Good evening everybody and welcome to tonight's webinar. My name is Bruce Stevenson and I have the honour and privilege of chairing tonight's webinar for us. Just to let you know, we have had some substantial technical difficulties and One of our panellists and and presenters is not yet on with us.

So unfortunately, we're going to have to just juggle the order a little bit. You're not going to lose any content at all, I promise you. It's just a slight rearrangement of the programme.

So if it doesn't run quite as smoothly as what you were expected, please just bear with us. We are live, so we are juggling and adapting as we go. Little bit of housekeeping.

First and foremost, a huge thank you to our sponsors tonight, Merlin Wit and Haggard Medical Institute. They have sponsored tonight so that we can bring all this information to you and we will hear from them a little bit later. If you have any questions, as the presentation goes, the first part is going to be a recorded session.

But you can still pose your questions. If you just move your mouse over the screen, little control bar will pop up, you'll see that there's a Q&A box. All you need to do there is just to pop the questions into the Q&A box, and those will come through to us.

I will hold those over to the end, and then we will pose those to our panellists and our presenters for tonight. So once again, a huge thank you to Merlin Wits and Haggard Medical Institute. And without further ado from my side, let's watch the recording, please, Phil.

Hi, my name is Nathan Slovis. I'm an equine veterinarian here at Haggard Equine Medical Institute in Lexington, Kentucky. I'm a board certified internal medicine specialist located on the campus here at the McGee Medical centre.

Today's discussion is gonna be on equine gastric ulcers. And with what's out in the press nowadays, it seems like everybody understands gastric ulcers. They're easy to cure, right?

I mean, I always hear about omeprazole. I hear about products such as sucralfate. I hear products such as misoprostol.

It's one of those three combinations. Your horse need to get better. Well, I wish it was that easy.

Sure, there's research out there showing these products are very good. A lot of them are FDA approved. Unfortunately.

Horses don't read the FDA approval label. Some horses have different causes of gastric ulcers. And some of them we don't really understand why they develop it.

Why does that brood mare and that luscious green pasture come in for a routine gastroscope because I'm doing a study and I happen to notice severe ulcerations. This animal is not clinical. Why did this animal get ulcers?

And then you try to put him on treatment. And some of them respond wonderfully to some of the FDA approved products while others don't. Is there a bioavailability problems?

That means how well is that horse absorbing the medications it's been administered for that problem. So it comes to equine gastric ulcers, what are some of the common clinical signs we've seen? There's been a variety of manuscripts out there documenting all these different clinical signs.

We're gonna be discussing a variety of these clinical signs. What is the most common clinical sign we'll see? Some people say they see stereotypic behaviour, and what that is is that horse that all of a sudden is stall walking.

The one that is walking the fence line consistently now, the one that is constantly maybe biting at its flanks, or maybe that horse that is now starting to crib when it never used to crib or chew wood before. This is what we're talking about stereotypic behaviour. Some other signs that we'll see that is very unique, really only to the horse.

It is cutaneous sensitivity, that is excessive sensitivity to your skin. And so why is that? Why these horses have increased sensitivity?

And for some reason, we believe it's the gastric acid build up within the stomach, the stomach irritation that is referred to as viscerosomatic pain, otherwise known as referred pain. So for instance, you're about to girth up your horse. It's been doing fine as soon as you start to cinch up that girth, he's never done this before, he tries to bite you.

Or as you're grooming the horse, you get into the flank area, they've never been censored before, they try to cow kick you, they may try to bite you or they try to may move away from the pressure. Of your grooming instrument. This is where we talk about sensitivity.

They aren't violently itching themselves. They're just more sensitive and maybe as you're riding, you're using your leg, and they never used to have problems responding to your leg. Now they may buck or kick as you put on your leg during that dressage test or as you're going over a jump.

Some other changes you may end up seeing is rideability. What do I mean by rideability? Well, it's that horse and any time you put on the leg, they will go forward.

They would have that movement, have that impulsion. All of a sudden now you gotta use more leg. They seem dull to your leg.

The horses that are going over jumps, they never used to knock down a rail, and now are knocking down some rails. And you have your veterinarian come out to do a lameness exam. And they give you a clean bill of health.

What are some other things you need to be thinking about? Or potential gastric ulcers. Then of course, eating behaviour.

They're not eating as well, or they eat a small amount, eat some roughage, come back, eat some small amount of their grain I'm talking about. How about the horses that are losing body score condition? You know, you wanna get a complete workup, but if that comes out clean, your blood workup comes up clean, you may wanna be thinking of gastric ulcers.

Then of course, the chronic colicers, those animals that especially if they start to colic or show abdominal discomfort after a meal. You may want to be thinking about gastric ulcers, and then there's a very small group of horses, as I was referring to earlier, those brood mares that I was just randomly taking some brood mares out of the field just trying to get an idea if they had gastric ulcers, and I was surprised that these pregnant brood mares end up having ulcers, but they had no clinical signs. Now, we know with humans, women that are pregnant, they get heartburn.

