchase examinations. The spirit of these guidelines is to provide a framework which will aid the veterinarian in reporting a purchase exam, and to define that it is the buyer’s responsibility to determine if the horse is suitable. These guidelines are neither designed for nor intended to cover any examinations other than purchase examinations. (e.g. limited examinations at auction sales and other special purchase examinations, such as lameness, endoscopic, ophthalmic, radiographic, reproductive examinations, etc.). While compliance with all of the following guidelines helps to ensure a properly reported purchase examination, it remains the sole responsibility of the veterinarian to determine the extent and depth of each examination. The AAEP recognizes that for practical reasons, not all examinations permit or require veterinarians to adhere to each of the following guidelines.

    1. All reports should be included in the medical record.
    2. The report should contain:
          a. A description of the horse with sufficient specificity to fully identify it.
          b. The time, date and place of the examination.
    3. The veterinarian should list all abnormal or undesirable findings discovered during the examination and give his or her qualified opinions as to the functional effect of these findings.
    4. The veterinarian should make no determination and express no opinions as to the suitability of the animal for the purpose intended. This issue is a business judgment that is solely the responsibility of the buyer that he or she should make on the basis of a variety of factors, only one of which is the report provided by the veterinarian.
    5. The veterinarian should record and retain in the medical record a description of all the procedures performed in connection with the purchase examination, but the examination procedures need not be listed in detail in the report.
    6. The veterinarian should qualify any finding and opinions expressed to the buyer with specific references to tests that were recommended but not performed on the horse (x-rays, endoscopy, blood, drug, EKG, rectal, nerve blocks, laboratory studies, etc.) at the request of the person for whom the examination was performed.
    7. The veterinarian should record and retain the name and address of parties involved with the examination (buyer, seller, agent, witness, etc.).
    8. A copy of the report and copies of all documents relevant to the examination should be retained by the veterinarian for a period of years not less than the statute of limitations applicable for the state in which the service was rendered. Local legal counsel can provide advice as to the appropriate period of retention.

     

    Recommendations for Purchase Exams at Public Auction

    • Radiographic interpretation for potential buyers should be performed by a veterinarian retained to represent that buyer’s personal interest with their particular needs and level of risk tolerance in mind.
    • Use of radiographic reports composed by the sellers’ veterinarian for proposed buyers has the potential to jeopardize all parties involved. The buyer may not be represented adequately, the seller incurs greater risk by potentially misrepresenting the horse and the veterinarian does not have the opportunity to explain his/her findings and their relevance to resale or training, in their opinion.
    • Veterinarians are encouraged to report all radiographic findings when interpreting radiographs for either the seller or buyer at public auction, with particular emphasis on those areas where pathology would commonly occur.
    • Modifying or altering radiographic reports, including deleting findings by either the veterinarian or anyone with access to the report, so that they might be used as a positive marketing tool in the auction venue is considered unethical and fraudulent.
    • Veterinarians with ownership in horses being presented for public auction should avoid being involved in the representation of those horses to potential buyers including, but not limited to, performing a radiographic or endoscopic assessment.
    • Veterinarians involved in performing radiographic examinations on horses for sale at public auction should strive to provide optimum radiographic quality with respect to proper positioning and appropriate exposure of all required views to ensure accurate and reliable determinations of findings.



    Radiographs – Custody and Distribution

    The AAEP recommends the retention of all radiographs on file for a period of three years. The AAEP and AVMA consider this essential for protection against litigation. The assertion of legal precedent is that radiographs are the property of the veterinarians who produced them, and only the information interpreted from the radiograph is the property of the client. In extenuating circumstances a copy of the radiograph can be made for distribution, including for referrals and consultations. Distribution of the original radiographs risks loss or misplacement such practice should be restricted to use in referrals and consultations, and then released only upon proper request.

    Reviewed by AAEP board of directors in 2010.


    Position on Sale Disclosure (1998)

    AAEP supports the position that when a horse is sold, any known invasive surgery, disease, injury, or congenital defect which is not apparent, should be disclosed to the intended buyer by the owner and/or agent.

    The AAEP supports disclosure of ownership by single or multiple owners of a horse at the time of offering for sale. 

    Reviewed by AAEP board of directors in 2010.

