Jeff Hall, DVM, Senior Equine Technical Services Veterinarian, Zoetis    Horses are stoic animals, especially when it comes to dental pain. They often show us only minor signs of discomfort, which can quite commonly show up as behavioral problems. For example, one horse owner told me she purchased a young horse who settled in well but had the strangest behavior while eating grain. After each bite, the filly stretched and twisted her head while chewing, spilling feed everywhere. The owner scheduled a dental exam with her veterinarian, and it revealed multiple tooth issues causing the horse pain. A few days after an exam and treatment, the filly was eating her feed normally. Many different factors cause physical and behavioral changes: In a 2020 survey, nearly three-quarters (73%) of horse owners indicated their horse had at least one behavior associated with dental pain.1 Additionally, a 2019 scientific study established a link between many common equine behavior problems and abscessed cheek teeth.2 Knowing the common signs of dental pain in horses can help you more easily recognize when something is off, signaling a call or visit with your veterinarian to mitigate potential problems as quickly as possible. Be in the know on common dental concerns It’s difficult to tell if your horse has tooth problems simply by looking at him. However, here are a few common dental problems your veterinarian can help diagnose.3 Infected teeth and/or gums Periodontal (gum) disease Abnormal or uneven bite planes Sharp enamel points forming on cheek teeth, causing lacerations of cheeks and tongue Lost and/or broken teeth Eating/drinking behaviors tied to dental pain Watch for changes in your horse’s behaviors and observe new horses for common signs that may indicate it’s time to talk with your veterinarian about a dental exam. Behavioral signs of dental pain may include:2 Eating hay slowly Dropping hay from the mouth (commonly called quidding) Pausing while eating hay Food pocketing (occurs when feed packs between the cheek teeth) Adjusting hay in the mouth while eating Turning head while eating hay Dropping grain from the mouth Dunking hay in water before eating Avoiding drinking cold water Social behaviors linked to dental pain Horses are naturally social animals—they thrive on interactions with you and their pasture or stablemates. When they are disinterested in others, a tooth problem could potentially be to blame. This could look like:2 Asocial behavior with people and/or other horses Aggressive behavior Head shyness General disinterest in their surroundings Performance issues associated with dental pain There are many reasons your horse’s performance or training progress could hit a roadblock. One reason might be a tooth abscess. Ask your veterinarian to perform a full oral exam to help uncover if dental pain might be causing your horse to:2 Evade the bit (which may look like “grabbing” the bit, being above the bit, or running through the bit) Respond differently to left and right rein contact when ridden or driven with a bit—rein contact is typically worse on the same side as the affected tooth Shake his head when ridden/driven with a bit Open his mouth when ridden/driven with a bit Resist bridling Common causes behind dental pain There are numerous potential problems that could be the root of your horse’s dental pain, including tooth abscesses, sharp points caused by uneven tooth wear, as well as a fractured or infected tooth. Your veterinarian can only diagnose and treat the source of pain through a comprehensive dental/oral exam. Say “ahhh…” Did you know? Horses are commonly sedated for a full oral exam and treatment (learn more about what to expect during a dental exam here). Your veterinarian may recommend using a sedative to help keep your horse, and any assisting handlers, safe during dental procedures. When your veterinarian recommends and uses Dormosedan® Sterile Solution (detomidine hydrochloride), they are working to help protect your horse’s safety and provide pain control in just one dose. With a 30-year track record, veterinarians continue to rate Dormosedan the highest of all equine sedatives for efficacy, safety, and reliability.4,5 Chances are you and your family see the dentist at least once, if not twice per year. Your horse needs regular dental care for his overall well-being too. If it’s been a while since your horse’s last dental exam, you’re not alone. A 2020 survey indicated that nearly 28% of horse owners shared it had been 12 months or longer since their horse had a dental checkup.2 Annual dental exams are an important part of a comprehensive spring tune-up for the horse(s) you know and love. Talk with your veterinarian today to schedule an appointment or discuss any concerns. IMPORTANT SAFETY INFORMATION Do not use DORMOSEDAN STERILE SOLUTION in horses with pre-existing atrioventricular (AV) or sinoatrial (SA) block, with severe coronary insufficiency, cerebrovascular disease, respiratory disease, or chronic renal failure. Intravenous potentiated sulfonamides should not be used in anesthetized or sedated horses. Careful consideration should be given to horses approaching or in endotoxic or traumatic shock, to horses with advanced liver or kidney disease, or to horses under stress from extreme heat, cold, fatigue, or high altitude. Do not use in horses intended for human consumption. Handle dosing syringes with caution to avoid direct exposure to skin, eyes or mouth. See full Prescribing Information, here.   References Zoetis Inc. Data on file. 2020 Zoetis Equine Dental Wellness Survey. Pehkonen J, Karma L, Raekallio M. Behavioral Signs Associated With Equine Periapical Infection in Cheek Teeth. J Equine Vet Sci. 2019;77:144-50. Accessed: January 20, 2023. The American Association of Equine Practitioners. AAEP horse health: The importance of maintaining the health of the horse’s mouth. https://aaep.org/horsehealth/importance-maintaining-health-your-horses-mouth. Accessed: January 20, 2023. Zoetis Inc. Data on file. 2020 Equine Pain & Sedation Market Research Study. Accessed: January 20, 2023. Data on file, Animalytix Market Segmentation, December 2022. Accessed: January 20, 2023. All trademarks are the property of Zoetis Services LLC or a related company or a licensor unless otherwise noted. Dormosedan is a registered trademark of Orion Corporation; distributed by Zoetis. © 2024 Zoetis Services LLC. All rights reserved. DOR-00093