Is there something going on with that in regards to the horses? We just don't know. So some horses may show colic signs.

And what that is is just some sort of, we believe epigastric pain. Humans see it quite often between the sternum and the umbilicus. And it's caused by excessive acid production and sometimes you may have a scope in them and you won't see huge ulcers, but you may see some irritation in the stomach.

Got to be thinking gastric ulcers for some of these colic signs. When it comes to equine gastric ulcer syndrome, it's complicated. There's no one solution for every horse.

Some horses are gonna respond to omeprazole perfectly. While some animals respond to reign GI perfectly. And then he had those they don't respond either.

Again, you need to take every case by case as if it's his own entity and investigate what are some of the causes going on in the environment that may be making these animals stressed. Is this an acid production disorder? Is it a feed issue going on, or is it just some maybe some vague inflammation in the GI tract, specifically the stomach, that the reline GI product, polysaccharide product can help?

Well, how we came about reline GI is well I was doing a proof of concept study on horses that I was just not happy how they were responding to omeprazole, sucralfate misoprostol, and I thought there must be something else out there that can help. And after doing some studies and research, I saw high molecular weight hyuronic acid. It had to be special high molecular weight hyaluronic acid.

We're not just routine hyuronic acid, and so I started doing some investigating, so it has some anti-inflammatory effects. So when it came to investigating polysaccharides, specifically high molecular weight hyaluronic acid to aid in gastric ulcer healing, is that a client's horse, a big dressage horse that usually shipped from Kentucky to Florida. And compete at FEI levels.

She's been to a variety of veterinarians, has been on a variety of gastrict protective products, everything from approved omeprazole to sucralfate to misoprostol to changes in her diet to pasture turnout, and we just could not get rid of these glandular ulcers, and this horse was clinical. She couldn't really show him because every time she tried to put her leg on him, either would decrease his impulsion. Or start swishing his tail.

And having some issues in regards to rideability, so I started doing some investigating, and I found an article is a rat model on the use of Heimlichterweight hyaluronic acid to help heal ulcers or prevent ulcers. So we tried it on this horse as a proof of concept. I thought, you know what, let's try it.

We have nothing to lose. We took everything else away. She can continue riding because he was ridable.

He just, she was having problems with the shows getting those high level scores and within two weeks of using the product, she said she noticed a night and day difference. I didn't believe it. I wanted to see the horse come back.

So the goal was, and it just happened to be coincidental, the horse is away for 30 days when it came back. We ended up scoping it and the ulcers had healed. The erythema part of that glandary aspect of the stomach had healed at that time.

I thought, OK, it's the end of one. I want to see more horses. I want to see horses that have had been on gastric products that did not improve, and that's how I was able to do that proof of concept study on a small group of horses that is currently published in the Journal of Equi Veterinary Science.

What we ended up adding to it was a beta glucan. Because with our beta glucan has some antimicrobial properties can help also stimulate the immune system, and maybe there's some more aspects of gastric healing than just the pH and anti-inflammatory aspects. In the proof of concept study when we're using a high molecular weight hyuronic acid, which is a polysaccharide, what we noticed is 90% of the horses in that study improved or healed when it came to their gastric ulcers, either in the glandular or squamous part.

So just to give you some examples, now you can see the date stamp, you know, exactly a month apart. And nothing changed other than this horse was on reline GI. So patient B had significant pyloric ulcers.

You'd see hyperemia, red, and if you look at it, look at the flash or the light hitting the mucosa, around that. You know, pyloris, you see, it's glistening, has great mucus there, where it has nice mucus. Do you see any irritation?

No, but look at the other part, almost looks like a matte picture, not glossy, just sitting there. You don't see the light gleaming back at you. Compared to the other slide.

The healed slide, he looks glistening. Everything looks glistening. Everything looks wet, moist.

So how did reline help? You know, did it help with the mucus production? Did it was it just an anti-inflammatory local that worked.

And you're looking at this horse right here, this is a borderline grade 4. You're looking at grade 3 squamous, and this ended up healing well while this had a grade or just a mild pyloric erythema and that healed as well within a month. Well, what makes our hyaluronic acid unique is that it's vegan based.

It is patented and from a traceable source that is produced the same over and over and over. So that is what makes us unique because we can guarantee the consistency and we can guarantee the quality of the product. So some of the success stories, so to speak, when it came to reline GI, some of the most memorable ones are the ones, the animals that were not rideable.

You try to get on them. These are younger horses during the breaking or training. Some were just young dressage horses and anytime they got into the dressage arena, try to do a show.

They would either stop, they don't want to go forward, swishing their tail excessively, and then they put them on the reline GI product within 2 weeks is a different animal. And the owners were very happy, so they're about to get rid of this animal. And try to get another horse they thought it was their fault, and we see it time and time again.