     

     

     

  • Veterinary PracticeClick to Expand

    Position on Practice of Veterinary Medicine (2014)

    Every veterinarian should be familiar with the legal definition of the practice of veterinary medicine as defined in their state or provincial Veterinary Practice Act. The AAEP defines the practice of veterinary medicine for the ethical guidance of its members as the following: 

    “Practice of veterinary medicine” means: 

    Any person practices veterinary medicine with respect to animals when such person performs any one or more of the following:

    a. Diagnoses, prognoses, treats or prevents animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode; or
    b. Prescribes, dispenses, or administers a drug, medicine, biologic, appliance, or treatment of whatever nature; or 
    c. Performs upon an animal a medical procedure, a surgical or dental operation, or a complementary, integrative, or alternative veterinary medical procedure; or
    d. Performs upon an animal any manual procedure for the diagnosis and /or treatment of pregnancy, sterility, or infertility; or 
    e. Upon examination determines the health, fitness, or soundness of an animal; or 
    f. Directly or indirectly consults, supervises, or recommends treatment of an animal by any means including telephonic and other electronic communications; or
    g. Represents oneself directly or indirectly, as engaging in the practice of veterinary medicine; or
    h. Uses any words, letters or titles under such circumstance as to induce the belief that the person using them is qualified to engage in the practice of veterinary medicine, as defined. Such use shall be prima facie evidence of the intent to represent oneself as engaged in the practice of veterinary medicine.

    Approved by AAEP board of directors in 2014.


    Position on Roles of Healthcare Providers in Veterinary Medicine (2014)

    The AAEP recognizes that quality professional healthcare often requires the services of a Healthcare Team. The attending veterinarian is the leader of the Healthcare Team and is ultimately responsible for all healthcare decisions made concerning an equine patient until that patient is referred or discharged. The attending veterinarian may delegate appropriate healthcare tasks, allowable by state law, to subordinate healthcare providers. Referral, as defined by the American Association of Equine Practitioners (AAEP), American Veterinary Medical Association (AVMA), American College of Veterinary Internal Medicine (ACVIM), American College of Veterinary Surgeons (ACVS), American College of Theriogenologists (ACT), and American College of Veterinary Emergency and Critical Care (ACVECC), is the transfer of responsibility for diagnosis and/or care of a specific problem from a referring veterinarian to a receiving veterinarian.

    The establishment of a valid Veterinarian-Client-Patient Relationship and the examination and diagnosis of the patient by the attending veterinarian prior to the delegation of any equine healthcare task to subordinate healthcare providers is prerequisite to ethical veterinary practice. The attending veterinarian is responsible for determining the professional competency of a healthcare provider before delegating equine healthcare tasks.

    The following outlines the appropriate roles of different healthcare providers within the scope of ethical professional veterinary practice:

    A. Licensed Veterinarians: The examination, diagnosis, prognosis, treatment, and management of equine healthcare are to be provided and supervised by licensed veterinarians.
    B. Credentialed Technicians: Licensed Veterinarians may delegate healthcare tasks that are not restricted to veterinarians, to Licensed/Certified/Registered Veterinary Technicians (LVTs) who are under the employ and supervision of the Licensed Veterinarian. While some states allow LVTs to perform “minor” dental and surgical procedures, the AAEP does not support the delegation of any invasive procedures and procedures with significant risk of complication (e.g. castration, dental extraction and
    advanced procedures, reproductive examination).
    C. Uncredentialed Assistants: Licensed Veterinarians may delegate ancillary healthcare tasks to Veterinary Assistants (not registered, certified, or licensed) that are under the employ and supervision of the Licensed Veterinarian. The Licensed Veterinarian may delegate direct supervision of a Veterinary Assistant to a LVT.
    D. Human Healthcare Professionals (HHP): Veterinarians occasionally confer with or have Licensed Human Healthcare Professionals (MD, DC, DDS, etc.) perform procedures on their equine patients. While the collaboration between veterinarians and HHPs advances healthcare standards, this collaboration is usually only appropriate between veterinary and HHP specialists. The ethical indications for having HHPs perform procedures on veterinary patients are rare, and procedures performed by the HHP on veterinary patients should be performed under the Immediate Supervision of a Licensed Veterinarian. The attending veterinarian is responsible for ensuring compliance with state law before soliciting HHP services.
    E. Unlicensed Allied Healthcare Providers (UAHP): (e.g., Veterinary Physical Therapist/Rehabilitator, Farrier, Hospice Caregiver, etc.) While conferring with and inclusion of UAHPs in an equine healthcare team may be appropriate in the treatment of some equine patients, the healthcare services provided by the ULHP should be performed under the order and/or supervision of the Attending Veterinarian, who is responsible for reviewing the training of the UAHP before soliciting his/her services. Ethical practice indicates that services beyond an attending veterinarian’s scope of professional training and competency be referred to an appropriately trained veterinarian who provides he required healthcare services. The AAEP does believe that, in certain situations, working with UAHPs under the proper context and within the construct of a Veterinarian-Client-Patient Relationship can lead to optimum health care for the horse.

