The Equine Lameness Clinic
We are very proud of our lameness investigation facilities here at Mayes and Scrine. The area used for lameness investigation in front of the clinic is fully fenced off. We have a smooth and flat area of concrete for walking and trotting up and flexion/forced weight bearing tests.
You or our experienced nurses can ride horses as part of lameness investigations if necessary. We do prefer to admit horses to the clinic for lameness investigation rather than carrying these out at yards, especially for more subtle “performance level” cases, as our facilities usually allow a more accurate and safer diagnosis.
Our menege allows lunging on both hard and soft surfaces and ridden assessment in safety. We have access to a gravel surface track for assessment of driving horses.
Normally the horse will have been assessed at the yard first before an appointment for investigation is made. If insured, we advise that you notify your insurance company of a likely claim prior to the horse being admitted for investigation. Should you have any queries on insurance cover for lameness investigation, please contact the office, or the veterinary surgeon in charge of the case. Once admitted, your horse will be reassessed for stance, muscle symmetry and palpable abnormalities before going on to the dynamic phase of the investigation. Once the gait has been fully assessed, including riding/driving if necessary, a sequence of nerve blocks will be performed, and the gait reassessed after each one. These nerve blocks are likely to include blocks into joints or other structures such as tendon sheaths where scrupulous sterility is required, hence the increased safety of carrying these out at the clinic in our “end-space” treatment rooms. These nerve blocks allow us in most cases to establish the site of lameness and allow us to go ahead with imaging of the affected area. We have diagnostic ultrasound machines with various probes and also state of the art digital radiography units for x-raying that allow us to reach a definitive diagnosis in the majority of cases. Should further testing be required, we will talk you through the reasons for this, and the options and costs. Once a definitive diagnosis has been reached, we can discuss with you the options for treatment, their costs, and the prognosis. Treatment can often be carried out, or at least started, on the same day as the investigation.
Equine Digital X-rays at Mayes and Scrine
The Practice now boasts two state-of-the-art digital “BCF Tru-DR” X-ray machines and three X-ray generators. This has significantly increased our x-ray capacity with two complete fully portable systems for use in the field as well as a larger static unit for use at the clinic. Images are viewable within mere moments of pressing the button, and are stored in electronic format. Images can be downloaded to memory sticks or onto discs, or can be emailed to clients and their farriers, or to referral centres such as Liphook Equine Hospital or Newmarket Equine Hospital for specialist opinions. This modern equipment has revolutionized our approach to possible fractures or laminitis cases which cannot be transported, and increases the service we can provide to clients who do not have access to horse-transport. We can tell immediately whether we have diagnostic images or not and whether any need to be repeated or further views taken. A luxury not available to use when using older x-ray systems. Whilst these new machines represent a frightening financial outlay, we are confident it has been worth the expenditure to massively increase our chances of accurate diagnosis, image-sharing and service to you – the client.
Equine Ultrasound Scanning
Diagnostic ultrasound allows us to image soft tissues by measuring and recording the echo of sound directed into that tissue. Different tissues echo sound in different ways allowing a tissue image to be built up on the ultrasound scanner screen. By comparing the image obtained with known normals, we can find areas of pathology and monitor changes in response to treatment. Diagnostic ultrasound is most commonly used to assess the reproductive tract in mares, and tendons and ligaments. However, there are many other uses including examining the abdomen and chest, assessing wounds for foreign bodies, assessing joints, evaluating muscles for damage and examining the eye. We can image structures up to 25cm beneath the skin. We have probes that allow us to examine parts of the navicular apparatus – an area which traditionally could only be evaluated with MRI. MRI is still the “gold standard” but can be prohibitively expensive and is not always covered, or is only partly covered, by veterinary fees insurance. We have four machines, three of which can run on batteries and are easily portable. Our newest machine, one of the portable ones, can be used to scan the heart. We can record images on paper, on CD format and as computer images, which can of course be e-mailed if required. Ultrasound is considered very safe, both for the handler and the horse, so repeat examinations can be carried out without concern.
Equine Shockwave Therapy
Shockwave therapy, full title “Extra-Corporeal Shockwave Therapy” is a now well established treatment modality for certain orthopaedic issues in the horse. Structures treated include ligaments, particularly the sacro-iliac, check, collateral and suspensory ligaments, tendons and muscles. These machines have been adapted from the “lithotripsy” machines which came in from Germany some years ago for treatment of kidney stones. Our shockwave machine is “focused” which means that we can fire heavy intensity sound waves as specifically as possible into the structure to be treated. The treatment has a pain-killing effect on the affected structure, helps break down scar tissue and can encourage new cells to migrate into the tissue for repair. The treatment regime usually involves three sessions of shock wave, each 10-14 days apart. In most cases, the patient will be sedated as the machine is quite loud and creates a strange sensation in the treated area. There are usually no (or very minimal) adverse after effects. In fact the treatment can afford profound immediate relief from a painful condition. Shockwave can also be used to increase the effectiveness of other treatments such as local steroid injections.
Videoendoscopy is a technique where a camera on the end of a long thin flexible tube can be passed into the airways, sinuses, gastro-intestinal tract, bladder or uterus and allow us to see in real time what is going on. These machines are invaluable in diagnosing diseases such as gastric ulcers, causes of “choke”, airway bleeds, bladder stones, reproductive problems and many others. We have a 2.6 metre long video-endoscope at the practice which is sufficient for most purposes. Should a longer “scope” be required, for example to look into the stomach and small intestine, we can call on the services of specialists with a three metre long scope who can visit either the clinic or your premises as appropriate. Technology exists for “telemetric videoendoscopy” – this allows us to assess the airway of a horse whilst exercising, allowing us to see problems which may occur at exercise. Again, we call on a specialist to provide this equipment.