Some of these horses, their ulcers do not completely healed, but the rideability is significantly improved, and the owners don't want to change their product. So it's one thing to take in point is that some of these ulcers may only improve 90%, but sometimes clients do not have the finances to go on prolonged use of omeprazole, sucralfate or misoprazole heal some of these ulcers. And they rely on rely GI to help their horse feel better.

Act better. Despite not having a 100% healing of that ulcer. So one question clients asked me is after the ulcers have healed, or they've been on the product for 30 days and they noticed a significant improvement, can they go down to once a day maintenance dose?

It all comes down to all horses are different. You can't treat them all the same. Some horses once at a time a day, they do well.

They never regress the clinical signs again, while others, after being on the product for once a day, they may end up showing clinical signs again and reverting back to their old selves. Those are the horses that are going to be benefiting on twice a day. So with my own personal horses, what I tend to do is twice a day.

They are doing well. They're on a concentrated diet twice a day. I just want something to help act as so called a buffer, because we know when you feed a concentrated food, what happens?

Your pH is going to go down. And so I don't want a product that is not going to alter the acid composition within the stomach but can act like a buffer and pretty much be the mucus layer. Best friend when protecting that stomach in the proof of concept study, these horses, we know their ulcers heal when they're given twice a day.

When we try to go once a day, there hasn't been any studies on that. It's extrapolated it may work. I've had clients that are very happy with it, referring veterinarians that are happy with it once a day.

But some of these horses need to be on it twice a day. Reign GI contains high moleculate hyuronic acid. It's a natural substance within your horse.

It should have no effect on the absorption of your medications or alter the effects of any of your horse's medications. So is reline GI safe for insulin resistant horses or horses that are prone to have laminitis or do have laminitis? The reason why they ask the questions these clients is because high molecular weight, hyuronic acid is a polysaccharide.

So when you think about polysaccharide, you think of Potent sugars with high calories. This isn't that type of product. It should have no effect on insulin resistant horses or laminitis.

There are actually some studies looking at high molecular weight, hyaluronic acid, trying to see if it can help horses that do have laminitis. Another question we get frequently asked is, can we use reline GI with other gastroprotective products like omeprazole, sucrofate, misoprostol? And the answer is absolutely yes.

Sometimes different horses respond to treatments differently. And sometimes you gotta do sort of a blanket therapy. You may give omeprazole, you're not seeing the improvement you want, but if you add in reline GI, it enhances it.

So reline GI was developed as a top dressing to be placed on your grain, but there's some finicky eaters that just won't eat, no matter what you put on there. Well, the great thing about reline GI you can place it in a dough syringe and you just gonna administer it orally. So how long does reline GI last when we have two different sizes.

We have a 3.78 litre that will last you 64 days when you administer 30 millilitres twice a day. We also have a 1.9 litre that will last 32 days when you administer 30 millilitres twice a day.

And one thing that's very important. That we as veterinarians always ask, do we treat to cure? How many of us have placed a horse on a gastroprotectant and the horses clinically respond.

The client is so happy. You go to scope and they still have these ulceration. So what do you do there?

Do you tell a client they got to be on these products forever, as soon as they take them off the products, the animals go back to their initial clinical condition, ridability problems, stereotypic behaviour problems. Cutaneous hypersensitivity. But when you put them on, they're better, but you can't get them cured.

And then you have some of these horses you put on reline GI, they feel great, they look great, their coats coming in, but if you look at them. In the glandular area, you still get some reddening. Now may only be 50% improved, what do you do?

And that's sort of a trick question because that is a debate we have all the time. I like to treat the cure, but what I've learned with gastric ulcers, sometimes you can't. Sometimes you treat to effect that these animals are doing well, but I may not be able to get the clinical picture of a 100% improvement.

And that's when you start to investigate a little further. Take the biopsy of their stomach, see if there's something very odd going on. That's when you start getting more aggressive diagnostics and try to figure this out.

But sometimes you're back to the same problem do you treat the cure. And that's a question in a debate for another time. Right, folks, that is the end of our recording.

We are now back live with you and I'm very, very pleased to say that we've managed after some technical problems, to bring on Brendan Emery, from Merlin Wet and Brendan's gonna give us a little bit of a, a chat and an insight into this fantastic product, Reline GI. Brendan, are you with us? I am Bruce.

Thank you very much and good evening everybody and I'm glad my webcam is not working. But my name is Brendan and I work with the Merlin vet team here in Scotland in the UK. And my role with the team is to help lead the launch of Reign GI into Europe and further afield into Middle East and Asia.

So we're, we're very excited to connect with you all this evening and for those of you watching on demand as well, to connect you with the Merlin team and also, Ken and the Haggard team and Doctor Slovis and his team there in Lexing in Kentucky. So evening to you all, . Tonight is really, it's an important day for veterinarians and owners, it gives us a chance for you guys to see what we be that the Haggard team have been working on for a number of years, and they've commercialised this, and this is, a collaboration that we're having with, Haggards for the Merlin team to bring this product to you in Europe.

