California Riding Magazine • October, 2008

California Riding Interview
Columnist Zazou Hoffman chats with
controversial, but respected veterinarian
Dr. David Ramey.

by Zazou Hoffman


Esteemed California veterinarian Dr. David Ramey takes care of Grand Prix rider Richard Spooner’s horses. He has also been my vet for many years. Dr. Ramey’s wisdom and thoughtful advice regarding horse care is invaluable. He is also something of a firebrand when it comes to his views on many veterinary topics including supplements, acupuncture for horses and certain pre-purchase flexion tests.

Dr. Ramey is very well known for his belief that good medicine should be guided by sound science and, because of that, he’s been critical of some practices that may be commonly used by some. His positions may be somewhat controversial, but they’re not easily dismissed.
His books, A Consumer’s Guide to Alternative Therapies in the Horse, and Complementary and Alternative Veterinary Medicine Considered (co-written with world renowned veterinary ethicist Dr. Bernard Rollin), provide an incisive look at veterinary “alternatives” and quackery.

Zazou: I spent some time with Richard Spooner and Chris Pratt at Thermal and I know you are Richard’s vet. What preventative measures should owners and riders take when it comes to Grand Prix horses?

Dr. Ramey: That’s a hard question, actually, and it sort of depends on what you want to prevent. I mean, you can prevent a horse from being too skinny by making sure he has enough feed! However, when most people think about preventing, they’re usually thinking about preventing injuries. And, in that regard, the most important thing you can do is not jump your horse too much. Grand Prix horses know how to jump. If you jump them over fences for day after day, dropping those big bodies down on little legs from five feet or higher in the air, pretty soon they’re going to injure themselves.

That may seem obvious, but the fact is that no supplement or treatment is going to prevent injury due to overuse. Even so, lots of horses get routine treatments (for example, they may get their joints injected, even though there aren’t any problems with them), even though there’s absolutely no evidence at all that such treatments are beneficial. I think that’s one area that I get controversial—I don’t recommend treatments to prevent problems that may not even exist!
To prevent problems, work your horse regularly and sensibly, and make sure that he has good food and fresh water. Don’t let him get fat, and take care of regular needs such as occasional vaccination and de-worming. If that’s all you ever do, your horse will probably do pretty well.

Zazou: What trends do you see that you don’t approve of?

Dr. Ramey: That’s quite a question—how much space do I get? Seriously, how about a couple of big ones?

The first trend that I see and don’t approve of is the rise of marketing over substance. I really don’t approve of the fact that horse owners are bombarded with all sorts of products and services, all of which are supported by glitzy advertisements and testimonials, but almost none of them by science.

I think that a lot of horse people have the idea that, in order to keep a horse healthy, they have to invest in all sorts of gadgets, products, supplements and services, when, in fact, most of them are useless. There seems to be very little concern about what actually works. But it’s very difficult for people to know what to believe, especially when everyone is marketing, including some veterinarians. It sometimes seem like everyone in the horse world is trying to get their hands into horse owners’ pockets.

Another trend that I don’t approve of is what seems to be a tendency to ignore science, or even truth, when it comes to evaluating and recommending products or services. I mean, most everyone seems to be in general agreement that science is pretty useful, and that telling the truth is a good thing. It’s just that when science doesn’t support one’s pet product or belief, or the truth gets in the way of a good story, people tend to ignore both. To me that’s silly because science has been responsible for essentially all of the great medical advances. And, everyone should tell the truth, right?

When I hear about people wanting to try “ancient” treatments (such as acupuncture, which isn’t old at all), or “natural” treatments (as opposed to ones that are supported by good science and sound medicine), I think it’s very unfortunate. Besides, we already know what happens when people rely on the old and natural stuff—they live neither long nor healthy!

Zazou: Is the NGB (National Governing Body) taking the best approach to banned substances and what do you think of the stringent FEI “no foreign substance” rules?

Dr. Ramey: That’s certainly a controversial topic! (Editor’s note: Five Olympic horses, including Courtney King-Dye’s Harmony’s Mythilus, failed the FEI drug tests. See Olympic coverage).