    Approved by AAEP board of directors in 2014.


    Position on Levels of Supervision (2014)

    Ethical veterinary practice dictates that members of the healthcare team be supervised by the attending veterinarian. The levels of supervision described are defined as follows:

    1. Immediate supervision: A licensed veterinarian is within direct eyesight and hearing range during the performance of healthcare tasks.
    2. Direct supervision: A licensed veterinarian is physically present on the premises where animal healthcare tasks are to be performed and is readily available.
    3. Indirect supervision: A licensed veterinarian is not physically present on the premises where animal healthcare tasks are to be performed, but has given either written or oral instructions
    (“direct order”) for treatment of the animal patient and is able to perform the duties of a licensed veterinarian by maintaining direct communication.

    Approved by AAEP board of directors in 2014.



    Contingency Fees (1965)


    It is not ethical for a veterinarian to enter into agreements with clients which provide that the fee to be charged for certain services will be contingent upon a horse’s successful performance on the racetrack or in the show ring. Such an agreement is unethical in that the veterinarian must at all times render the ultimate in assistance to the patient and charge a fee appropriate for the services rendered. The veterinarian’s fee is not based on a subsequent event, but directly connected with the services
    rendered. There are no guarantees in medicine, expressed or implied. 

    A fee contingent upon the outcome of a race gives the veterinarian a vested interest in the horse, and the racing rules in many states preclude such practices. In other states where the rules do not exist, such vested interest will be considered as a conflict of interest with the owners of all other horses in the race.

    This is not to be confused with attempted surgical repair or treatment of cases with poor prognosis if such efforts promise educational benefit, and of cases that would have been destroyed for economic reasons. In those cases, it is proper for a veterinarian to share efforts on a contingency basis with the client.

    Reviewed by AAEP board of directors in 2010.

     

    Conflicts of Interest (2007)

    A conflict of interest, as it pertains to veterinary medicine, is a situation in which the veterinarian has competing professional or personal interests. Such competing interests can make it difficult for the veterinarian to fulfill his or her duties impartially. A conflict of interest can exist even if no unethical or improper act results from
    it; however, it can create an appearance of impropriety that can undermine confidence in the person or profession.

    The AAEP suggests the following guidelines for its members:

    1. A veterinarian should strongly consider whether or not to render services to a client if in doing so the veterinarian’s independent professional judgment will be adversely affected by a personal, professional or financial relationship with either the client or a third party. 

    2. A veterinarian should strongly consider whether or not to render services to a client if the services to that client will be adversely affected by the veterinarian’s responsibilities to another client, a third party or the veterinarian’s own interests. 

    Reviewed by AAEP board of directors in 2010.


    Position on Equine Dentistry (2012)

    The practice of equine dentistry is an integral branch of professional equine veterinary practice. This discipline encompasses all aspects of the evaluation, diagnosis, prognosis, treatment, and prevention of any and all diseases, disorders, and conditions that affect the teeth, oral cavity, mandible, maxillofacial area, and the adjacent
    and associated structures. Additionally, equine dentistry includes the evaluation of the presentation and contribution of systemic diseases within the oral cavity and the contribution of oral conditions to the overall health of the individual horse.

