b'THIS MONTHSREADER SERVICESCONTRIBUTORS For new subscriptions and renewals, visit us at TheHorse.com/Subscribe. For inquiries about gift subscriptions, payments, missing or damaged issues, changes of address, or other Sarah Evers Conrad is an equestrian journalist in Lexington, Kentucky. She has workedinquiries: for The Horse, Equestrian, and US Equestrian and now owns All In Stride Marketing. CALL 800/607-4410 E-MAIL [email protected] Matt Leshaw, DVM, is an FEI treating veterinarian and practitioner at Creekside Veteri- WRITE The Horse, Circulation, P.O. Box nary Service, in Escondido, California. 292368, Kettering, OH 45429. Please include a copy of a current mailing label or yourChrista Lest-Lasserre, MA, is a freelance writer specializing in equine topics. A nativepersonal subscriber number.Texan, she rides English, breeds Warmbloods, and raises three young equestrians in Paris,AAEP Members, please contact AAEP at800/443-0177 for changes of address.France. TOBA Members, please contact TOBA at859/276-2291 for changes of address.Nancy Loving, DVM, owns Loving Equine Clinic, in Boulder, Colorado, and has a special interest in sport horse care. She has authored several books and many veterinary articlesMISSION STATEMENTfor both horse owner and professional audiences.The Horse: Your Guide toEquine Health CareNatalie DeFee Mendik, MA, is an award-winning freelance journalist with more than three The Horse is an all-breed, all-discipline equine decades of horse experience. She lives in Colorado with her husband and two daughters. education provider for hands-on participants in the horse industry. It will disseminate the Stacey Oke, DVM, MSc, is a freelance medical writer based in Saratoga Springs, Newlatest and most reliable news and information on the health, care, management, and welfare York. Her areas of interest are equine nutrition, supplements, and osteoarthritis. of equids through print and electronic means.AltrenDOSAGE CHART:Approximate WeightDose ADDITIONAL INFORMATION: INFORMATION FOR HANDLERS:in Poundsin mL A 3-year well controlled reproductive safety study was conductedWARNING: Altren (altrenogest) Solution 0.22% is readily in 27 pregnant mares, and compared with 24 untreated controlabsorbed by the skin. Skin contact must be avoided; protective (altrenogest)7707 mares. Treated mares received 2 mL altrenogest solutiongloves must be worn when handling this product.88080.22%/110 lb body weight (2x dosage recommended for estrus SOLUTION 0.22% (2.2 mg/mL) 9909 suppression) from day 20 to day 325 of gestation. This studyEffects of Overexposure110010 provided the following data: There has been no human use of this specific product. The CAUTION: 121011 information contained in this section is extrapolated from data Federal law restricts this drug to use by or on the order of a132012 1.In filly offspring (all ages) of treated mares, clitoral size wasavailable on other products of the same pharmacological classlicensed veterinarian.(altrenogest)increased. that have been used in humans. Effects anticipated are due to WHICH MARES WILL RESPOND TO ALTREN 2.Filly offspring from treated mares had shorter interval fromthe progestational activity of altrenogest. DESCRIPTION: SOLUTION 0.22%: Feb. 1 to first ovulation than fillies from their untreated mare Altren (altrenogest) Solution 0.22% contains the active syntheticExtensive clinical trials have demonstrated that estrus will becounterparts. Acute effects after a single exposure are possible; however, progestin, altrenogest. The chemical name is 17-allyl-17- suppressed in approximately 95% of the mares within threecontinued daily exposure has the potential for more untoward hydroxyestra-4,9,11-trien-3-one. The CAS Registry Number isdays; however, the post-treatment response depended on the3.There were no significant differences in reproductiveeffects such as disruption of the menstrual cycle, uterine or850-52-2. The chemical structure is: level of ovarian activity when treatment was initiated. Estrus inperformance between treated and untreated animalsabdominal cramping, increased or decreased uterine bleeding, mares exhibiting regular estrus cycles during the breeding(mares & their respective offspring) measuring the followingprolongation of pregnancy and headaches. The oil base may season will be suppressed during treatment; these mares returnparameters: also cause complications if swallowed.to estrus four to five days