RREH Surgery the final 2 weeks!!!

Hello Everyone! I am starting out with saying that my experience at Rood and Riddle Equine Hospital was one of the GREATEST experiences of my life! The people are what really make this hospital an amazing place to be!!! I have learned so much from every single person here and I would not have traded my summer experience for any other hospital!!!! With that being said my last 2 weeks were jammed pack with fun surgeries and ambulatory experiences. To anyone considering RREH surgery next summer, you will gain horse handling skills you didn't even realize you needed!!! You work with predominantly young racehorses and it is a skill to handle them safely for both the people and the horses involved!! You will also be responsible for dropping horses, hoisting them, and placing them on the table correctly for various surgeries. You will learn how to clip, scrub, and sterile prep various surgical sites and then you will act as the technician in the surgery room helping the surgeon in any way that is needed. You will help the horses to recovery and then set up the room for the next surgery. If you are interested in surgery this is the experience for you because you will see some of the coolest surgeries around every day! Some other things I was lucky enough to learn was how to place arterial lines while the horse was under general anesthesia, place catheters, give pre-op drugs, give iv and im injections, draw blood, change bandages, flush mares, and castrate horses. If you are interested in learning anything equine, I recommend applying for RREH!

My last two weeks there were some interesting colic surgeries!

Pictured above is a horse suffering from multiple strangulating lipomas and unfortunately extensive necrosis to the small intestine. The first picture shows one of the many lipomas.

                                                                    Closing the orbit

                                                         Eye after it had been removed

                                              

 The next 3 pictures above are of a broodmare that suffered from a viral infection for many years in her eye. The virus was managed for many years in the infected eye until the damage was so extensive the decision was made by Dr. Latimer to perform an enucleation on the mare. An enucleation is when there is a surgical removal of the globe, conjunctiva, and nictating membrane. Before removing the eye she performed nerve blocks on the mare. Different blocks you can perform before an enucleation are an AP block (palpated dorsal to zygomatic arch), frontal block, retrobulbar block, and an infratrochlear block. This procedure is sometimes done on a sedated standing horse, but for this mare she was placed under general anesthesia. Then 2 incisions were made (one above the eye and one below the eye) and the procedure was performed. Due to the vascular nature of the orbit, it was essential to pack the orbit with gauze for at least 5 minutes. Then Dr. Latimer closed the orbit and placed a bandage on the mare (pictured above). 

Pictured above is a horse placed under general anesthesia to have a tieback performed. This horse was first run through the new CT machine at RREH to get a better picture of airway before surgery. The CT machine uses computer-processed combinations of many radiographs taken from different angles to produce cross-sectional tomographic slices of specific areas of a scanned area on the horse. It can produce a virtual 3-D image and basically allow the doctors the opportunity to see a specific area on the body without cutting the horse open. It will be interesting how CT images advance in equine medicine and allow new insights into disease processes. 

Above are a few pictures of Hats Off Day sponsored by Rood and Riddle!

Super cute draft horse yearling who was being treated for canker in all 4 of his feet and he didn't feel like going back to surgery!

                                                                 Triple Crown Winner! 

                                      I even had time to work my horse and he loved Kentucky! 

 It was a great summer and I want to extend my sincerest thanks to Dr. Embertson, Nicole Bone, and Alanna Mathes for allowing me to come to this awesome place! To Dr. Woodie, Dr. Hopper,
Dr. Bramlage, Dr. Ruggles, Dr. Latimer, Dr. Bras, and Dr. Friend, thank you for teaching me and letting me help out! To Dr. Schott for working so hard for all of the fellows and setting up this program! I truly believe we are so lucky to have this available to all of the MSU veterinary students! To Stephanie Welsh for letting me be your shadow and training me! You are the best mother duck!!!!! To the interns you are all amazing doctors and thank you for putting up with me at night and your early mornings especially! Finally, last but not least thank you to entire staff at RREH. I learned so much from each and every one of you and I can't thank you all enough!!!!!
That is all from me, hope everyone enjoyed reading and I encourage everyone to apply next year!

