January 2008
Happy New Year!!!  Well I decided to write my next Newsletter a little early as I’m so excited to dive into this year with many new adventures in my practice.  I have some lectures that I want to let you know about so you can plan ahead to attend and perhaps I’ll give you a hint of new things on the horizon!  
I had some emergency contact memo boards made up for you.  I came up with this idea after the fires and I’m so excited to finally have them arrive!  I hope you find them useful.
Lecture Series at Helen Woodward     Tuesdays at 6:00pm
Feb 12, Mar 11, May 13
I will be presenting three community lectures this spring at the Helen Woodward Animal Center.  The first on Tuesday February 12th will be on Advanced Equine Veterinary Dentistry, what unknown dangers lurk undetected in your horse’s mouth.  The second lecture will be on Tuesday March 11th and will deal with Performance Horse Medicine:  How Regenerative Cell Therapy can improve sport injuries and get you back in the saddle faster.  Some of these therapies include: IRAP, Acell, Stem cell and PRP.  The third lecture will dive into Acupuncture:  Where East meets West and how a 3000 year old modality can improve musculoskeletal problems and resolve difficult to treat cases.  Each lecture will last about an hour and then 30-45 minutes of Q&A. I am really excited to be providing these lectures for you.  We will be providing some refreshments.  I hope you will join me for fun and informative evenings in a casual atmosphere.  Please feel free to invite your friends.  To keep track of numbers an RSVP would be appreciated at 858-759-5144, but last minute drop-ins our always welcome. You can also drop by my website to register:  www.drlisagrim.com.  Also sign up to receive my Blog so you can get up to date announcements at www.drlisagrim.blogspot.com.
Wellness Program
We are putting together a yearly wellness program available to you.  The Wellness Program is designed to provide you with the peace of mind that comes with knowing your horses are receiving the best preventative health care on a regular and timely basis.  Twice yearly medical evaluations and preventative care services are provided for your horse in a professional and convenient manner.  Many of the regular services you are already using are provided at a substantial discount,  when you sign up for this in advance, also allowing you to budget your yearly expenses ahead of time.  Our office staff will contact you twice yearly, 10-14 days prior to your appointment for your convenience.  A few options are available depending on your horses needs.  The services include annual exams, vaccinations, deworming, and dentistry.
More detailed information of the different options can be found by calling the office, 858-759-5144, or on my website:  www.drlisagrim.com/wellness 
     
Fly Reduction
During the hot summer months we all have to deal with the pesky flies that are around and on our horses.  I always hear the comments during the hottest months of the year, and yet this is the time of year we can start thinking about preventing their overpopulation.  Flies can be a nuisance, spread disease and for some horses they can create major skin allergy problems.  Last year I saw more fly allergy skin problems than any other year and so I’m recommending an option for you. Of course cleanliness and regular removal of manure from the property weekly is the best option but not always practical. I have found that commercial fly repellents available are minimally effective and expose us to frequent inhalation of pesticides.  One effective, safe and natural option is the use of Predator flies.  These small beneficial flies actually feed on the pupae of the offensive flies thus deterring the emergence of adults and their reproduction. For this method to be effective you need to start releasing flies before it gets too warm and the natural fly population becomes too overwhelming.  We have information at the office about a company that offers this service or I can give you a catalog at one of your appointments.  Depending on your situation it costs about $2-$3 per horse per month plus shipping, with a minimum order of $18.45/mo (servicing 1-5 horses).  If you are at a small stable you could consider everyone pitching in a couple bucks a month.  Please call the office for details.  The best time to start this program is in the Spring before the fly population gets overwhelming, thus requiring many more predator flies.  As always, it’s better to prevent a problem before it gets out of control.	
Laboratory
We are very excited to have added two new blood analysis machines to our practice.  These machines will deliver information on CBC’s (complete blood counts) and chemistry analysis.  Steve is very excited about adding this to his repertoire and is already fully trained.  This will allow much faster turn around on routine blood samples, and in emergency situations.
       
February Dental Month!
I have decided to offer a discount on dentals in the month of February—woo hoo!  If you mention this newsletter at the time of making your appointment we will be pleased to give you 10% off of your total dentistry bill!  AND for the first 10 people that visit my website and mention the special promo code at the time of making your appointment, we will take off 20%!  We all know that dentistry is a very important part of your equine companion’s regular health care.  Similar to hooves the equine teeth continue to grow (erupt) during their lifetime, and are subject to constant wear during mastication (eating), so just like hoof care, dental care is necessary on a regular basis.  Poor dental care can lead to painful conditions in the mouth, discomfort in the bridle, behavioral issues when ridden, weight loss, colic and diarrhea.  Proper dentistry can decrease illness, decrease pain to your horse, decrease feed bills and increase performance.  When you compare the annual cost of hoof trimming or shoeing to dentistry, sophisticated dental care does not seem that expensive.  But, here is an opportunity to reduce that cost in February!                             
Looking to the future we are planning to expand our dental services.  As you know I took a special interest in providing exceptional equine dentistry for your horses about 10 years ago.  I have found it will be the best use of my time to pull further back from the dentistry to free up time for my other interest: performance horse medicine.  This will be a transition over time but my vision is to have another veterinarian working with us in the dental area.  I will of course still be involved in overseeing the training and quality of dentistry and will be brought in to consult on difficult cases and extractions.  We will always provide veterinary administered or supervised dentistry.  There will always be a veterinarian at every appointment to administer sedation, examine and diagnose your horse, and oversee if not perform the dentals.  In the state of California only veterinarians or technicians under the direct supervision of a veterinarian may legally perform dentistry. We will continue to maintain this high standard of practice and as always, attend current continuing education on the forefront of dentistry.
If you know of someone that would benefit from Advanced Equine Dental techniques we would appreciate your referral and will gladly credit your account $25 for each referral. (Also, you may want to check back with my website as we will be introducing Online Coupons periodically)

