Effectively storing FMT products might have future implications for improving gut health in sick horses. | istockEquine fecal microbiota transplantation involves a veterinarian transferring feces from healthy horse into the gastrointestinal tract of a sick horse aiming to improve the microbiome and gastric health of the ill horse. However, researchers do not fully understand the method and a lack of standardization exists, especially in storage techniques used to preserve the product over time.Finding the Best Way to Store FMT ProductResearchers recently evaluated the viability and diversity of both fresh and frozen fecal microbiota transplant (FMT) products to determine if they could be preserved for later use in horses with intestinal microbiome issues. For this, the team collected fresh feces from three healthy adult horses. They stored the feces in varying preservation solutions (saline with glycerol and saline only) and temperatures (-20 C or -80 C ) before assessing the bacterial populations in each sample.They found that freezing the product at -80 C in a saline and glycerol preservative was most effective for maintaining healthy, viable microbial communities that could help address intestinal issues in horses needing transplant.Future Applications for FMTI see the most useful application (of this storage method) being if a horse were to undergo an elective procedure where they were going to be receiving prophylactic antibiotics as part of the procedure, said Alicia Long, DVM, Dipl. ACVIM, ACVECCS, assistant professor at the University of Pennsylvanias New Bolton Center, in Kennett Square. That way their feces could be saved prior to any changes that occur, (when the gut is) at its most normal.We know that antibiotics particularly have a huge effect on the gut microbiome, and it takes weeks to months to restore the normal microbiome after antibiotic administration, Long added. If stored feces from the horse undergoing surgery are not available, then feces from a healthy horse from the same farm, and relatively the same age, could also be used for FMT, she added.The next research step involves giving the frozen product to live horses and seeing if their microbiomes become more like that of the donor horse, said Long. Scientists could also evaluate the effect of an FMT transplant on horses with clinical conditions, such as colitis (inflammation of the large intestine, or large colon), to determine its effectiveness in resolving these issues.Long said she hopes future studies will demonstrate that larger volumes of FMT product can be stored successfully, because horses with intestinal problems would need greater amounts for successful treatment.The study, Assessment of fecal bacterial viability and diversity in fresh and frozen fecal microbiota transplant (FMT) product in horses appeared in BMC Veterinary Research, in July 2024.

Embracing antimicrobial stewardship benefits horses and humans.Antimicrobial stewardship involves using antibiotics only when necessary, for the shortest duration, and with the correct drug, dose, and route to ensure optimal efficacy. | Adam Spradling/The HorseImagine your horse was sick or injured, and your veterinarian said no to antibiotics for that cough, runny nose, traumatic wound, gnarly looking lump, or another ailment you felt should be treated with an antibiotic. Would you be upset your horse wasnt receiving what you believe is high-quality care, or would you appreciate that your vet is a good antimicrobial steward?What Is Antimicrobial Stewardship?The American Veterinary Medical Association (AVMA) defines antimicrobial stewardship as actions veterinarians take individually and as a profession to preserve the effectiveness and availability of antimicrobial drugs through conscientious oversight and responsible medical decision-making while safeguarding animal, public, and environmental health.In practical terms, this means only using antibiotics when absolutely indicated, for the shortest amount of time, choosing the most appropriate drug, and making decisions such as dose and route of administration that optimize efficacy, says Sharanne Raidal, BVSc, MVSt, PhD, GradDipEd, FANZCVSc, Dipl. ECEIM, a professor at Charles Sturt University, in New South Wales, Australia.Some of the many ways veterinarians act as antimicrobial stewards include:Maintaining equine health and welfare by focusing on preventive care that will minimize the need for antimicrobial drugs. This includes husbandry and hygiene, vaccination, and biosecurity and infection