So we're right in this launch phase, which is really great to have. It's important for vets because it gives you another card in your back pocket to help support your horses you're managing with ongoing gastric ulceration syndrome. As you'll hear as we go through the, the proceedings of the evening that We'll be able to, give you more insight into the background to this.

I guess more importantly, it's, it's an important night for all horse owners, more importantly, the horse itself, because there's something there that we can give, to these animals long term to maintain normal digestive balance, which is, which is great. So, so please don't hold back, we have. You know, a world-renowned opinion leader at the top of Equi Medicine, and we're very pleased that we are hosting this and then we can participate in going forward with you.

Thank you. Thank you, Bruce. Thanks, Brendan, and so pleased that you managed to get on with us.

Before we go over to our esteemed presenter tonight, I'd just like to introduce Ken Ford, CEO of Haggard Medical Institute, who would also like to say a few words. Ken, welcome to the webinar vet. Over to you.

Thank you, Bruce. One from from Europe and around the world, joining the webinar tonight. It's really a privilege to to have Reign GI be featured here with, with Doctor Slovis from Haggardyine Medical Institute.

We're also very excited to, to continue this collaboration with Merlin, over in Europe and throughout the world. You know, we've had Reign GI. On the market here in the States since 2015, and it's done tremendously well.

And so it's part of our strategic vision, this year to, to start broadening our horizon and, and taking it to, to Europe and to other parts of the world. And that's where we found a tremendous partner in Roland that to, to help launch this product, and be able to demonstrate and show. The field tested results that that we've seen in in the US, both on the sport horse side, and also on the thoroughbred and, and the racing side.

So we've seen a couple of Triple Crown, Triple Crown races here in the US that that were on this, on this product. And, so we've seen tremendous success on the track and also off the track. So.

Thank you to everyone that's participating tonight. We're really excited to see, your success with Redi GI, you know, throughout the world. So thank you, Bruce and your team.

To, to bring in your team at Merlinet for, for inviting us and back to you, Bruce. Ken, thank you very much. And before I introduce the main speaker, I'd just like to once again thank Brendan and Merlin Wits and Ken and Haggard Medical Institute for their sponsorship of tonight.

Guys, without your sponsorship this evening wouldn't be possible. So thank you both very, very much. Some of you recognised our main speaker in that recorded session for us, as Doctor Nathan Slovis.

He has published over 50 manuscripts in both national and international peer-reviewed veterinary journals. He's a frequent speaker at many national and international veterinary conferences. He's the editor of both the Atlas of equine Endoscopy, as well as the Atlas of disease disorders of the foetal of, of the foal, both distributed by Alicecivia.

He has also authored numerous book chapters related to equine neonatology, equine neurology, hyperbaric medicine, and infectious diseases. He implemented the current infectious diseases and equine emergency response programmes at Haggard Medical and holds the position of infectious disease officer and equine emergency Response co-director. He is also a certified hyperbaric technologist and a member of the Veterinary Infectious Disease Society.

So, Nathan, welcome to the webinar vet and thank you for that fascinating recording that you did for us. My pleasure, Bruce. I I appreciate the opportunity, and I appreciate everybody staying up late to listen.

To that information about the use of hyuronic acid and a beta leuccan to help, to heal some ulcers in in horses because as we know, not all ulcers are created equal in regards to the GI tract, especially the stomach. I mean, we all have used approved medications that some horses respond very well, some don't. So there's other factors when it comes to equine ulcers that we're just learning.

And there's many universities, many different continents, veterinarians are studying this disorder, and I still feel like we're we're we're still in our infancy, but we are, you know, we, we learn from each other and we're learning as we're going. Yeah, fantastic, fantastic. Nathan, I'm going to paraphrase some of the questions that are coming through because there is a, a common theme coming through on a lot of these questions.

So rather than read each one out to you, one of the, the questions and, and, and I'll, you took the words out of my mouth, you were saying, you know, ulcers are not all created equal. One of the, the themes that are running through here is, not all products are created equal. What is the difference between the reline GI and some of the other products that are on the market.

Yeah, the, the, again, some of the other products on the market. You know, can inhibit acid production, you know, those are some of the big ones that are out there or acid buffering products that are out there. And with the hyaluronic acid product that we have, along with the beta glucan, that does not suppress acid.

It's strictly like, it's an anti-inflammatory property. At the same time, it has some immunomodulatory effects that may be able to help locally in this in at the ulcer site to help modulate the immune system that can help promote healing. So, That's a big factor.

It will not alter your pH of the stomach. So if your horse is developing ulcers and it's associated with the pH, you know, low pH. This product may not help as well as the, the products that can actually alter the, the, the gastric pH.