    Any surgical procedure of the head or oral cavity; the administration or prescription of sedatives, tranquilizers, analgesics or anesthetics; procedures which are invasive of the tissues of the oral cavity including, but not limited to, removal of sharp enamel points, treatment of malocclusions of premolars, molars, and incisors, reshaping of teeth, the extraction of first premolars and deciduous premolars and incisors; extraction of damaged or diseased teeth; treatment of diseased teeth via restorations and endodontic procedures; periodontal and orthodontic treatments; and dental radiography are veterinary dental procedures and should be performed by a licensed veterinarian.

    In states where the Veterinary Practice Act allows, the AAEP supports the use of licensed veterinary technicians under the employ and immediate supervision of licensed veterinarians for specific and appropriate veterinary dental procedures as enumerated in that state’s practice act. In states where the Veterinary Practice Act allows, the AAEP supports the use of licensed human dental healthcare providers under the immediate supervision of licensed veterinarians for specific and appropriate veterinary dental procedures as enumerated in that state’s practice act, only when a veterinary dentist is unavailable.

    Revised by AAEP board of directors in 2012.



    Euthanasia Guidelines (2011)

    The AAEP recommends that the following guidelines be considered in evaluating the need for humane euthanasia of a horse. The attending veterinarian is often able to assist in making this determination, especially regarding the degree to which the horse is suffering. It should be pointed out that each case should be addressed on its individual merits. The following guidelines are guidelines only. It is not necessary for all of these criteria to be met. Horses may be euthanized at an owner’s  request for other reasons, as the owner has sole responsibility for the
    horse’s care. Prior to euthanasia, clear determination of the insurance status of the horse should be made as an insurance policy constitutes a contract between the horse owner(s) and the insurance carrier.

    In accordance with AVMA’s position on euthanasia of animals, the AAEP accepts that humane euthanasia of unwanted horses or those deemed unfit for adoption is an acceptable procedure once all available alternatives have been explored with the client. A horse should not have to endure conditions of lack of feed or care erosive of the animal’s quality of life. This is in accord with the role of the veterinarian as animal advocate.

    The following are guidelines to assist in making humane decisions regarding euthanasia of horses.

    • A horse should not have to endure continuous or unmanageable pain from a condition that is chronic and incurable.
    • A horse should not have to endure a medical or surgical condition that has a hopeless chance of survival.
    • A horse should not have to remain alive if it has an unmanageable medical condition that renders it a hazard to itself or its handlers.
    • A horse should not have to receive continuous analgesic medication for the relief of pain for the rest of its life.
    • A horse should not have to endure a lifetime of continuous individual box stall confinement for prevention or relief of unmanageable pain or suffering.

    echniques for Euthanasia – The following techniques for performing euthanasia of horses by properly trained personnel are deemed acceptable:

    1. Intravenous administration of an overdose of barbiturates.
    2. Gunshot to the brain (Shearer JK, Nicoletti P. Humane euthanasia of sick, injured and/or debilitated livestock. University of Florida IFAS Extension).
    3. Penetrating captive bolt to the brain (Shearer JK, Nicoletti P. Humane euthanasia of sick, injured and/or debilitated livestock. University of Florida IFAS Extension).
    4. Intravenous administration of a solution of concentrated potassium chloride (KCl) with the horse in a surgical plane of general anesthesia.
    5. Alternative methods may be necessary in special circumstances.

    Special Considerations for the Insured Horse and Cases Involving 
    Multiple Practitioners:
    Each insurance policy for a horse is a contract between the horse owner and the insurance company and will dictate the specific terms and conditions concerning the payment of a mortality claim. Careful consideration should be given to possible “conflicts of interest” as referenced in the Ethical and Professional Guidelines in the AAEP Resource Guide and Membership Directory. The attending, consulting and referring veterinarians should follow the Ethical and Professional Guidelines under section IV, “Attending, Consulting and Referring,” as described in the AAEP Resource Guide & Membership Directory.

    Reviewed by the AAEP board of directors in 2016.