I try to keep the horse at the forefront of such thoughts. The humans involved tend to let concerns such as winning get in the way of the best interests of the horse. I think that, in general, it’s not a good thing to be giving lots of substances to horses that compete. How would people react if we treated young human athletes like horses? How would people react if, without their knowledge, teenage baseball players were given steroids, tranquilizers, stimulants, etc? I really don’t see that much difference between that hypothetical situation and what goes on in the horse world.

In my opinion, it’s in the best interest of the horse’s health to minimize the things that they’re getting, and the best interests of the horse should be the bottom line. In an ideal world, good riders and good horses should just go out and compete in good faith. But the desire to win changes most everything.

As for the FEI’s policy, I think that it’s mostly a good thing. We don’t tolerate human athletes taking drugs to perform. I think that we should have even less tolerance when people give drugs to horses, because horses don’t know what they’re being given, and couldn’t say, “No,” even if they wanted to.

Zazou: In regard to the five Olympic cases, why would a competitor use capsaicin or felbinac?

Dr. Ramey: Competitors might use capsaicin or felbinac in an effort to relieve pain and inflammation (in the case of felbinac), or to try to block pain sensation (in the case of capsaicin). There’s really not any reason to use such substances on healthy horses. I’ve never prescribed either substance in my clinical practice.

Zazou: What are your thoughts on the use of steroids in high performance horses? How would they help a show jumper?

Dr. Ramey: Personally, I think it’s very sad that we think that performing is so important that we have to drug horses to get them to do what we want. Steroids are a particularly good target. There’s no evidence at all that they help horses perform at any level. Horses are running at pretty much the limits of their athletic abilities, and you can’t make them perform better by giving them steroids. You can make them act more like stallions by giving them steroids (more aggressive, more dangerous, that sort of thing), but if that’s what you want, why not just buy a stallion?

Zazou: What do you look for in a Grand Prix prospect and what is the most important trait the horse should possess for determining future soundness?

Dr. Ramey: Well, honestly, I think it’s up to my clients to find what they think is the best prospect: They’re the ones who have to live with them! I’ve seen top horses that have come from many different backgrounds. Still, I think that quality often (but not always!) pays.
I’m always wary of terms like “future soundness,” because I haven’t figured out a way to predict the future. Still, if it’s one important trait that you’re concerned with, I’d say look for a horse with a good foot. This is both in terms of good hoof conformation; adequate heel, good size, etc., and good hoof quality; a nice, firm foot that isn’t shelly or cracked. No matter what level of performance is desired, the old “No hoof, no horse” adage is very true.

Zazou: How closely do you work with the farrier to maximize the potential of the top Grand Prix jumpers?

Dr. Ramey: It depends on the farrier, mostly. I love working with farriers. I think that the horse benefits when everyone looking after him is working together. Unfortunately, veterinarian-farrier relationships can be a bit rocky sometimes. It’s sort of a turf protection thing, and people sometimes let their egos get in the way, so it’s not always possible to engage as fully as I’d like.

In my best show barns, such as Richard Spooner’s, I can confidently say that by working closely with his farrier we’ve been able to help many top horses reach and sustain their full potential.

Zazou: I just read that the tracks in California are now allowing horses to race barefoot. Is there any advantage to keeping race or show horses barefoot?

Dr. Ramey: There are likely to be good sides and bad sides to racing and showing barefoot. Under any circumstances it’s a complicated discussion. On the one hand, people have tried to implicate shoes in a whole variety of racing injuries, so, to a certain extent, if horses didn’t race with shoes, it might help prevent some injuries that may be associated with extra traction from the shoe (such as some people think occurs with toe grabs). But on the other hand, shoes do protect the horse’s foot, so you’re probably helping prevent hoof and foot injuries when you’re putting shoes on. However, the bottom line is that no one has ever studied the question (at least to my knowledge), so, honestly, just about everyone you ask is likely to have an opinion, but there’s not much evidence to back up any of those opinions.

Zazou: How is technology impacting your practice?

Dr. Ramey: Not so much, actually. Technology has changed some diagnostic and treatment options, but not necessarily for every horse, mostly because of the economics. For example, while digital X-rays may be the rage, the machines are very expensive, and they don’t necessarily improve the quality of the diagnostic images, even though you can see the pictures immediately.