control strategies.Using evidence-based decisions and diagnostics to determine if an antimicrobial is necessary.Prescribing antimicrobials sparingly and judiciously with close and continual evaluation of the therapy outcomes.Selecting alternatives to antimicrobials when possible.Educating clients about the importance of antimicrobial stewardship and what conditions do not need antimicrobial drugs.There are also tricks that we can use to enhance antibiotic efficacy, says Raidal. For example, some antibiotics work best when we are able to provide very high drug concentrations in the region of concern using intravenous regional perfusion.Developing Antibiotic ResistanceWhat does antimicrobial stewardship and antimicrobial resistance have to do with you and your horse? After all, its just one horse were treating. Surely resistance cant develop from a single patient, can it?Indeed, it can. In fact, scientists detected antimicrobial resistance almost simultaneously with the discovery of antimicrobials.Sir Alexander Fleming observed and reported antimicrobial resistance to penicillin in his original work back in the 1940s, Raidal says. In Flemings 1945 Nobel lecture he wrote, The time may come when penicillin can be bought by anyone in the shops. Then there is the danger that the ignorant man may easily under dose himself and, by exposing his microbes to nonlethal quantities of the drug, make them resistant.When it comes to resistance, Raidal emphasizes the importance of understanding the two main types:1. Innate resistanceThis means that the bacteria are fundamentally unable to be killed by the antibiotic, she says. A good example would be that aminoglycosides, such as amikacin, have no effect against anaerobic bacteria. Because aminoglycoside uptake into bacteria is an oxygen-dependent process, anaerobes are innately resistant to them, and we therefore need to make a different choice for anaerobic infections.2. Acquired resistanceThis is the type of resistance we are concerned about, stresses Raidal. As Fleming warned, we select for this type of resistance by exposing bacteria to low, sublethal concentrations of antibiotic. This is the single most effective method of selecting for antibiotic resistance.Further, a small percentage of bacteria, by genetic chance, have mechanisms that confer resistance to antibiotics.By killing susceptible organisms, we allow these more resistant types to preferentially multiply, she explains.Misusing Antimicrobials: Not Always NeglectDespite Flemings warnings, people have misused antibiotics in both human and veterinary medicine by underdosing, extending treatment durations unnecessarily, and addressing nonbacterial conditions with antimicrobials. As a result, multidrug-resistant bacteria and superinfections have emerged, defying even our strongest antibiotics.Recently van den Brom-Spierenburg et al. (2024) conducted a survey of equine veterinarians prescribing habits in cases of equine asthma. In that survey 249 veterinarians from 25 countries received descriptions of horses with mild, moderate, and severe asthma. Overall, 53% of the respondents reported they would use antimicrobials at least sometimes in at least one of the three equine asthma cases. The most common reason they chose to use antimicrobials at least sometimes was because they suspected a secondary bacterial infection. The most prescribed antimicrobials included trimethoprim sulfonamide combinations (80%), penicillins (40%), and tetracyclines (29%). However, a smaller number of respondents selected the critically important antimicrobials: cephalosporins (15 practitioners, or 11%), fluoroquinolones (9, or 7%), and macrolides (1, or less than 1%).At first glance these results might seem to suggest that equine practitioners engage in antibiotic misuse. However, Clare Ryan, DVM, PhD, Dipl. ACVIM, an assistant professor at the University of Georgias College of Veterinary Medicine, in Athens, says, Veterinarians almost neverintentionally misuse antibiotics, but practical factors may prevent them from closely following antimicrobial stewardship guidelines. For example, if owners do not approve the diagnostic tests needed to fully rule out a bacterial infection, the veterinarian may feel it is risky to withhold treatment. Veterinarians might also face significant pressure to treat with antibiotics from horse owners or farm managers, who may not be able to differentiate between a horse with asthma and a horse with bacterial pneumonia.The Real Threat of Antimicrobial