    Guidelines for Equine Veterinary Case Referral (2014)

    Executive Summary
    The Veterinary Oath obligates practicing veterinarians to use their knowledge and skills for the benefit of society and the prevention of animal suffering. This is often best accomplished rough the coordinated efforts of multiple individuals working on behalf of a single patient to provide the highest quality veterinary care in a professional and collegial environment. This document was developed through the collaborative efforts of the AAEP, American College of Veterinary Internal Medicine (ACVIM), American College of Veterinary Surgeons (ACVS), American College of Theriogenologists (ACT), and American College of Veterinary Emergency and Critical Care (ACVECC) with a goal of providing practical communication guidelines for individuals who collaborate in equine patient care.

    Definitions

    Referring Veterinarian: The veterinarian (or group of veterinarians) providing care at the time of the referral.

    Receiving Veterinarian: The veterinarian (or group of veterinarians) to whom a patient is referred.

    Consultation: A communication between two or more veterinarians concerning the diagnosis and/or care of a patient. 

    Referral: The transfer of responsibility for diagnosis and/or care of a specific problem from a referring veterinarian to a receiving veterinarian.

    Recognized Veterinary Specialist: A veterinarian who is certified by an AVMA-recognized veterinary specialty organization. Only those individuals who have completed all aspects of the specific training and testing required by a recognized veterinary specialty organization can describe or advertise themselves as a veterinary specialist. These individuals are ethically bound to only advertise or claim expertise in their area of board certification. Veterinarians who have completed internships or residencies but have not fulfilled all of the requirements of a specialty discipline (e.g. credentials and testing), may not call themselves veterinary specialists and the terms “board eligible” or “board qualified” should not be used.
    The AVMA has stated that only veterinarians who have been certified by an AVMA-recognized specialty organization should refer to themselves as specialists.
     
    Legal Owner/Client: The legal owner is the individual or syndicate of individuals who have legal ownership of the horse. The term “client” refers to the agent with legal authority to make health care decisions for the horse at the time it is being examined and treated. This individual may be the legal owner, trainer, caretaker, or other proxy.

    It is in the best interests of individual horse health that veterinary professionals work as a team to provide the highest quality of veterinary care possible in an environment of exceptional client service and education. For this to happen, it is imperative that clear lines of communication and responsibility be established between veterinarians, clients, and other interested parties.

    Prior to Referral
    Prior to referral, it is the responsibility of the referring veterinarian to be aware of specialty referral resources in their geographic area, communicate the option of referral to the client in a timely fashion, and contact the receiving veterinarian to discuss the patient. It is the responsibility of the receiving veterinarian to provide appropriate preliminary visit information to the referring veterinarian and owner or agent of the horse. The referral process functions optimally if the owner or agent communicates clearly their expectations for the horse and the limits of costs that may be incurred. It is important that all parties provide a clear and accurate medical history to the receiving veterinarian. Both the referring and the receiving veterinarian should emphasize a team approach to patient care.

    During the Referral Visit
    During the referral visit, the referring veterinarian transfers the responsibility for health-care decisions to the receiving veterinarian but remains accessible for communication. The receiving veterinarian should clearly explain all aspects of the examination, evaluation, diagnostic, and treatment procedures and options to the client. This process should emphasize support of the referring veterinarian to the fullest extent possible without a compromise of integrity. The receiving veterinarian should communicate with the referring veterinarian and client regularly about case progression and decisions. The receiving veterinarian should limit services to those related to the problem for which the horse was referred. Additional services should be provided only when they are in the best interest of the patient and after consultation with the referring veterinarian. All parties should work together to formulate a follow-up treatment and evaluation plan for the patient that can be implemented effectively and economically. It is the responsibility of the owner to clearly determine and communicate who is legally and financially responsible for the horse and assure that this individual or their legal proxy is available for decision-making during the referral visit and at the time of patient discharge.

    After Referral
    At the time of discharge of the patient from their care, the receiving veterinarian should ensure that all relevant medical information and instructions for patient care are clearly communicated to the referring veterinarian. In most cases the referring veterinarian will then resume responsibility as the attending clinician for the patient. That individual is responsible for agreed-upon follow-up care as described in discharge instructions. The receiving veterinarians should be informed of the results of follow-up evaluation and care. It is the responsibility of the owner to comply with all discharge instructions to the best of their ability and to communicate in a timely way with veterinarians if they are unable to comply with the instructions and to meet all financial obligations incurred with all involved parties.