So that's the biggest thing that is unique about this product, and then also hyuronic acid is a normal molecule in your body. I mean, you have it in all your, your tissues, your joints, so it isn't like we're giving them a product that is not naturally already in their horse. The difference is we're giving a very concentrated Pretty much a purified high high molecular weight hyaluronic acid that would be given orally at that one moment in time, and it helps try to coat.

That the stomach and and those those ulcers and can help pretty, you know, create an environment that can be friendly for your body to naturally heal those ulcers, and I think even like this, you know, we all know of horses that develop proud flesh. And when we think about proud flesh, you get the exuberant granulation tissue. And sure, we can bride it and cut it back, probably put some pressure wraps on it.

But some of the thing is just overt inflammation that can occur at that site that triggers you get that proliferative granulation tissue, what do we do? We, we tend to put them on some steroids, topical steroids. At the same time, this topical steroid creams has some antimicrobials to it too, some sort of topical antibiotic.

And you can help decrease the inflammation of that area of the proud flesh. Well, it's almost the same kind of, you know, theory of what goes on in that horse's stomach with his ulcers, some of those ulcers that won't heal, especially those pyloric ulcers. And therefore you get a coating, and we know that higher molecular weight hyaluronic acid, at least in the rat model that we were discussed in the video, has some potent anti-inflammatory effects, at least locally.

And then at the same time, instead of using antimicrobials, we have the beta glucan that can help augment the immune system and healthily help try to kickstart it, so to speak, locally and fight off whatever maybe local inflammation going on at the same time. So that's sort of the You know, how we came about this product. Yeah.

It's, it's interesting to, to hear you say that, you know, hyaluronic acid is actually a, a natural product in your body because that leads on to the next strand of of multiple different questions and that comes back to doping and you know, is it registered for use with the BHA in racing thoroughbreds, that kind of, of, line of questions. Yeah, in regards to the anti-doping aspect is considered a clean drug. We had it tested here in the United States for FEI competition, our local competitions for racing jurisdictions, there's nothing in the product.

And that includes all the other components of it, you know, majority of its hyaluronic acid and beta glucan, but, you know, all the other products that make it into this viscous, you know, application, there's nothing on it that will test, so it's safe sport, as you call it, and Brendan, you may be able to talk about it more about how you're you're labelling it, but we could be assured that it is safe in regards to any sort of medication rules. It's all natural. There's nothing that will be able to be tested.

In, in regards to racing jurisdictions, and so we made sure of that. Fantastic. Brendan, if you want to add anything on that, I, I see you have popped some, some comments in the the box there, but if you wanna come back on live.

Yeah, thanks, Bruce. Yeah, just add to Doctor Sloss's comments. Yeah, we, we have, we support clean sport, so because we know from the testing that has been done, by the team in the US, which is an independent lab there, confirms that, you know, there's no, natural occurring prohibited substance there, which is why we, you know, put a stamp on our, our new packaging that it says that we support clean sport.

So you're, you're fine from a, a competing and doping perspective. We're gonna come back to that point in a minute. I've got something to ask Nathan, but Brendan, while you're on, a couple of questions popping up, about, this product, being available in various countries in Austria and, and, here in the UK and everything.

Do you want to talk a bit more about your release and rollout? Yes, Bruce. So currently we're right in this launch phase, so we do have product available, which we have our central warehouse there in Scotland that we can, we can ship direct to you at veterinary practise level anywhere in Europe or further afield for that matter.

So. We'll have my contact details just at the end of, of the webinar, by all means, just contact us directly at the Merlin office or on the support at reline.co.uk.

We'll, we'll give you that information or we can put it in the chat and then we can come back to you directly to, to have products shipped to you. Fantastic. Question just popped up there, which may not be answerable directly by you, Brendan, because, but give it a go.

Available in Canada. That's probably one more for Ken and his. I know that they're, they're busy, they, they were going through a process to, to have it registered there and maybe Ken can give us an update on that, later on, but, yeah, it can certainly really come from the Haggar's team in US, and it's much closer.

I was, I was gonna wind Gillian up a little bit there and, and ask her if it wasn't part of America. And then I thought, no, that probably wouldn't go down too well. Ken, or, or, Nathan, do you, are you aware of its availability in Canada?

Yes, so we we're actually in the process of registering it, so it should be available in Canada in 2021. There you go. Gillian, 2021.

And I promise you, I do know and appreciate and respect that Canada is not part of the US. My brother lives there, so that's why I wind him up all the time with that. So, Nathan, coming back to you, the source of the hyaluronic acid and in your product and why it is not inactivated by stomach acid.

Yeah, great, great question. In regards to the hyuronic acid, so when we get it's a vegan product, so it's a And it's out in Eastern Europe. That's where we end up sourcing it from.

And so this product line has been out there for, I mean, decades. And we are trying to source this hyuronic acid, we found out there's many different places you can buy hyaluronic acid, and the source of it, the consistency of the product is all over the place. This product is very consistent the way they've made it, they've made it for years.