ResistanceNonetheless, antimicrobial resistance threatens all animal species, and we must take steps to improve our judicious use of antimicrobials. Tallon et al. (2023) reported that in 2019, bacterial antimicrobial resistance contributed to an estimated 4.95 million human deaths, with 1.27 million of these deaths directly attributable to antimicrobial resistance. By 2050, experts anticipate 10 million people will die each year because of antimicrobial resistance.There are already glaring examples of the impact antibiotic resistance has on the equine community, says Ryan. The bacterium Rhodococcus equi, which causes pneumonia in foals has, in some parts of the U.S., acquired resistance to more than one class of antibiotics. This means veterinarians can be left with few, if any, effective antibiotics for treating infected foals.Encourage Laboratory Testing Before Antibiotic Use in HorsesCulture results can contribute to faster resolution of an infection, with less chance of treatment failure. | Getty imagesOne of the most powerful tools veterinarians have available when choosing antimicrobials is a bacterial culture with antimicrobial susceptibility testing, often referred to as culture and sensitivity, Ryan explains. It is currently the most accessible and practical way for veterinarians to identify which bacteria are causing an infection and help guide antibiotic selection.Researchers have shown, however, that veterinarians either do not or cannot perform culture and sensitivity before antibiotic use in some situations. Ryan says major roadblocks to performing this test include:The urgent need to institute therapyFinancial constraintsSampling difficultiesLength of time until results become available (three to five days)Concerns about relevance of in vitro (in the lab) resultsWhen testing is not performed, veterinarians must rely on information gathered from previously described cases and take their best guess about what bacteria are causing the infection, says Ryan. These educated guesses can easily be incorrect. Veterinarians are also then assuming that the offending bacteria are not resistant to typically used antibiotics.Raidal agrees, adding, Sometimes we need to start treatment straight away because the horse is so sick that we cant wait or because the clinical condition is so strongly supportive of infection that it is unwise to delay treatment.When Is Antimicrobial Testing Important?She considers laboratory testing (cytology or culture and sensitivity) important for four reasons:If testing does not support infection, veterinarians and owners can stop antibiotic treatment straight away.When available, culture and sensitivity results reveal whether the first guess (i.e., empirical choice) was correct.If the clinical condition is not responding or the veterinarian wants to de-escalate treatment (e.g., narrow the choice of antibiotic activity or select an oral antibiotic to save the horse from injections), the results will direct the second choice of treatment for that horse.Every set of results helps build a record of which bacteria cause specific problems in treated horses and which drugs are likely effective in the equine population. In other words, each horse treated benefits from the information gathered from previous cases.Ryan adds, There are, of course, some situations when culture truly is not possible to perform. However, owners can contribute to good antimicrobial stewardship by discussing the value of performing a culture with their veterinarian whenever bacterial infection is suspected.Veterinarians can engage in conversations with clients to clarify how culture results could contribute to faster resolution of the infection, with less chance of treatment failure, she says. Even if a client initially declines culture tests, veterinarians can make it a habit to obtain consent to collect and store samples for later submission in case treatment failure occurs.What Antimicrobial Alternatives Do We Have?We must fiercely protect our remaining antimicrobials, our sources say, because few, if any, alternatives are on the horizon.Most of the antimicrobial agents we use in horses were originally developed for use in people, Ryan explains. New antimicrobials are rarely discovered, and of those, even fewer prove safe and effective enough to successfully make it to the market. As resistance spreads, we continue to lose effective antimicrobial drugs to combat potentially deadly infections.Economic drivers for drug development do not favor the production of new antibiotics, and certainly