following treatment and continue tointerval from Feb. 1 to first ovulation, in mares only.cycle normally. Mares in winter anestrus with small folliclesIn addition, the list of people who should not handle this product continued in anestrus and failed to exhibit normal estrusmean interovulatory interval from first to second cycle (see below) is based upon the known effects of progestins used following withdrawal. and second to third cycle, mares only. in humans on a chronic basis.Response in mares in the transition phase between winterfollicle size, mares only.anestrus and the summer breeding season depended on theat 50 days gestation, pregnancy rate in treated maresPEOPLE WHO SHOULD NOT HANDLE THIS PRODUCT: degree of follicular activity. Mares with inactive ovaries and smallwas 81.8% (9/11) and untreated mares was 100% (4/4). 1.Women who are or suspect they are pregnant.Each mL of Altren (altrenogest) Solution 0.22% contains 2.2 mgfollicles failed to respond with normal cycles post-treatment,after 3 cycles, 11/12 treated mares were pregnant2.Anyone with thrombophlebitis or thromboembolic disordersof altrenogest in an oil solution. whereas a higher proportion of mares with ovarian follicles(91.7%) and 4/4 untreated mares were pregnant (100%). or with a history of these events.20 mm or greater in diameter exhibited normal estrus cycles ACTIONS: post-treatment. Altrenogest Solution 0.22% was very effective forcolt offspring of treated and control mares reached3.Anyone with cerebral-vascular or coronary-artery disease. Altren (altrenogest) Solution 0.22% produces a progestationalsuppressing the prolonged estrus behavior frequently observedpuberty at approximately the same age (82 & 84 weeks4.Women with known or suspected carcinoma of the breast.effect in mares. in mares during the transition period (February, March and April).respectively).In addition, a high proportion of these mares responded with5.People with known or suspected estrogen-dependent neoplasia.stallion offspring from treated and control maresINDICATIONS: regular estrus cycles post-treatment. showed no differences in seminal volume, spermatozoal6.Women with undiagnosed vaginal bleeding.Altren (altrenogest) Solution 0.22% is indicated to suppress (altrenogest) SOLUTION 0.22%: concentration, spermatozoal motility, and total sperm per7.People with benign or malignant tumors which developed estrus in mares. Suppression of estrus allows for a predictableSPECIFIC USES FOR ALTREN ejaculate.occurrence of estrus following drug withdrawal. This facilitatesSUPPRESSION OF ESTRUS TO: during the use of oral contraceptives or other estrogen-the attainment of regular cyclicity during the transition from1.Facilitate attainment of regular cycles during the transitionstallion offspring from treated and control mares showedcontaining products. winter anestrus to the physiological breeding season. Suppressionperiod from winter anestrus to the physiological breedingno difference in sexual behavior. 8.Anyone with liver dysfunction or disease.of estrus will also facilitate management of prolonged estrusseason. To facilitate attainment of regular cycles during thetesticular characteristics (scrotal width, testis weight,conditions. Suppression of estrus may be used to facilitatetransition phase, mares should be examined to determineparenchymal weight, epididymal weight and height,Accidental Exposurescheduled breeding during the physiological breeding season. the degree of ovarian activity. Estrus in mares with inactivetesticular height, width & length) were the same betweenAltrenogest is readily absorbed from contact with the skin. In ovaries (no follicles greater than 20 mm in diameter) will bestallion offspring of treated and control mares. addition, this oil based product can penetrate porous gloves. CONTRAINDICATIONS: suppressed but these mares may not begin regular cyclesAltrenogest should not penetrate intact rubber or impervious Altren (altrenogest) Solution 0.22% is contraindicated forfollowing treatment. However, mares with active ovariesREFERENCES: gloves; however, if there is leakage (i.e., pinhole, spillage, etc.), use in mares having a previous or current history of uterine(follicles greater than 20 mm in diameter) frequently respondShoemaker, C.F., E.L. Squires, and R.K. Shideler, 1989. the contaminated area covered by such occlusive materials inflammation (i.e., acute, subacute, or chronic endometritis).with regular post-treatment estrus cycles. may have increased absorption. The following measures are Natural or synthetic gestagen therapy may exacerbate existingSafety of Altrenogest in Pregnant Mares and on Health andrecommended in case of accidental exposure.low-grade or smoldering uterine inflammation into a fulminating2.Facilitate management of the mare exhibiting prolongedDevelopment of Offspring. Eq. Vet. Sci. (9); No. 2: 6972. uterine infection in some instances. estrus during the transition period. Estrus will be suppressedSquires, E.L., R.K. Shideler, and A.O. McKinnon. 