Acupuncture case
As you know I have been using acupuncture in the last couple of years in my practice.  To give you more of an idea of what acupuncture would be good for I thought I’d write about a case presentation of a horse with lameness of the hock and secondary back pain.  Acupuncture was used as an alternative and complementary treatment to help alleviate a lameness that had not been responding well to Western Medicine alone.  This horse had been treated with the standard hock injections for osteoarthritis of the right hock, but the duration of the pain relief was decreasing substantially.  When this horse was examined from an acupuncture point of view it was found that there was blockage in 3 of the 12 energy “meridians” described in Chinese Medicine.  Many of the acupuncture points can be used diagnostically.  When they are sensitive they can indicate certain problems.  Drilling down further in Chinese medicine by putting all of the symptoms together a diagnosis can be made.  In this horse the blocked meridians were cleared and points were needle to increase the flow of blood and Chi.  This horse was relieved of the back pain and was sound through his hocks for a much longer treatment period than before.  Acupuncture can be used alone or in conjunction with Western medicine to help many lameness issues.  In this case it extended the period between joint injections.

Introducing “Care Credit” & Financial Policy Update
It has become evident that I have not always been clear at articulating my billing policy, which is “Payment is due at the time of service”.   Because I am a small business I do not have the ability to extend credit, but do accept Visa and MasterCard.  To be able to provide top notch veterinary care and have staff available to answer the phone I must keep my cash flow current. I understand that occasionally unforeseen episodes happen and finances can become a problem, but if this occurs it is expected that the financially responsible party must contact our office.  To provide another option in these cases we are making available to you the option of signing up with Care Credit, which offers many different short term no-interest agreements and also revolving credit accounts.  
For those that cannot be available at the time of their horse’s treatment to make payments, we can keep your credit card on file to bill monthly.  Because of the rising cost of billing each month, the minimum finance charge on accounts over 30 days will be increased to $10.  We are asking you to understand and help us adhere to this financial policy.
New Products
Surpass                                               This product actually came out more than a year ago.  It is an anti-inflammatory product (diclofenac) that is in a specialized cream base that allows the medication to penetrate the skin.  The advantage of using a delivery system like this is that the drug is absorbed locally and most of it is affective in the region where the problem exists.  There are also fewer complications with gastric ulcers since it is not absorbed through the GI tract.  Many people have found it useful for acute injuries with swelling and arthritic joints.  It can be used on show horses as long as it is not applied within 12 hours of showing.
Equioxx                                             Is a new Anti-inflammatory oral paste that was introduced in August 2007.  This is a potent once a day anti-inflammatory drug that does not affect the pharmacokinetic pathway that can lead to gastric ulcers which differentiates it from Bute or Banamine.  Although it has only been in use commercially for 5 months it has been found to be very safe and effective for acute painful musculoskeletal problems.  It also may be used during shows if given greater than 12 hours before showing.
Shampoos                                                    This last year brought about a much higher incidence of horses with hypersensitivity to insect bites.  Because of this I have been exploring new treatment options one of which includes some new shampoos.  There is a veterinary line of shampoos that I have added to my arsenal.  One of which is called “Relief” that helps with itchy skin.  Shampoos unfortunately are not enough in certain cases which need a full body approach including oral medications at times, but some of these new shampoos have helped relieve our horse’s symptoms.  Another Shampoo is “Sebalyte” which helps with Keratinic skin problems; this includes the sometimes painful crud that builds up on the front of horses cannon bones.  These conditions we aim to “control” as there are no specific cures, but by regularly using these shampoos, the process and symptoms can be held to a minimum.   There are a few other shampoos available for skin conditions so if you have a question about your horse’s skin please call to ask. 	
Deworming packages                                 I have been getting more questions about deworming this last year.  I also have been finding more owners forgetting to deworm their horse on a regular basis as our lives get busier and busier.  I recommend a rotating program every 2-3 months depending on your horse’s environment.  Some people have a lot of questions about which dewormers to use and when to use them, so to ease confusion and add convenience I am making available grouped packages of dewormer for you to administer with easy to follow labels instructing you to which wormer to use and when.  You can purchase a 6 month supply or a year supply which can be brought to you during your vaccination appointments.  This will also be part of the Wellness Program for a complete preventative care program.
.