The “gee whiz” value may be considerable, but it comes at a high cost, thus, so far, I’ve decided not to invest (and I do mean invest) in the equipment. Or, MRI, for example, offers some great diagnostic information, but the cost means that many people are more than happy to save the money and wait the problems out—and waiting is often the only real useful treatment available anyway!

I’ve never really worried about being the first “kid” on the block to own new equipment. I’d rather sit back and see how it all plays out. The exception to that was ultrasound. I jumped on that when it first became available, because the diagnostic advantages were so obvious. But every piece of equipment comes with a cost, and when you have to pay for something, there’s pressure to use it and get it paid for. That may sometimes mean that horses get things done that they don’t need: extra X-rays, taken to pay off a new digital machine, for example, or applying a “shock wave” to as many horses as possible. I don’t want my practice to be impacted in that way.

Zazou: What advice do you have for Junior riders who want to learn more about caring for their horses? Is there one book you can recommend?

Dr. Ramey: Can I recommend any of mine? (smiles) There’s so much information and misinformation out there that it can be pretty hard to sort through. In that regard, my personal favorite was my first book, Horsefeathers: Facts vs. Myths about Your Horse’s Health, which took on a lot of the lore that pervades the horse world. You can still find copies, and I hope to be able to get a new edition out in the next year or so.

Another bit of information I can offer is, “Don’t believe everything that you read or hear.” Much of the information that’s out there is driven by the desire to sell products or services—just look at any horse magazine! In fact, it can be pretty hard to find unbiased information. The old line, “If it sounds too good to be true, it probably is,” is really true.

Zazou: What is the horse world equivalent of the New England Journal of Medicine and can we non-professionals subscribe to it or find it online?

Dr. Ramey: The NEJM is written for doctors, so the problem for most people is not really subscribing, it’s understanding the information! The equine equivalent is probably the Equine Veterinary Journal, which is published every other month, out of the UK. Its sister publication, Equine Veterinary Education, is published monthly. Those are probably the best two magazines devoted strictly to horses and their health. You can look for information at www.evj.co.uk.

Zazou: I keep reading and hearing about different theories on icing the legs of high performance horses. What do you think?

Dr. Ramey: I wasn’t aware that there were different theories! Ice is a time-honored, and medically proven, way to reduce pain, swelling, and inflammation in an injured limb. When you get into icing limbs to allow injured horses to perform, frankly, I think that can be dangerous, both for horse and rider, but the benefits of icing are pretty well established when it comes to treating acute injuries.

Zazou: What is the most rewarding part of your job and what do you hope to accomplish in the next few years?

Dr. Ramey: The most rewarding part of my job is helping people. It’s funny in a way, because when I first started in veterinary medicine I thought that it would be all about the horses. The horses are owned by people, and there’s as much taking care of the horse owner as there is taking care of the horse.

Frankly, as time passes and I understand the medicine better and better, the challenges of the job itself have lessened. However, I’ve come to really appreciate the opportunity that I have to help people understand and deal with the problems of an animal in which they have a huge investment of time, money and emotion.

As far as accomplishments, honestly, I’ve achieved far more than I ever thought was possible, both in terms of professional success, as well as in lectures, travel and notoriety! And, I never really looked for any of it. I just thought that there were some things that needed to be said (still do).

I’d like to get people thinking more in terms of what’s really necessary for their horses, and less in terms of racing to follow the latest trend.
I hope to keep writing and lecturing, even if it does seem that I regularly go against the tide!

Zazou: While I’m on that subject may I prevail upon you to find a cure for scratches which plague the horses at WEF and for the dreadful skin allergy to gnats, which drives our horses crazy in Sullivan Canyon and other parts of Southern California? Both problems seem to be epidemic in scale, as well as costly in terms of competition days lost. Why isn’t there a vaccine?

Dr. Ramey: The cure is easy: move! Seriously, there’s not a vaccine because the problem is an allergic reaction (as I recall, it’s to some coastal mite). And trust me, if I could find a cure for allergies, I’d sure do it, because then I’d be writing you from my private island in the South Pacific!

Zazou: Dr. Ramey, many thanks for taking the time to answer my questions. Best of luck to you!