    Conclusions
    For all equine patients, effective communication between referring and receiving veterinarians, clients, farm managers, trainers, and insurance agency representatives is essential to ensure optimal patient care. Despite the best efforts of all involved, there will be times when communication is less than optimal or when difficult information must be discussed. Referring and receiving veterinarians are encouraged to seek training to develop communication skills through any of a wide variety of excellent public and private resources. This type of training is especially beneficial for young professionals at the beginning of their veterinary career.

    To see the full guidelines visit www.aaep.org/info/guidelines.

    Approved by AAEP board of directors in 2014.


    Equine Veterinary Compounding Guidelines (2005)

    The AAEP recognizes the importance of a sound relationship between the equine veterinarian and their pharmacist. Because of the valid role of pharmacy compounding in equine veterinary medicine, the AAEP Drug Compounding Task Force has compiled the following guide to aid the veterinarian in making responsible decisions involving the use of compounded medications.

    Veterinarians must understand the differences between the following:

    I. FDA Pioneer Drug: A drug that has undergone the scrutiny of blinded controlled studies to demonstrate safety and efficacy in accordance with federally mandated Good Laboratory Procedures (GLP). The active ingredient and product were manufactured under federally mandated Good Manufacturing Practices (GMP) in federally inspected plants. Therapeutic consistency, product quality, accurate drug shelf life and scientifically substantiated labeling are all federally mandated on these products. 

    II. Generic Drug: A generic drug is bioequivalent to a brand-name drug in dosage form, efficacy, safety, strength, route of administration, quality and intended use. Generic drug labels display an ANADA # or ANDA # signifying FDA approval of a generic animal drug or human drug, respectively. Generic drugs and their active ingredients also must be manufactured under GMP in federally inspected plants.

    III. Compounded Drug: Any drug manipulated to produce a dosage form drug (other than that manipulation that is provided for in the directions for use on the labeling of the approved
    drug product).

    The veterinarian must realize that the use of bulk drugs in preparation of compounded medications is, under strict interpretation of the Federal Food Drug and Cosmetic Act, illegal because it results in the production of an unapproved new animal drug. Preparation, sale, distribution and use of unapproved new animal drugs is in violation of the Act. The preparation of compounded medication from bulk drugs may be permissible in medically necessary situations when there is no approved product available or the needed compounded preparation cannot be made from an FDA-approved drug. Therefore legal compounding can only begin with FDA-approved drugs in compliance with federal extra-label drug use regulations. International AAEP members should adhere to the rules and regulations set forth by the appropriate governmental regulatory bodies that pertain to the country or province where they practice.

    Legal compounding requires a valid veterinarian-client-patient relationship. The veterinarian should limit the use of compounded drugs to unique needs in specific patients and limit the use of compounded drugs to those uses for which a physiological response to therapy or systemic drug concentrations can be monitored, or those for which no other method or route of drug delivery is practical. The prescribing veterinarian should remember that compounded drugs have not been evaluated by the FDA approval process for safety, efficacy, stability, potency and consistency of manufacturing. One should not assume compounded drugs are consistent from one batch to another, contain the stated amount of drug substance or the desired drug substance, or are safe and efficacious for the intended use.

    Consider that veterinary compounding pharmacies currently operate in a very dynamic regulatory situation and laws, regulations and guidelines regarding veterinary compounding may vary widely from state to state. Ensure that the pharmacy you use is licensed in the state in which you practice. Proactively seek to educate yourself on regulations concerning compounded medications. Be wary of pharmacies using trademarked brands in the literature to promote “look-alike” compounded products. Be wary of firms that appear to disregard federal, state and local laws, regulations and guidelines concerning disposition of compounded drug products. Be aware that compounding drugs to mimic licensed, FDA-approved drugs is illegal. Assuming there is an FDA-approved product that is in the appropriate dosage form that can be used for the specific patient indication, veterinarians cannot use compounded “look-alikes” as substitutes.

    The decision to use the products, in lieu of the FDA-approved product, is illegal and potentially jeopardizes the patient and the veterinarian’s liability insurance. In the long term, this practice by veterinarians discourages new product development by pharmaceutical companies.

    Veterinarians are encouraged to contact their state pharmacy boards concerning the re-selling of compounded products. Some state pharmacy boards reportedly require compounded drugs to be dispensed at cost and some allow regular mark up. 

