Tighter controls on tooth extractions in horses supported by NZ Veterinary Association

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The New Zealand Veterinary Association is backing tighter controls relating to tooth extractions in horses, citing animal welfare concerns.

The association, in its submission to the Ministry for Primary Industries in relation to proposed regulations intended to clarify the rules for surgical procedures in a range of animals, has put its weight behind the stricter of two proposals.

Supporting documentation for the regulations outlined the two extraction options.

The first would allow a competent person to extract a deciduous incisor (milk tooth) or cheek tooth (molars and premolars) from an equid provided in all cases they were loose.

All other tooth extractions, including wolf teeth, would be veterinarian-only, for which pain relief must be used.

Under the second option, backed by the NZVA, a competent person may extract a finger-loose deciduous incisor (baby tooth) or cheek tooth in an equid that has an obvious visual recession of the gums and is protruding above the occlusal surface, but may not use tools or other equipment.

Again, all other extractions would be veterinarian-only, with pain relief required.

Under each scenario, the owner or person in charge of the animal would have the responsibility to ensure that only competent people perform this procedure.

The NZVA said the second option was also supported by the New Zealand Equine Veterinary Association.

It suggested that the wording be changed to make it clear that pain relief was mandatory in relation to “all other extractions”, not loose deciduous or cheek teeth.

The association added that pain relief and/or sedation is not required for “cap” extractions, which can be done by non-veterinarians. Caps are deciduous teeth that have not been lost and sit on top of the permanent teeth as they come through.

The association said it did not think non-veterinarians should be able to continue to remove wolf teeth, nor should they be providing pain relief for extractions. It believed such a ban would have minimal impact.

“Wolf teeth are only removed once in a horse’s life and as such wolf tooth removal only constitutes a fraction of the routine dental care required over the horse’s lifetime,” it said in its submission.

“Currently, there is a lack of evidence to support that idea that all wolf teeth need to be removed (i.e. in the absence of evidence that proves that they need removal, unless there is a diagnosis)”

The association said there were veterinarians throughout the country with additional equine skills and knowledge related to dental work. Such veterinarians are available to travel to more remote locations.

“For other non-surgical procedures, horse owners can choose either their dental provider (equine dental technician or veterinarian).”

Discussing extractions, the association said tooth removal should be preceded by a thorough discussion (and record made) of the horse’s history, an oral examination, as well as a general examination to ensure the horse’s general health and rule out other reasons that may preclude the need for tooth removal.

“This means that before any tooth is removed, a sound case for this need is established based on a thorough clinical examination (subjective and objective evidence is gathered, and recorded). This is the basis for all veterinary practices, and an expected standard of behaviour as determined by the Veterinary Council of New Zealand’s Code of Professional Conduct.”

So, should wolf teeth be able to be removed to address behavioural issues? Again, a thorough clinical history and examination is required in every case before this judgement can be made, it said.

“Only veterinarians are trained to undertake such a clinical examination process, and as such are the only profession that should be making decisions about the need to extract wolf (and other) teeth.”

The association proposed that some clarification of what constituted “pain relief” during equine dental procedures is required.

For veterinarians, pain relief can include a sedative (for minor extractions only), an opioid included with a sedative, which might suffice for some extractions such as small wolf teeth, or local nerve blocks, which should be performed for all significant extractions.

Non-steroidal anti-inflammatory painkillers (NSAIDs) can be given to reduce post-operative pain.

“The NZVA’s position is that use of NSAIDs (bute/phenylbutazone) alone at the time of the procedure does not constitute sufficient pain relief for an extraction.

“Many horse owners will have bute on hand from previous injuries. While bute is a useful analgesic for some disease, it is not an appropriate analgesic choice for extractions.”

It added that any bute that is on hand from a previous disease process is not legally allowed to be used for dental work – using it for this purpose would breach the authorisation that provided it in the first instance and therefore is an offence under the ACVM Act.

“A restricted veterinary medicine may not be used outside of the purpose for which it is authorised.”

The association said it would undertake to ensure that its members are fluent with this part of the law (and its Code of Professional Conduct).

Dealing more generally with the proposed regulations, which deal with procedures across all animals, including farmed species, the association said to truly protect animal welfare, many veterinarians consider more significant surgical procedures (SSPs) should become veterinarian-only, rather than permit increased non-veterinary access to restricted veterinary medicines that allow more SSPs to be performed by non-veterinarians.

“Veterinarians in New Zealand are trained for a minimum five years, gaining underpinning knowledge that includes anatomy, pathology, pharmacology, physiology and surgical technique.

“This knowledge and skillset uniquely places veterinarians as the best people to undertake surgical procedures.

“This includes an ability to manage the risks and any complications, including by virtue of immediately accessing the full range of restricted veterinary medicines.

“Where it is not reasonable or practical to only allow veterinarians to carry out a specific SSP, the exception should be carefully targeted.

“The NZVA strongly agrees that owners and person in charge need to also be responsible making careful choices regarding who they let manipulate their animals.

“However, it is unclear how they might be expected to assess competence in the absence of any qualification/registration to be evidenced, given they themselves are unlikely to be subject matter experts.

“Competency requires ongoing maintenance; those carrying out SSPs should carry the burden of demonstrating, with evidence, that they are competent. Evidence might include training records, logs of procedures carried out.

“In principle, the NZVA believes that allied veterinary professionals (AVPs) who carry out SSPs present risks to the public and animal welfare and should be subject to some level of direct regulation.

“These risks include market access risks having unregulated (and in some instances uneducated) people contributing to (or detracting from) animal health and welfare management in New Zealand.

“The NZVA strongly recommends urgent regulation of all AVPs in New Zealand for animal welfare and for public safety. Direct regulation of AVPs is not practicable in the short term and the NZVA accepts that a combination of veterinary supervision and personal responsibility will be required until a more appropriate regulation framework exists.

“Veterinary supervision may allow non-veterinarians to undertake some SSPs while retaining sufficient veterinary oversight to protect animal welfare.”

The association said it did not support the establishment of an independent association for equine dental technicians. Rather, they should be part of the Allied Veterinary Professional Regulatory Council’s voluntary registration process for AVPs in New Zealand, it said.

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