End of the Summer at Saginaw Valley Equine Clinic

Again I have been delinquent in my blogging.... but, my last few weeks at Saginaw Valley Equine Clinic were definitely full of experiences.  One of the most interesting, albeit the saddest, was a horse that presented with colic following a hard fall at a barrel race.  One of the differential diagnoses was a diaphragmatic hernia.  However, the owners were unable to have surgery for the horse so we euthanized it and performed a field autopsy.  It turned out to be a colonic torsion, a cause of colic completely unrelated to the fall.  Much of the colon was already necrotic and the horse would have required a lengthy colic surgery and bowel resection.

I learned a lot over the summer and am grateful that I was given the opportunity to experience practice at an equine specialty clinic!

Final Post from Equine Analysis Systems

This is my last week in Kentucky with Equine Analysis Systems. Since concluding my research project, I have had a bit of down time to explore research articles that interest me and ride along to some really neat farms in the area. Since we have heart scanned some mares recently, I have been able to work on my ultrasound skills (yearlings, two year olds, and race horses don't quite have the patience to be scanned by both a vet and myself). Today I even scanned well enough that the technician was able to use my scan for the measurement phase. It may not seem like a huge deal, but trust me, it is a pretty big feat to get the exact view in the correct scan plane, etc etc that they need to take accurate measurements. Overall, I am in shock that my summer here has passed so quickly and I will really miss Kentucky and my coworkers. I would suggest that future Equine Fellows consider this position if they are interested in Thoroughbred racing and research, are self-starters and ambitious, understand professionalism and the importance of confidentiality, and are looking to be a part of an exceptionally intelligent team for the summer. For anyone who is considering a career working in the Thoroughbred industry, this position provides important contacts and exposure to the inner-workings of the industry.

The Sun Shines Bright On My Old Kentucky Home...

 -Nicole

Last few weeks at Rood and Riddle

Hey everyone!

I know I'm a little late but we've been extremely busy the last few weeks at Rood and Riddle. But all the busyness has led to some great experiences! In addition to the pictures I have to share, I would like to give an overview of the things I became competent in over the summer under the careful guidance of Dr Friend. I have been able to give both IV and IM shots, draw blood, rectally palpate mares, find ovaries, find pregnancies, flush and infuse the uterus, artificially inseminate mares, sew caslicks, castrate colts, and I even got to inject some joints as well as do a few nerve blocks. I had a wonderful experience down here and can't thank Dr Friend enough for everything he taught me as well as the faith he had in me to trust me to work on some of his patients. I highly recommend this experience for anyone who wants to know what a busy ambulatory practice is like and who wants the chance to learn practical skills.

 A 3 month old foal with trauma to the eye, sent to surgery for an enucleation

 Horse who sliced a chunk of hoof out on a fence

 Uterine prolapse post foaling

 Barn cats and chickens

 Castrating

 Foal who went through a fence

Yearling who broke her maxilla

Thanks for reading along all summer!

Sarah

Greetings from Clinton Vet!

Hey guys!

Just wanted to give some updates on all that was going on in mid-Michigan the past couple weeks. While I am technically done with this externship, I still wanted to share some final, interesting cases.

Clinton is wonderful in that they offer so many different avenues into the world of large animal medicine. I'm sure all of the hospitals and clinics have a handful of amazing veterinarians, and Clinton has been able to show me the other half of that as well. While I know that this is for the Equine Blog, I wanted to share a little bit about the bovine world that I encountered. It's fairly standard, the farms generally like to have the same vet come out consistently, about once a week typically. They go and perform the standard herd healths; preg checks, palpations, ultrasounds, etc. However, there are always the emergency situations as well. I got to help with a DA (displaced abomasum) surgery on site. It was very clearly audible on percussion on the left side, and was a routine, common left DA. The owners did mention that they had already tried to "roll and toggle", which is basically just trying to anchor the abomasum in the correct place. However, she was still lethargic and ketotic. So Dr. Trierweiler went in on a right flank abomasopexy and attempted to deflate and reposition the abomasum. It was difficult and she could tell that she had been in this state for a while because the fat was very thin and tearing very easily. She got in the best position possible and just secured the omentum to the abdominal wall and closed her up. Based on the state of the cow however, she will most likely get culled from the herd, but we did what we could.

