Tuesday, April 12, 2016

Dr. Don Moore responds to spin of 2 National Wild Horse & Burro Advisory Board Members

Straight from the Horse's Heart


pielstick-1
(It doesn’t look like Dr. Leon Pielstick has put on the sterile sleeve yet in the photo above.)
Below we’ve posted:                                                                                                                                                                                                              1) the comment Don Moore, DVM to BLM on their barbaric plan to sterilize wild mares.   2) the response to this from two National Wild Horse & Burro Advisory Board members – Sue McDonnell (NOT a vet) and Julie Weikel, DVM.   3) Dr, Don Moore’s response to their response.
Here is a copy of Dr. Don Moore’s original comment to the BLM regarding wild mare sterilization experimentation:
Attention Project Lead:
BLM stated it was “investing in a diverse portfolio of research projects to develop new, modern technologies and methods for wild horse and burro management”.   BLM is looking to improve existing population growth suppression methods or develop new methods according to the environmental assessment.  However, BLM does not need to investigate the safety and efficacy of three separate methods of surgical sterilization of wild horse mares.  These three methods have been performed on domestic mares and discounted as a last and least preferred method to manage hormonal issues.
The three surgical procedures for permanent sterilization of mares described in the mare sterilization research project, ovariectomy via colopotomy, tubal ligation and hysteroscopically-guided laser ablation of the oviduct papilla all require certain pre-operative and post-operative considerations  for aseptic surgical protocol and pain management.  Pre-operative bloodwork and a thorough examination are always performed on the relatively few domestic mares which are spayed.  Other options other than surgery are always considered first due to the risk involved with any of these procedures.   Aseptic surgical protocol and pain management is the standard of care for each and every surgery or the performing veterinarian would undoubtedly be sued by the owner and reprimanded by the state veterinary board.
Wild mares will not have their surgeries performed in a sterile surgical suite.  Their surgery will be performed in a non-sterile chute or standing in stocks at the local BLM facility without benefit of routine standard of care.   Unlike domestic mares who are easily handled, the very handling of these wild mares presents additional pre-operative stressors, which cannot be mitigated.
BLM does not possess the statutory authority to treat America’s wild free roaming mares as research test subjects to perform  surgeries which are not the standard of care for domestic mares.
Case in point, is a photograph of Dr. Leon Pielstick as he was beginning to perform a surgery attired in bibs used predominately for working cattle and performing the surgery with a non-sterile plastic sleeve that is used to pregnancy check cattle.  This is not acceptable for a domestic mare, why wild mares?  To learn this procedures has been performed on some of the Sheldon wild mares, undoubtedly in a similar manner, is gross negligence and inhumane on the part of the Department of Interior and the veterinarians who performed the surgery in less than aseptic conditions.
This type of trial and error butchery is a violation of the least feasible management clause of the Wild Free Roaming Horses and Burros Act.
In private practice, colopotomy is considered an inferior procedure with likelihood of post-surgical infections and complications (i.e., colic) especially during these unsterile conditions.  Post-operative care usually lasts several days to often weeks and mares are monitored and in most cases are monitored in box stalls or cross ties, which cannot be accomplished with wild mares. Post- operative bleeding is a situation which cannot be easily remedied even in domestic mares.
Standard of care for tubal ligation and/or ovariectomy is performed under aseptic conditions with a laparoscope and pain mitigation along with private confinement and treatment which can last days to weeks.  Complications can also be colic, infection and pain mitigation is required.
Hysteroscopically guided laser ablation is not a preferred method by board certified equine surgeons because it is considered experimental even under the best of conditions.  Field veterinarians and veterinary students are woefully inadequate to perform any of these surgeries, which in my opinion should only be done by board certified equine surgeons in appropriate surgical suites and with post- operative care performed by educated and expert staff in an equine veterinary hospital setting.
In recent conversations with Littleton Equine Medical Center veterinarians Scott Toppin, DVM, DABVP and Kelly Tisher DVM the following comments were made to me.
Dr. Toppin stated he had serious concerns about the dangerous and inhumane conditions under which these surgeries would be performed. He also stated concerns about the sterility of the procedure and pre and post-operative pain control.
Dr. Tisher shared that their practice equine surgeon,  Dustin V. Devine DVM, MS DACVS, performs  approximately six to twelve of these surgeries with a laparoscope annually.  Littleton Equine is the leading equine veterinary private practice in Colorado.
Mass experimental surgeries performed under these conditions outlined in the proposal, amounts to negligence and abuse.   I believe experiments such as this proposal are unethical, inhumane and unwarranted.   Any veterinarian(s) who would perform these experiments is in violation of the oath taken as a graduating veterinarian, “above all else, do no harm”.  If a veterinarian in private practice performed these procedures in the manner described in this document they would most certainly be reported to and disciplined by the regulatory board of that state.  Discipline would likely mean suspension of that veterinarian’s license to practice in that state.