1989. Skin Exposure: Wash immediately with soap and water.in mares exhibiting prolonged behavioral estrus either earlyEye Exposure: Immediately flush with plenty of water for PRECAUTIONS: or late during the transition period. Again, the post-treatmentReproductive Performance of Offspring from Mares Administered15 minutes. Get medical attention.Various synthetic progestins, including altrenogest, whenresponse depends on the level of ovarian activity. The maresAltrenogest During Gestation. Eq. Vet. Sci. (9); No. 2: 7376.administered to rats during the embryogenic stage of pregnancywith greater ovarian activity initiate regular cycles and con- If Swallowed: Do not induce vomiting. Altren (altrenogest) at doses manyfold greater than the recommended equine doseceive sooner than the inactive mares. Altren (altrenogest)WARNING: Solution 0.22% contains an oil. Call a physician. Vomiting should caused fetal anomalies, specifically masculinization of theSolution 0.22% may be administered early in the transitionFor oral use in horses only. Keep this and all otherbe supervised by a physician because of possible pulmonary female genitalia. period to suppress estrus in mares with inactive ovaries tomedications out of the reach of children. Do not use indamage via aspiration of the oil base. If possible, bring the aid in the management of these mares or to mares laterhorses intended for human consumption. container and labeling to the physician.DOSAGE AND DIRECTIONS: in the transition period with active ovaries to prepare and While wearing protective gloves, remove shipping cap and seal;schedule the mare for breeding. HUMAN WARNINGS: Store at or below 25 C (77 F). Reclose tightly.replace with enclosed plastic dispensing cap. Remove cover3.Permit scheduled breeding of mares during the physiologicalSkin contact must be avoided as Altren (altrenogest)from bottle dispensing tip and connect luer lock syringe (withoutbreeding season. To permit scheduled breeding, maresSolution 0.22% is readily absorbed through unbroken skin.HOW SUPPLIED: needle). Draw out appropriate volume of Altren solution. (Note:which are regularly cycling or which have active ovarianProtective gloves must be worn by all persons handling thisAltren (altrenogest) Solution 0.22% (2.2 mg/mL). Each mL Do not remove syringe while bottle is inverted as spillage mayfunction should be given Altren (altrenogest) Solutionproduct. Pregnant women or women who suspect they arecontains 2.2 mg altrenogest in an oil solution. Available in result.) Detach syringe and administer solution orally at the rate0.22% daily for 15 consecutive days beginning 20 dayspregnant should not handle Altren (altrenogest) Solution1000 mL and 150 mL plastic bottles.of 1 mL per 110 pounds of body weight (0.044 mg/kg) oncebefore the date of the planned estrus. Ovulation will occur0.22%. Women of child bearing age should exercise extreme daily for 15 consecutive days. Administer solution directly on the5 to 7 days following the onset of estrus as expected forcaution when handling this product. Accidental absorptionManufactured by:base of the mares tongue or on the mares usual grain ration.non-treated mares. Breeding should follow usual procedurescould lead to a disruption of the menstrual cycle or prolon- Aurora Pharmaceutical, Inc.Replace cover on bottle dispensing tip to prevent leakage.for mares in estrus. Mares may be regulated and scheduledgation of pregnancy. Direct contact with the skin shouldNorthfield, Minnesota 55057Excessive use of a syringe may cause the syringe to stick;either individually or in groups. therefore be avoided. Accidental spillage on the skin should therefore, replace syringe as necessary. be washed off immediately with soap and water. Approved by FDA under ANADA # 200-620 04/20198December 2019The Horse|TheHorse.comReadersServ_Contributors_Dec.indd 8 10/29/19 10:34 AM'