Another cow story, I went with Dr. Mike Trombley on an emergency calving. She had been in labor for over two hours by the time we got there, and as horse people, this might make us cringe..! I learned a lot of differences between bovine and equine delivery aspects, and there's a great deal of difference. The length of labor is drastically different, as well as the amount and frequency of dystocias. Cows are much more inclined to a dystocia because the fetus has no real restrictions in growth, and if the heifer is too small or has been bred to a large bull, this baby can be majorly disproportionate to mom! Also the angles and shapes of their pelvis leads to more complications. Another difference encountered is the retained placenta. Horses cannot stand to have it retained for more than a few hours without running into massive potential problems, yet cows can keep it for much longer, with no trouble.

A final case I wanted to mention was a yearling filly we met who had decided to try to jump a fence in between pens. She had failed miserably and ended up falling right on her chest. She immediately had massive swelling, and was far from her rambunctious self. The owners kept her on stall rest for the night, and believed she had a large hematoma. We traveled out to the farm and immediately took an X-ray. Even when we got there, she was markedly depressed and struggled to move, exhibiting some neurologic signs. She was eating and drinking normally though, which was a plus. The results, however, were not so optimistic.

This was a lateral projection of the neck at about C3-C4. You can see that the spinous process is just completely shattered. It seems that when she landed, her chin and chest just telescoped those vertebrae into each other, causing massive trauma. Based on the intent and purpose of this horse, it was clear that it was catastrophic. Even with a miraculous surgery and recovery, she would never be able to have a good quality of life. The decision was made to put her down, unfortunately.

That was definitely not a case seen everyday, and although it was with less than ideal results, the owner was very reasonable and did what was best for the animal. At the end of the day, I guess that's all we can hope for. I am very sad to have concluded my time at Clinton Vet, but incredibly thankful for what this summer had for me and am truly grateful to all the staff there and the Fellows Program for the opportunity, I hope you all have a great rest of the summer as well! Enjoy and see you soon.

-Taylor

Weeks 9 and 10 RREH in surgery

Hello Again! Surgery has been busy preparing for the September Sales! Kentucky has been experiencing a ton of thunderstorms this summer which unfortunately means lacerations.

The laceration pictured above was presented to RREH surgery on emergency. After taking radiographs and evaluating the edema it was confirmed that the laceration entered the joint space and there were bony chips that needed to be removed. Dr. Woodie decided to wrap the leg in a full limb bandage with an osmotic sweat to reduce the edema and then remove the chips via an arthroscopy the following day and repair the laceration.

The next laceration was on a yearling was repaired immediately and a drain tube was placed and the leg was wrapped. The yearling was placed on antibiotics and stall rest.

Along with lacerations there have been many foal colics. The foal pictured above was being treated in the hospital for enteritis for two weeks. The foal did not improve and therefore an abdominal exploratory was performed. Pictured above is feet of small intestine that was necrotic and infected. A culture was taken to try and discover what bacteria was causing the intestine to die. The small intestine on palpation was paper thin and would perforate easily in multiple places. The foal was 4 weeks old at the time of this surgery. Unfortunately, the damage was very severe with a guarded prognosis and a high chance of the foal being a chronic lifetime colic candidate.