All horses should be judged the same when it concerns care.  Elective, unethical treatment should not be performed on  either domestic horses or wild horses.   BLM gives the impression that all wild horse areas are overpopulated, when in fact, most wild horse areas do not have a genetically sustainable population without intervention.  This is due to over manipulation of herds to promote adoption, decreasing original herd use areas and allowing livestock to over graze our public lands.  Once again, BLM is exceeding the statutory authority granted by Congress in the management of our wild horses.
Since the inception of the WHBA, BLM has practiced a management for extinction policy. It is ever so clear in the “experimental research policy” BLM is now proposing.
Sincerely,
Donald E. Moore, D.V.M
*******
Comments by Sue McDonnell (who is NOT a vet) and Julie Weikel of BLM’s National Wild Horse & Burro Advisory Board to an advocate who sent an email with link to an article by Debbie Coffey and Dr. Don Moore’s comment to the BLM:
Responses from Sue McDonnell and Dr. Weikel:
CC
Apr 1 at 7:05 PM
Thank you for the link.  That is very helpful. I trust that you want the information you circulate to be accurate, so I will share what I know.
I work with people who do this procedure in a world class equine vet hospital where I work, the University of Pennsylvania New Bolton Center. I have had ovariectomy via colpotomy done on my own research and clinical mares, and i find it a relatively non invasive procedure for ovariectomy.  I should explain a couple things that you may understandably misunderstand about the procedure.
You mention the rectal palpation sleeve and implicate it as unsatisfactory because it is used also with cattle.  The photo shows what to me looks like a sterile glove over the palpation sleeve. That is how it is done for ovariectomy via colpotomy on a farm or in a clinic or at a vet school hospital for horses. Using the clean (or sterile, Probably can’t tell for sure by photo alone) sleeve and sterile glove, all surfaces (typically only the sterile glove) that contact  internal abdomen of the patient that should be kept free of “germs” are sterile. The sleeve is used as additional coverage that is very clean if not sterile as added protection. The bibs are not relevant, really, and they could be very clean, but it doesn’t matter much since they don’t touch the internal abdomen of the patient.
I will copy the veterinarians on the board, Dr. Cope and Dr. Weikel, to comment if they have time and can add to my comments. Believe it or not, out in the open air can in many cases can be a “cleaner” environment in terms of infection for colpotomy than inside a hospital, where germs and resistant strains tend to accumulate.  If the outdoor area is dusty there would be concerns.  Veterinarians are usually doing their best to protect the animal patient.  I am not a vet, but have worked professionally with veterinarians in a vet school for over 35 years, and have found very few veterinarians who don’t try their best in this regard. I hear Dr. Moore’s concerns, and have not worked with Dr. Pielstick myself, but trust he is doing his best, which looks from your photos to be as good as here at a world class vet hospital or at other fine vet clinics.
I hope this is helpful. Please let me know what you think.
Sue McDonnell
Julie Weikel 
To
CC
Apr 1 at 8:30 PM
Thank you Dr. McDonnell for a very thorough coverage of (name redacted) concerns. I concur with all the points you make and add that dust management is routinely addressed during these procedures. I would also add that long term pain management and long term antibiotics are also routine for this procedure.
Certainly any handling of wild horses is stressful for them. However, the goal with these procedures is to achieve population stabilization so that further gathers are greatly reduced and bands can be left undisturbed, thus reducing total lifetime stressful events.
Julie Weikel DVM
*********
And Dr. Don Moore’s response to these comments by Sue McDonnell and Julie Weikel :
The University of Pennsylvania New Bolton Center is no doubt a fine surgery facility.  I am also certain that surgeons at the New Bolton Center operate in surgical suites that are properly vented and sterilized, and for Dr. McDonnell to suggest anything less is to insult the very facility she is works for.
It has been my experience at Colorado State University that surgeons as well as veterinary student observers in the suite, were routinely in sterile, long sleeved surgical gowns and gloves. They also wear surgical masks and caps.  This is the same protocol used by the excellent private practice facility I spoke with when researching these procedures. Standard of care dictates this diligent surgical preparation of the patient and surgical suite.
To suggest a “clean” sleeve is acceptable for abdominal surgery is ridiculous.   Aseptic conditions are the required standard of care for any abdominal surgery and the equine patient is more susceptible to peritonitis than any other species that veterinarians deal with.  To suggest an outdoor “facility” used by BLM could be a better choice than any properly equipped surgical suite is ludicrous.  Academia and research facilities are no longer exempt from good standard of care.
Again, for BLM and the Advisory Board to propose this type of mass experimental surgery under the conditions outlined in the proposal, amounts to negligence and abuse. 
To accept this mass butchery by BLM under the guise of research is inconceivable in a civilized society and to apologize for it suggests a complete misunderstanding of the ethics we as veterinarians pledge to adhere to.
 For BLM to promote that there is over population of wild horses on public lands is without merit.  Most wild horse areas are managed at levels below what is needed for self-sustaining, genetically viable numbers.  Many wild horse areas, such as the Little Bookcliffs (which has long utilized PZP), still need to have additional animals introduced to avoid inbreeding.  The Advisory Board would best focus research efforts to change the current BLM management practice of managing wild horses in significantly smaller subsets of original herd use areas that cannot physically allow for genetically viable, self-sustaining herds.   The next focus should be proper management of the domestic species that are causing range degradation.
Donald E. Moore, D.V.M.

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