And that was very important to us. At the same time, this product has been patented, this specific hyaluronic acid hasn't patented, and it's a variety of different things anywhere from joint issues, muscle skeletal issues. And so it it has been patented before we even got involved on this product, and that's what we we thought was really neat is that the people that have produced this, they've come up with different patents, and that's what really made it worthwhile.

Now, in regards to this hyuronic acid, does it get broken down and with in the acid. You know, what I can tell you is I can't tell you for sure, yeah, you know, it gets broken down or does not not get broken down because in regards to once we administer this, at least, and we gotta look at the lab animal studies, it has been shown to have some protective effects locally in regards to anti-inflammatory effects. So, We know it can act locally.

And then beyond that, a lot of that hyaluronic acid will get absorbed in the small intestine and gets in your, in your body, and then you utilise it different mechanisms from there. So, I can't tell you how much of it does get broken down in regards to the the acid. But what we can say is at least locally and from the studies they've done with the rats, and, and what we've seen clinically, it still has an effect.

So hopefully that that answered your question, but I can't tell you, we only 50% gets broken down versus 10%, you know, the stomach acid, you know, acid will have some effect to it, but that's about what I could say. Fantastic, Nathan. Folks, I, this is turning into a little bit of a geography lesson here.

We cannot, or I cannot possibly go through every single country that's popping up here. What I can tell you is that Brendan at the end is going to put a slide up with some contact details, and a call to action. And my advice for everybody asking all the questions about what about my country and what about my country.

Email Brendan, and, I'm sure he will be kept occupied for the next couple of days answering with pleasure, all of those questions that you have for him. The other comment just to say is we cannot go into detail tonight on each individual specific case that you have. But in general, Charlotte and a couple of other people, Nathan, have asked a really good question about Horses that have specific problems at specific times of the year for whatever weird reason, would you just put them on this product, say a month before they kind of predicted problem times, and then stop a month afterwards or would you treat them year round?

You know, that's a great point. I mean, if the horse is doing fine year round and don't does not have any issues, and that the client can tell either at the competitive level or, you know, whatever they utilise their horse for. I don't know if you needed to use it, year round if they are happy with what they have.

Now the animals under stressful situation or stressful events. Yeah, I mean, I personally use this product on my racehorses, and at the time my dressage horses, and I use it year round because I'm competing my horses year round. And there's many more benefits to hyuronic acid than just your GI aspect.

So I have placed my horses on it year round, but these specific horses that you really want to see if it really works for these specific horses that have an incident. What is it a month or so out of a year for so what God knows what reason and it happens year after year, and yeah, I would probably try it a month beforehand. And then ended a month after the event and to see if it helps, you know, it could, it maybe it maybe it will help, or maybe it has nothing to do with the stomach, it has something to do with some carbohydrate that's in the grasses or sugar that's in the grasses that they're fed during that time of year, cause maybe they have higher sugar content in the grasses, and these animals get a little bloated or get a little sour stomach, so to speak, due to their diet, and then it may not have any effect.

But I, I think that's a very logical approach if you want to see if it works. And if it works, then if it works, then you decide yourself, hey, it seemed to work. Do you want to continue on for year round or just during that time period.

It's up to you. Yeah, I think that's great and that leads into a whole lot of other questions that we're getting about is it safe to use as a trial? We've got a couple of questions coming through about sort of unknown colicy times, random patterns and that sort of thing.

Would it be safe to trial on those horses when nothing else seems to be helping? Sure, I, I mean, I mean it's a very safe product, and if you wanna do a trial, there's nothing wrong with it, you know, I mean, it's not gonna harm the horse. And the, the big thing is, as long as you've tried, you know, for me to, to know that if a product is working, you know, I've tried other products, it has not helped.

And you know, the horse is consistently off. You try this product, if it helps, then you know the product is really helping, it's not just a waxing and waning of this animal's clinical signs, that's making you feel like it's working, if you know what I mean, you know, if you've ruled out other things and you wanna try it, then absolutely, it's very, very safe. There's nothing wrong with giving it a try, and you will know, clients know a difference.

Average is gonna be 10 and 14 days of being on the product. If you do not see a difference after being on it for 30 days, cause usually the 30 day supplies the the least amount of volume, don't waste your time with it. Good, good, you know that it's not gonna help, you know, you don't say to yourself, I'm gonna give it 45 days of work, you know, relatively quickly.

Now some of these animals, if you go to scope them again, they may not have. Maybe 10 or 20% improvement on their gastro gastroscopy findings. But that is a big debate we're having with internal medicine specialists.

Do you treat to cure or do you treat to effect? Cause some of these gastric ulcers, especially these pyloric ulcers, doesn't matter what product you have them on, trust me, I've tried plenty. They still show some erythema and some small plaques around the pyloris, but when they're on these products, They tend to get better.