Finally this foal that weighed only 150lbs was presented with severe angular limb deformities. The foal required transphyseal screws and wires to be placed correct the deformity. The screws are placed on the outside of the limbs to slow the growth of the outside so the legs will straighten and turn in.
Thanks everyone for reading!!
Jackie

Angular Limb Deformity and Mandibular Fracture

Last week a 4 month old filly came in for surgery to help fix her angular limb deformity. This can occur with a medial or lateral deviation of the limb. The cause of this deformity is multifactorial and can range from being born with it or multiple developmental factors after birth. Radiographs were taken to help determine the best therapy and as a prognostic indicator.

Pre- surgical carpus radiographs

Note the filly's right front is convex on the inside at the level of the carpus

Dr. Devine performed a transphyseal bridging on her right limb. This procedure is performed when the deformity is 15 degrees or greater. There are multiple techniques for this but the basic premise of is to slow the grow on the convex surface with bone plates, screws, or wires to allow the concave side to catch up. The implants are placed on either side of the growth plate. The down side to this option to correct her deformity is that it requires a second surgery to remove the implants once the limb is straight. If not removed in time, the limb can overcorrect.This filly will be monitored by her referring veterinarian until her screws and wire are ready to be removed. 

Post surgery radiograph of the carpus with bone screws and wires

Last Wednesday a 1 month old Quarter Horse colt returned with a suspected mandibular fracture. He actually foaled out at the clinic so it was sad to see him return. Radiographs were taken to confirm the fracture. It is suspected that the mare did it to him but the incident was not observed. 

The next day Dr. Devine performed surgery on the colt to insert a pin into his mandible to hold the bones in place while they heal. The pin will be removed in 4-6 weeks once the mandible is healed. 

Pin inserted into left mandible

Placing the pin

The foal woke up from surgery like nothing happened and was extremely eager to nurse. He is a tough little guy and never acted painful and has been extremely active since surgery. Unfortunately, Sunday the colt had a couple neurologic episodes such as circling only to the right and seizures. He was given diazepam (valium) IV and placed on oral Phenobarbital. Thankfully he has not had anymore episodes since Sunday and is back to his normal happy self. It is not quite clear why this occurred. His antibiotics were switched to one that can cross the blood brain barrier to hopefully take care of any possible infection that may be in his nervous system. He will remain on the oral Phenobarbital for 1-2 months in case there is some underlying neurologic factor that may have caused the seizures. 

Yesterday he was back to being a silly boy playing and giving kisses

Greetings from the Great Lakes Equestrian Festival

Hey guys!

I'm sitting in beautiful Traverse City, MI watching the hunters and jumpers show their horses.  This relaxing venue comes after several weeks of intense Arabian horse shows, followed by prep work to send horses to their national youth competition in New Mexico.  This trip began June 14th with a short two days in Cleveland, OH where we helped prep horses for an upcoming show in Springfield, OH.  This included our usual work of flexion tests, ultrasounding and radiographing limbs, joint injections, shockwave therapy, etc.  From there we traveled to the Region 13 Arabian horse show.  As Equine Athlete is the official show vet for this event, during the week we not only took care of lamenesses, but any and all emergencies.  In typical horse fashion, our best emergency occurred after a particularly slow day and close to midnight.  One of the horses spooked, got loose from her groom and bolted, only to later fall on the asphalt.  After all was said and done, the mare ended up with lots of road rash, a laceration to her elbow and a laceration to her stifle, both required suturing.

The following week took us to Lexington, KY for the Region 14 Arabian horse show.  This was held at the horse park, one of my favorite venues.  The last time I was at the Kentucky Horse Park, I was with one of the riders I groom for, Dale Dedrick, who was beginning her journey to the Paralympics.  Being classified as a para athlete at the 2010 World Equestrian Games was the first step down the road to the 2012 London Paralympic Games.  Having finally returned to our starting point, successfully completing our goal, felt as good as when I finally found out I had been accepted into vet school.  From one incredible journey to another, always going good in the right direction.