Dr. Jacquelin Boggs, Equine Technical Services Veterinarian, Zoetis Your veterinarian plays an invaluable role in the lives of the horses you know and love—they possibly even care for your neighbors’ and friends’ horses too! Equine veterinarians are the heroes who travel out to barns in the middle of the night to care for a horse that’s experiencing colic or tend to a complicated birth. Have you ever wondered about the type of career lifestyle large animal vets lead? The equine veterinary practice is no doubt a highly rewarding job, but did you know that it consistently ranks high on the charts for burnout? I experienced my own form of burnout after serving as an ambulatory veterinarian and a Board-certified Internal Medicine Specialist for about a decade, which launched me into a passionate pursuit of how to support my well-being in order to meet the needs of my equine patients and colleagues too. I’ve worked with incredible clients over the years, horse owners who extended their gratitude in simple yet meaningful ways that really kept me going through the tough seasons. A few of these clients even expressed how they learned about the growing gap in the number of equine vets still practicing, and that they wanted me to truly know how much they valued my time and attention to their horses. In this article, I unpack some of the stats currently shaping the equine practice industry and how we can collectively partner to support veterinarians in small ways that truly can make a big difference.  Always by your side: navigating burnout in equine veterinary medicine Frustrated that you sometimes can’t find a veterinarian? Much like the nursing and education professions, equine veterinary medicine grapples with alarming retention challenges. According to data from the American Association of Equine Practitioners (AAEP), only 1.3% of new veterinary graduates choose to enter the equine field each year. Perhaps even more significant, within 5 years of practicing nearly 50% of the equine graduates either transition to small animal practices or leave the profession altogether. The attrition rate is a testament to the weight of the challenges equine vets face day-in-and-out. Logging many hours driving, responding to calls in the middle of the night, the physically demanding nature of the job and the emotional toll of working through critical cases can lead to exhaustion and mental strain, even compassion fatigue. To support these dedicated professionals, it’s important for everyone in the industry to recognize the urgency of addressing burnout and working toward sustainable solutions. Pioneering work-life sustainability: the industry’s game plan In the pursuit of a more sustainable future for equine veterinary medicine, thought leaders have emerged to champion the cause to find solutions. The AAEP formed a Commission on Equine Veterinary Sustainability, aiming to pave a new path for a career that allows more veterinarians to continue their practice while recruiting future practitioners to the field. The commission is one that I’ve been personally devoted to getting involved in—it’s led by member-volunteers with work focused in five key areas: strategies for effective emergency coverage, veterinary practice culture, compensation, internships and supporting the growth and development of equine veterinary students.  Another changemaking organization is led by Dr. Amy Grice, a prominent figure in the field who founded the Decade One initiative, with a focus on empowering early-career equine veterinarians and those seeking further mentorship in a support network. The team at Zoetis acknowledges the challenges faced by equine practices and aligns with various organizations (like Decade One) doing excellent work in this space, including Not One More Vet, the AAEP, as well as regional veterinary clinics and organizations, all of which share the mission of promoting equine veterinary career sustainability.  What horse owners can do: nurturing appreciation for equine veterinarians Know that emergencies are challenging Simply understanding that emergencies can be emotionally and physically taxing for veterinarians is more helpful than you may know. Additionally, providing a safe and organized environment for veterinary visits, including lighting and a safe place to work. Handling horses in a calm and cooperative manner, can greatly ease a veterinarian’s workload as well. Also, when it comes to emergencies, recognizing abnormalities in your horse early and calling sooner than later increases positive outcomes, decreases stress for all parties and hopefully will allow intervention when conditions are more ideal (such as not in the middle of the night, if possible).  Recognize expertise and express gratitude Recognizing a veterinarian’s expertise and expressing gratitude for their dedication can go a long way in boosting their morale. Moreover, horse owners can advocate in the industry for fair compensation and reasonable working hours for veterinarians, since these factors play a pivotal role in preventing burnout. Yes we went into this profession because we love horses, but our professional expertise does come with a cost—for example, trucks, gas, sophisticated diagnostic equipment and continuing education and licensing.  Accept new veterinarians It’s quite common for horse owners to become attached to their vets. And that is understandable! You’re building a relationship and trust over time. But please think twice before saying you’ll only see a specific doctor. New to the industry veterinarians bring skills and innovations from their recent time in veterinary school and are ready to dive in with enthusiasm. Established veterinarians gain a stronger work-life balance when they can mentor newer vets, creating a win-win for everyone. Collaborate on partnerships  By working together as a team, horse owners and veterinarians can create a supportive and sustainable environment that benefits everyone involved, most importantly the horses we cherish. Horse owners can even participate in local events and educational workshops organized by regional veterinary clinics and organizations. The more you learn, the better partner you can be on behalf of your horse. By attending these gatherings, you can not only gain a deeper understanding of the demands placed on equine vets, but also forge meaningful connections with these dedicated professionals. As horse owners, your support and gratitude is invaluable, serving as a beacon of hope for these dedicated