not at prices that will enable us to treat animals in our care at prices their owners can afford, adds Raidal.Thus, whenever possible, our sources say we should embrace strategies that avoid the use of antimicrobials, which is exactly what some researchers are doing. Here is a short summary of a few recently published research studies attempting to spearhead antimicrobial stewardship.Using honey as an antimicrobial In the case of skin wounds, Manuka honey has received increasing attention (see TheHorse.com/woundcare#honey). For example, Gandini et al. (2024) examined the effect of a pectin-honey hydrogel to prevent surgical site infections (SSIs) following abdominal surgery (laparotomy). These abdominal-incision infections occur relatively frequently, complicate healing, and represent an additional financial burden for horse owners.Manuka honey has received increasing attention as an antimicrobial alternative for surgical and other wound healing.The researchers randomly divided 36 horses undergoing emergency abdominal surgery into two groups. They treated half the horses with the hydrogel on the body wall (linea alba) closing the subcutaneous tissues and skin, and they did not treat the other half with the hydrogel (controls). Gandini and colleagues saw an overall SSI occurrence of 19.4%, but only one out of 18 horses (5.5%) treated with the hydrogel developed an infection. In contrast, six out of 18 (33.3%) horses in the control group developed SSI. Horses in the control group were 8.5 times more likely to develop a surgical site infection.Antimicrobial powers of orthobiologics Veterinarians are also looking at stem cells and platelets for their antimicrobial properties. In a literature review Pezzanite et al. (2023) reported that both stem cells and platelets exert potential antimicrobial effects, particularly platelet lysate products. These are created by pooling platelets collected from multiple donor horses and lysing the platelets to release their antimicrobial peptides (short chains of amino acids). In preliminary studies researchers have shown these products effective against both gram-positive and -negative bacteria, as well as biofilms produced by Staphylococcus aureus. Scientists have also studied commercially available lysate products effects in joint infections.Plant-based antimicrobials On an experimental stage, researchers are looking for novel plant-based antimicrobials. In a recent study Emiru et al. (2024) used strangles as an example. Strangles, caused by the bacterium Streptococcus equi, is often treated with penicillin; however, resistance is now developing. Emiru et al. cited research showing 12.5% of S. equi isolated from upper respiratory tract samples had resistance to penicillin. Hoping to identify plant-based antimicrobials, the researchers evaluated the antibacterial activity of ethanol extracts from the stem bark, leaves, and roots of the velvet bushwillow plant, Combretum molle, against S. equi cultures isolated from clinical strangles cases. All tested extracts had significant antibacterial activity against clinical isolates of S. equi in vitro, with the root extract performing better than the stem bark and leaf extracts. Of note, bark and root extracts both had a greater inhibitory effect on S. equi growth than penicillin G.The researchers concluded, These findings support the traditional social claims that the plant can be used to treat equine respiratory conditions and suggesting its high potential to be developed as an effective antibacterial drug.Raidal acknowledges the importance of this type of research but adds, There is no limit to what we might achieve; however, it remains unwise to expect that we can use available resources in a foolish manner and expect additional fixes to become available. We need to look after what weve got!Take-Home MessageThe AVMA has an extensive list of ways equine veterinarians can embrace the judicious use of antibiotics (available at tinyurl.com/bdhkf2zw). In a nutshell, our sources say the best way to preserve antimicrobial efficacy involves choosing the right antimicrobial for the right patient, at the right time, with the right dose, and for the right route, causing the least harm to the patient and future patients. Veterinarians and horse owners all have the same goal: to treat the sick or injured animal in front of us, says Ryan. As an equine community, we need to take it one step further and support practices that protect future generations of horses and their humans from antibiotic resistance.