Clinically, they they show better, they're not refusing jumps, they're eating better. And but when you do your gastroscope, you're like, boy, I only got 20% improvement and maybe this product isn't helping, then you take them off the product and then the horses, you know, revert to how they were acting. So sometimes you can just get a treat to effect.

Yeah, excellent. I, I think you've already answered this in, in the video earlier, but, if we can just go over it, we're getting quite a few questions about using it together with other products, and do you have to stop the other products before you put them onto this or when do you withdraw the other products? So the question is, I'm the type of person I wants to know that it is really this product that is working or any drug I I use.

I, I'm not a big polypharmacy fan cause I always wanna know what product is really working. Now, some products, it takes a multi-pronged approach, you know, and, and, and gastric ulcers can be one of those cause you wanna, you may use an acid suppression. Medication like a proton pump inhibitor, but at the same time, you want to increase prostaglandin.

With the use of a drug we we call here in the United States misoprostol to help with mucosal blood flow and mucus secretion. So sometimes I use an acid suppressor, as well as a drug called misoprostol. So what I'm trying to say here, kind of a long winded answer, that you can use this with other products if you think like it's gonna give you the advantage or give you a leg up.

But if your other products are not helping at all, Then you can take them off the other products and just start this on reline and see what happens over 2 to 4 weeks. But it's very safe to use other products. I've done it before and we have had no issues of I felt like it altered the effects of the other products.

Fantastic. Nathan, a couple of questions coming through about ages, that it can be started at and specifically people asking about fos, and then one specific question about, esophageal ulcers and folds. All right, so in regards to falls, now the study or proof of concept study, I did not do any young animals, but we have used it routinely in our neonatal ICU.

So it depends on the clinician, but the dose, the big question is what dose do you give? And I almost think of like a vaccine, you know, if you're gonna be vaccinating a mini horse versus a Clydesdale, or you're one of these big draught horses, you still use the same amount of your vaccine, you know, double or triple dose your your vaccine. So I almost seem seem to be almost the same when it comes to this product.

I may divide it up in a, in a few, extra feedings if I feel like the animal is gonna spit it out, but I'll go anywhere from, 15 to 30, 15 to 30 mLs. And 30 mLs is the adult horse dose twice a day, and I'll do that with my neonate 30 mLs twice a day, but sometimes they spit it out, so I may go 1515 mLs, you know, 2 to 3 times a day if you feel like they're spitting it out. And you know it's roughly half the horse dose, but if you can get the full horse dose, that's just what what we've done, cause that's just what our proof of concept has been, and that's what the the rat model showed that kind of dose, cause that was 200 milligrammes of high high molecular weight hyuronic acid.

So, that's what we tend to use. Now with esophageal ulceration. It can help coat it, it can help relieve some of the inflammation of that area.

But some of that esophageal erosions, a lot of it is, substantiated by gastric pH. It's usually a proton pump inhibitor. Is utilised for those kind of cases as well.

So, so the hyaluronic acid may be able to soothe it and coat it, but a lot of these esophageal ulceration is because of gastroesophageal reflux, and a lot of that is as acid. Yeah, excellent. Makes a lot of sense when you've got to combine it, as you say, for the reflux rather than just an ulcer.

Couple of questions coming through about its effect or benefits on colonic ulcers. Yeah, and I have not used it for colonic ulcers. I, I, it's this product in the small intestine and other studies looking at high molecular weight hyaluronic acid, it gets quite readily absorbed and this can be a topical sort of component, I, I don't think it's gonna work that well for right dorsal colitis.

And so it's not something I take, I, I utilise in my treatment plan for right dorsal colitis. Now, I've had some clients that utilised it. They've also done diet changes and etc.

And they said it helped, but, you know, did it really help, so. I, I, I would not, it would not be primary on my medication list to use. OK.

And would you, would you choose it, if we're talking about gastric ulcers now, would you choose this product as your first line go to product now that you know what it does, or would you kinda use it on a combination or wait until other stuff has failed, or how would you question. So first of all, I get the history of the client and just get an idea of what's going on. And how long this has been occurring?

What are my gastroscopy findings? I mean, do I have grade 4 ulcers? If I have some horrible, horrible ulcers.

You know, grade 4 is diffuse everywhere, the pyloris, as well as the, the, so glandular and non-glandular, you know, I tend to go to a multi-pronged approach because this animal has some serious issues with acid secretions, a lot of these times, especially if it's diffused everywhere. So I'll do it a multi-prong and I may do a proton pump inhibitor with the reline GI. If it's just one sing singular or just some scattering of of ulcers in my first time I've I've looked at the animal.

I'll I will use the reline GI as sometimes my primary medication just because of the expense for the client and they they've they've expressed to me before that they cannot afford the the acid suppression drugs. But out of the proton pump and we'll try this as our first line and had had success. So it's all patient specific.

There isn't. A lot of it comes down to economic wise, what can they afford? What's their husbandry aspect?

