A lameness exam begins with a history and basic physical exam of your horse. The physical exam includes palpation of all joints, tendons and ligaments to note heat, pain or swelling. The dynamic exam begins with observation of your horse walking and trotting in a straight line as well as being lunged in a circle both directions. Many exams also include observation at the canter as well as being ridden. We have facilities to observe your horse on both a hard surface and on soft ground. Flexion tests are also performed to assess range of motion, pain on flexion, and lameness induced after flexion.
The next step is to perform diagnostic nerve blocks or intra-articular joint blocks. We do this to desensitize a portion of the lame leg to determine if this is the region causing the horse pain.
In addition to the physical and dynamic exam and diagnostic blocks we use diagnostic imaging. This often includes both digital radiography and digital ultrasound. In some cases we recommend advanced imaging modalities such as nuclear scintigraphy or MRI. In these cases we work closely with a referral center to ensure a cohesive and complete approach to resolving any underlying problems.
The pre-purchase exam allows potential buyers to have a thorough understanding of the sale horse’s health and underlying medical conditions. First, a clinical examination is performed, focusing on the horse’s eyes, heart, lungs, gastrointestinal and musculoskeletal systems to identify underlying conditions.
Next, palpation of the limbs, back and neck is performed and hoof testers are applied. Flexion tests are then utilized. By isolating/flexing the leg joints and asking the horse to “jog off”, the horse can be evaluated for lameness isolated to specific areas. This helps to indicate which joint(s) or areas should be radiographed, or ultrasounded.
An evaluation of the horse on a lunge line is also done to observe the horse at a walk, trot, and canter while bending both left and right. Ideally, we like to have the horse travel on both hard and soft surfaces, if available. Also, we advise that the horse should be evaluated when under saddle, in order to see how the horse will perform in it’s intended purpose.
After the clinical exam, further diagnostics are discussed with the buyer. It may be suggested that radiographs be taken if lameness was elicited during the exam. Many clients prefer to take full sets of radiographs as a baseline for comparison in case of future injury, or to utilize as an aid for selling the horse in the future.
Additional tests that may be included in the exam at the buyer’s request include drug screening or routine blood work, a neurological examination, endoscopy, ultrasound, or nuclear scintigraphy.
The veterinarian’s job is neither to pass nor fail the horse. Rather, it is to provide you with information regarding any existing medical problems and to discuss those problems with you so that you can make an informed prepurchase decision. Your veterinarian can advise you about the horse’s current physical condition, but cannot predict the future. The decision to buy is yours alone to make, but your veterinarian can be a valuable partner in the process of providing you with objective, healthrelated information.
We often work with clients from out of town that are purchasing horses locally. We will work with your Veterinarian and send any information and radiographs or other diagnostics via email in a timely manner, so your Veterinarian can also consult on the purchase of the horse.
Please call the office to schedule an exam. Keep in mind that these examinations can often run up to two hours in length minimum, so please plan accordingly.
Platlet Rich Plasma
PRP stands for platelet rich plasma. Platelets are small cell fragments that circulate in the blood. Platelets play an important role in blood clotting and contain a large amount of growth factors. If you do not have enough platelets minor injuries can result in excessive bleeding or even spontaneous bleeding. Similarly, to many platelets can cause blood clotting. The growth factors in platelets, which include platelet-derived growth factor, transforming growth factor, platelet factor interleukin, platelet-derived angiogenesis factor, vascular endothelial growth factor, epidermal growth factor, insulin-like growth factor and fibronectin, are released upon platelet activation. These growth factors recruit healthy inflammatory cells to the area of tissue injury, promote formation of new blood vessels,and enhance production of new connective tissue and regeneration of tendon, ligaments and even skin.
PRP is made from your horse’s own blood. We draw 60 to 120 milliliters of blood from the jugular vein after a sterile prep. We then combine the blood with an anti-coagulant and centrifuge it to increase the number of platelets in each milliliter that we will be injecting. It can then be injected directly into a tendon or ligament lesion, such as a suspensory branch lesion, using ultrasound or radiographic guidance to enhance healing. We can also inject PRP directly into joints to treat acute injury or osteoarthritis. It can also be used on wounds.
Interleukin1 Receptor Antagonist Protein Procession System or IRAP is designed to block the excessive production of interleukin1 in joints affected by osteoarthritis. Osteoarthritis, or secondary degenerative joint disease (DJD) is a primary cause of lameness in the horse. Cartilage destruction, which leads to secondary DJD, occurs due to inflammatory mediators in the joint, such as interleukin1. IRAP blocks IL1 from binding to the tissues and causing damage.
To perform IRAP treatment, a sample of blood taken from the affected horse is incubated with substances that encourage healing, such as growth factors and antiinflammatory aids. The sample is then “spun” to separate these beneficial substances in the serum from red blood cells. This serum is then injected into the injured joint, halting the inflammatory cycle and encouraging healing. Multiple samples are usually harvested and injected at one to two week intervals. Although research in IRAP therapy are still ongoing, the results are promising.
Extracorporeal Shockwave Therapy (ESWT) is an efficient noninvasive therapy used to treat common musculoskeletal and orthopedic disorders in equine patients. The unit generates focused shockwaves (positive pressure acoustic waves) of low and high energy that can be transmitted to deeper structures in the body. This energy stimulates the areas of interest to increase healing. Treatment sessions range from one to four times with an interval of 1 to 3 weeks apart, depending on the injury. Use of this treatment has led to astonishing results in the treatment of pain in the region of tissue located close to bones and in the healing of tendinopathies, desmopathies, fractures, and degenerative joint disease. Use of ESWT has also had some great success in treating chronic back soreness and kissing spine lesions.
Class IV Laser Therapy
Laser therapy is the use of laser energy to create therapeutic effects. Laser therapy can speed healing, decrease pain, and reduce inflammation to surrounding tissues. It is useful for both acute and chronic conditions. Laser therapy is painless and well tolerated. When the laser light is absorbed by the cell a chemical change within the cell takes place called photobiomodulation. This increases cellular function helps the cells repair themselves.
Examples of conditions that can be treated with laser therapy include:
- Suspensory desmitis
- Muscle Injuries
- Neck Pain
- Back Pain
- Joint arthritis
- Stimulation of acupuncture points
Horses do not need to be sedated for laser treatment. Treatment intervals vary depending on the condition that is being treated.
We use flexible endoscopes to diagnose and evaluate numerous nose, throat, and respiratory problems. We have two types of endoscopes; a handheld portable endoscope and a video endoscope. The video endoscope has a camera chip at the end of a long, narrow tube while the handheld endoscope allows you to look directly through the eyepiece. Both allow for the visualization of certain respiratory conditions, such as dorsal displacement of the soft palate or left laryngeal hemiplegia. It is also useful for taking samples of the fluid in the trachea, lungs, or guttural pouches for diagnostic purposes.