Key Considerations Challenges Solutions Practical Tips Choosing the Right First Pony: Focus on Older, Experienced Ponies Pony Size Matters (not exceeding 12.2hh for children under 10) Budget Considerations Common Challenges: Settling In and Adjustment Issues Pony Misbehavior and Building Confidence Companion Ponies Addressing Behavioral Issues: Pony Health and Comfort Checks Training and Riding Techniques Establishing Trust Practical Tips for Parents: Consider Trial Periods Before Purchase Seek Professional Advice and Vet Checks Ensure Consistent Training Prioritize Safety Navigating Challenges: A Parent's Dilemma with a Child's First Pony and Building Riding ConfidenceIntroducing a child to the world of horse riding can be a thrilling and rewarding experience, but it also comes with its own set of challenges. One of the most critical decisions parents face is selecting the right first pony for their child. Here, we will delve into the key considerations, common issues, and practical advice to help navigate these challenges and build your child's riding confidence.Choosing the Right First PonyWhen it comes to finding that perfect first pony, several factors must be taken into account to ensure a safe and enjoyable experience for a beginner rider. Focus on Experienced PoniesOlder, more knowledgeable ponies are generally the best choice for children learning to ride. These ponies have typically encountered various situations and mastered their roles, making them more forgiving and safer for inexperienced riders. Ideally, a first pony should be at least 10 years old, as younger ponies may lack the necessary experience and patience[2].Size MattersThe pony's size is another crucial consideration. A pony that is proportionate to the child's height can make them feel safer and more confident. For children aged 10 and under, ponies should not exceed 12.2hh, ensuring better control and reducing accident risks[2].Budget ConsiderationsWhile the lure of a top-tier pony may be strong, investing in a seasoned, confidence-building pony can often be achieved within a modest budget. Emphasis should be placed on safety and suitability rather than competition prowess. Experienced ponies that are perfect for learning are usually more affordable than those intended for competitive riding[2].Common Challenges with First PoniesEven with careful selection, there are common challenges that arise when introducing a child to their first pony. Settling In and Adjustment IssuesWhen a new pony arrives, allowing it time to settle in is critical. Stabling the pony initially and gradually familiarizing it with the field or riding arena can help minimize stress and excitement. However, the adjustment period can sometimes lead to behaviors like bucking or bolting, particularly if the pony isn't given enough time to adapt[1].Building ConfidencePony misbehavior, such as bucking off a rider, can damage a child's confidence. Introducing a more confident rider to showcase the pony's safety can be beneficial. However, this must be managed carefully to prevent further fright for the child or the pony[1].Companion PoniesAdding a companion pony can sometimes ease a new pony's stress, but it also creates a new dynamic as both ponies might prefer being together, which can lead to additional challenges in the riding arena[1].Addressing Behavioral IssuesBehavioral issues in ponies can arise from various sources, and it is essential to address these problems promptly and effectively. Health and ComfortThe initial step is to ensure the pony's behavior isn't due to pain or discomfort. Regular grooming and inspections for sore spots, injuries, or hoof abscesses are vital. A pony's misbehavior might signify an underlying health issue rather than mere poor conduct[4].Training and Riding TechniquesA pony's behavior can be heavily influenced by how it is ridden. Inexperienced riders using incorrect aids may inadvertently confuse and upset the pony. Correct timing and placement of aids are crucial. If problems persist, professional trainer assistance can be invaluable[4].Establishing TrustBuilding a solid foundation of trust between the pony and the rider is essential. Achieving this through consistent training and positive reinforcement aids in forming a trusting relationship, such as teaching the pony to respond to nose pressure and easing the neck can help[4].Practical Tips for ParentsHere are some practical tips to assist parents in navigating the challenges of introducing a child to their first pony: Trial PeriodsConsider trialing a pony for a month or so before a purchase commitment. This period allows observation of the pony's behavior in your environment and how well it suits your child[3].Professional AdviceAdvice from experienced equestrians should always be sought when selecting a pony. A vet check before bringing the pony home is strongly recommended to identify any undisclosed health issues[3].Consistent TrainingConsistent training is the cornerstone of maintaining a well-behaved pony. Ensure regular schooling for the pony and proper instruction for your child to prevent bad habits[4].Safety FirstSafety should always reign supreme. Children should never be left alone with a pony, and an experienced adult should always be present during interactions[4].ConclusionIntroducing a child to their first pony marks a significant milestone, demanding careful planning and consideration. By opting for experienced, older ponies, choosing appropriate sizes, and promptly addressing any behavioral issues, parents can bolster their child's riding confidence. Ultimately, safety and suitability should take priority, and professional guidance can significantly enhance the success of this journey. With thoughtful navigation of these challenges, parents can help foster a durable love and appreciation for horse riding in their children.For further insights, explore the Jodhpur Collection, or consider practical gear needs like the Horse Riding Boot Collection, and the Horse Riding Gloves Collection. Additional support can be found with Everyday Horse Vitamins & Supplements to maintain pony health.Visit Just Horse Riders for expert advice and equestrian needs today.```html```