    The prescribing veterinarian should consider the legal, ethical and clinical ramifications when making recommendations concerning the use of compounded medications for their patients. They should provide information about the benefits and risks of compounded drugs as it is important to an owner’s decisions about therapy. They should understand the concept of “Standard of Care.” One acts below the standard of care when he/she fails to exercise the level of care, skill, diligence and treatment that is recognized as the standard of acceptable and prevailing veterinary medicine.

    The prescribing veterinarian should understand that his/her professional liability policy may or may not respond to allegations of negligence arising from the use of compounded drugs. Veterinarians insured with the AVMA-PLIT may review comments at www.avmaplit.com

    Do not miss the opportunity to form a relationship with a pharmacist experienced in compounding who, when medical necessity exists for a specific patient, can produce the best possible compounded product and discuss related product expectations.

    Reviewed by AAEP board of directors in 2010.

     

     

    Prudent Drug Usage Guidelines (2006)

    The health and welfare of horses and their owners is the primary goal of members of the AAEP. We believe that these guidelines merely reiterate the standard of practice and what is common in equine veterinary medicine. The AAEP provides continuing education for veterinarians That focuses on the appropriate use of antimicrobial drugs. Our members are committed to the practice of preventive immune system management through the use of vaccines, parasiticides, stress reduction and proper nutritional management. The AAEP recognizes that proper and timely management practices can reduce the incidence of disease and therefore reduce the need for antimicrobials; however, antimicrobials remain a necessary tool to manage infectious disease in horses. In order to reduce animal pain and suffering, prudent use of antimicrobials is encouraged. The following are general guidelines for the prudent therapeutic use of antimicrobials in horses:

    1. The veterinarian’s primary responsibility is to aid in the design of management, immunization, housing and nutrition programs that will reduce the incidence of disease and the need for antimicrobials.
    2. Antimicrobials should be used only within the confines of a valid veterinarian-client-patient relationship; this includes both dispensing and issuance of prescriptions.
    3. Veterinarians should:
          a. Participate in continuing education programs that include therapeutics and emerging and/or development of antimicrobial resistance.
          b. Avoid antimicrobial use in transient virus associated conditions.
          c. Have clinical evidence of the identification of the pathogen associated with the disease based upon history, clinical signs, laboratory data and experience.
          d. Select antimicrobials that are appropriate for the target organism and should be administered at a dosage and route that are likely to achieve effective levels in the target organ.
          e. Make product choices and use regimens that are based on available laboratory and package insert information, additional data in the literature, and consideration of the                  
             pharmacokinetic and pharmacodynamic aspects of the drug.
          f. Use products that have the narrowest spectrum of activity and known efficacy in vivo and/or in vitro against the pathogen causing the disease problem.
          g. Utilize antimicrobials at a dosage appropriate for the condition treated for as short a period of time as reasonable, i.e., therapy should be discontinued when it is apparent that the immune system   
             can manage the disease, reduce pathogen shedding, and minimize recurrence of clinical disease or development of the carrier state.
          h. Select antimicrobials of lesser importance in human medicine in preference to newer generation drugs that may be in the same class if this can be achieved while protecting the health and safety of            the animals.
          i. Utilize antimicrobials labeled for treating the condition diagnosed, and whenever possible, at the labeled dose, route, frequency, and duration if the available scientific information still supports their            efficacy.
          j. Utilize antimicrobials on an extra-label basis only within the provisions contained within AMDUCA regulations.
          k. When appropriate, utilize local therapy over systemic therapy.
          l. Be discouraged from using combination antimicrobial therapy unless there is information to show an increase in efficacy or suppression of resistance development for the target organism.
         m. Protect integrity through proper handling, storage and observation of the expiration date.
    4. Veterinarians should endeavor to ensure proper on-farm drug use.
        a. Prescription or dispensed drug quantities should be appropriate so that stockpiling of antimicrobials on the farm is avoided.

    The American College Veterinary Internal Medicine has developed a very detailed and extensive consensus statement for antimicrobial drug use in veterinary medicine. To view this document visit ACVIM’s website at www.acvim.org.

    Reviewed by AAEP board of directors in 2010.