Week Seven in Somerset

We celebrated the Fourth of July this week by welcoming two overseas vet students to the clinic. Jenny is originally from West Virginia and is going to school in New Zealand; Sonea is from Austria and is going to school in Vienna. It is really interesting to hear about school and life in general from a foreign perspective. As I show them the ropes around the clinic, they are sharing their knowledge about the cases with me.

This week was full of new cases, exciting hands-on experiences, and very little sleep. We had two yearling Standardbreds in for arthroscopies to remove OCD lesions in their hocks. Assisting for these arthroscopies has become less daunting for me, despite all the strange instruments. I am also finally able to identify anatomical landmarks on the screen. I was pumped beyond pumped when Dr. Brown allowed me to remove OCD lesions from the distal intermediate ridge of the tibia in both hocks for one of the horses. I have a new appreciation for the coordination required to grasp a small chip with only the small view on a computer screen for guidance. Dr. Brown makes it look easy. The second arthroscopy revealed that the chip we could see easily on an x-ray was actually buried in a collateral ligament. Dr. Brown and Dr. Tull were both very excited to examine the soft tissue structures of the joint with the scope. They figure that the horse tore his deep short medial collateral ligament, which carried a chip from the medial malleolus with it. Dr. Brown was able to clean up the torn ligament and remove the chip, but he does not hold much hope for the horse’s racing career.

We also had two more foals with swollen joints come in, but neither of them turned out to have septic joints. The first has an infected physis, or growth plate, which we are treating with systemic antibiotics and regional limb perfusions. The second, Dr. Tull suspects has Rhodococcus, based on his findings from a thoracic ultrasound. Rhodococcus is a bacterium that can cause pneumonia in foals by forming abscesses in the thorax. Due to the connect blood supply between the metaphysic and epiphysis in foals the bacteria can gain access to the joint area, causing inflammation around the joint. For this reason, sometimes the most visible sign of Rhodococcus is swollen joints. We are treating the infection with targeted oral drugs that are proven to penetrate the abscesses.

        

Here are some action shots of the arthroscopy surgeries. On the far left, I am "assisting" in a whole new way. In the middle two frame, I am examing and gripping two OCD lesions on the computer screen in preparation of removal. The final picture is of my proud display of the first chip I removed.