What, what kind of lifestyle these horses are in, and so these are all things that I, I utilise all all together. But one thing we have done is that once we treat the ulcers, and if I use the, a proton pump inhibitor or a a drug called or sucralfate. Or misoprostol, they get results, then sometime I'll I'll follow up with reline GI and I will keep them on that product as a prophylactic measure and see how they do.

Individual tailoring is always good medicine, so regardless of what you're talking about, isn't it? Yeah, correct, yeah, I mean, I mean they're not all easy. I wish it was easy.

I can just look in a book and go, yeah, I put this on a reline GI. Yeah, just because I'll look down the list and give you the answers. Yeah, yeah.

Yeah. Veterinary science would be boring if we could do that in every case. Nathan, what about pregnancy?

Yeah, so, We have, in the study, one of those horses was a pregnant mare that was out on the field and because we have seen pregnant mares come in. To the clinic clinical that have horrible GI ulcers, but these animals are turned out 24/7, and it doesn't make any sense why they have ulcers. And so, you know, I think pregnancy is a whole different entity of what's going on because you with my wife and and and those of you that are in the audience that have been pregnant, you know, they talk about the heartburn from hell and just what goes on with the hormone changes, etc.

So God only knows what else goes on with these poor mares stomachs. There really hasn't been a a great study looking at a bunch of mares that are pregnant. And just seeing just normal mares and see what the instance of ulcers are, I think they'll probably be almost as high as some of these racehorses.

I'm I'm wondering. But it is very safe. We've used it plenty, plenty of times in pregnant animals, and it is a safe product.

It is natural and it it won't won't affect absorption of other nutrients. Excellent, excellent. Brendan, I've got another one for you, and I'm gonna bring you back in here because I'm going to want you to share your slide with us now as well.

Is this product going to be a prescription vet only product or is it OTC or how is it being marketed? Thanks, Bruce. Yeah, this product is classed as as a food that feed stuff, so it's classed as a supplement that you talk dress onto your feed daily.

So there's no need for a prescription for this, so, that's the classification. And, and you are marketing out through vets, or you're gonna make it available in other outlets as well? Well, we have, we have taken a sort of a two-pronged strategy that is that we know from our own market research that that a lot of supplements are purchased by owners and trainers and then users directly online, and to sort of help.

After the RRP and the retail price of a B2C strategy is that they can purchase directly from our site, which is reline.co.uk.

But we also are aware of the success that this product's had with Nathan and his team and obviously a number of veterinarians now right throughout America with the success of Reign. So, and we wanted to make sure that the veterinary surgeons in Europe and and other countries have access to this as an additional tool to pull out of their back pocket to use when they're trying to look after long-term gastric health. And so it will be available, it is available, I should say, to all veterinary surgeons across Europe.

Excellent. Brendan, do you want to bring up your slide with the call to action for us and then you can talk us through it? Definitely can do, yeah.

So first of all, I just wanted to say that thank you everybody for, for joining us this evening and those watching on demand as well. And, and there's a number of questions has come through there on the chat and on the live link. So, if we don't get them all answered today, by all means, you know, we, we will come back to you on that.

But if you would like further information or you wish to order, or more importantly, we are running what's called an international sample study where we You've put a protocol together with Dr. Slos and his team to allow you to also try and experience the product with your ongoing gastric cases or in this case with some new cases, and we can send that protocol to you by PDF and then we can chat to you about how we can actually get product directly to you. So my contact number there as well as the the Merlin team.

In the office, you have the office number and if you want to send an email, looking for any information regarding to the product, the introductory offer that we have, or more information about the, the sample study, or any other questions you may have even after this webinar, then please send us an email at [email protected].

Fantastic. Go, this is a a a a fantastic opportunity for a product. Which, can only help.

It's worth a try. And you've got a dedicated team, at the end of a couple of phone calls and an email address. Why wouldn't you?

I, I, I think that's absolutely fantastic. I really think so. Remember also that this webinar has been recorded and will be up on the webinar vet website, in the next day or 3.

So you can rewatch anything that you want to. You can watch, Doctor Nathan Slovis's fantastic presentation in the beginning. You can go and get these, slides if you haven't taken a screenshot or a photograph of it now, and, you can rewatch the whole thing again to get a second uptake, I think, is always amazing how much you didn't get on the first one.

So, Think about it, go back to the website and make use, try the product. I, I really think it sounds like an absolute winner. So from myself, Bruce Stevenson, I would like to especially thank Brendan Emery from Merlin Wits for his sponsorship of tonight's webinar.

Ken Ford, the CEO of Haggard Medical Institute, as well, and then especially to Doctor Nathan Slovis for your time and your very insightful presentation. Gentlemen, thank you so much. Thank you, Bruce.

My pleasure. Good night everybody. And to all of those that attended tonight, thank you very much for your time and I hope you enjoyed it as much as I did.

From myself and my controller in the background, Phil, thank you and good night. Take care. Thanks.