From Region 14 to Region 15 in Lexington, VA.  I should add that these horse shows are typically a week in duration. With riders and horses arriving on Monday or Tuesday and official showing beginning Wednesday and concluding on Sunday.  We try to arrive with the horses and leave when they leave to ensure that they have access to veterinary care at each leg of their journey.  Often times, these animals arrive from long, long trailer rides and need IV fluids and electrolytes.  During transition from traveling to new stabling, some can develop a mild colic, respiratory issue, or diarrhea.  Dealing with these issues requires special considerations in regards to which medications can and cannot use.  Show horses are frequently tested for drugs and the USEF places restrictions and time limitations on the uses of specific medications.

On the way home from Region 15, we stopped overnight in Cleveland to continue prep work for the next show.  I was able to enjoy a few days off at this point as the doctors of Equine Athlete traveled to MN, CA, and AZ to work on horses.   And lastly, while half of Equine Athlete travelled to NM for Youth Nationals, the other half ventured to Traverse City for the Great Lakes Equestrian Festival.

So enough chatter.  Here are some photos from some horses we've worked on.

This is a photo of a coffin bone fracture. Can you tell where the fracture line is? There are actually 7 types of coffin bone features categorized by where they occur and whether or not they involve the coffin joint. 

This photo is of a horse with laminitis.  The shot on the left is the most recent where the shot on the right is from when this episode actually began. As you can probably tell, we beat the disease process to the punch and while this horse was very sore on her feet, we were lucky to avoid any significant rotation.

Injecting the navicular bursa.

Ultrasound guided sarcoiliac injection

Research project blog-READ THIS IF CONSIDERING FELLOWSHIP AT EQUINE ANALYSIS SYSTEMS!

After presentation of my project to the vets at EAS, our office manager asked me to write a blog post for the company website about my experience here and the findings of my research. Please follow the link www.equinanalysis.com/news to find my post, and learn the results of my project. To anyone considering applying for this internship in the future, please please take the time to read this, as I believe it explains the views of the company quite well and will give students an idea of what to expect when coming to Equine Analysis Systems. Cheers from Kentucky,
Nicole

Week 8

Hello again! We never slow down is the official theme at Rood and Riddle! Surgery has stayed busy with some great learning experiences! It is weaning time in Kentucky which unfortunately results in many lacerations and sadly fractures. A foal was presented at the clinic to fix a complete calcaneus fracture. The picture to the right is of the fracture prepped and ready to go in surgery before Dr. Ruggles fixed it. You can see the severe angle and swelling of the leg.












Dr. Ruggle place 2 plates to fix the fracture and allow the foal a chance to grow normally.

 

My favorite thing will always be colic surgeries! I was able to help out with some late night colic surgeries where one horse had a small intestinal torsion. 

 Pictured above is about 10 feet of necrotic small intestine that needed to be resected!

Finally there was another Ovariectomy performed on a mare with a tumor. Unlike the surgery that was performed earlier in the summer where the horse was not placed under general anesthesia, this mare was placed under general anesthesia and placed dorsally on a table and the ovary was removed. It was really interesting to the see the same surgery performed in 2 drastically different techniques. If there is one thing I have learned it is to keep an open mind and learn as many techniques as possible! 

  Ovary after it was removed! 

 

On that note, I would like to end this week with two of the amazing hard working interns at RREH! Dr. Lauren Mundy and Dr. Liz Anderson! They are flushing a septic joint on a foal! Working hard day and night! 

Thanks everyone for reading!! 

Surgery Case

Although Cleveland Equine doesn't have a surgeon on staff, we do have an induction stall, hoist and anesthesia equipment, so once every month or two a surgeon comes in for a day to do a few surgeries if we have some cases. This month, we did a cryptorchid castration & umbilical hernia closure on a colt, a tie back surgery, and also a sort of "rhinoplasty":

This horse had managed to lacerate its nostril on a waterbucket. After being repaired, the nostril began to constrict over the following months until it was so small that it was limiting air intake and affecting performance.

Below is the right nostril for a size comparison:

So the horse was taken to surgery, where the alar fold and cartilage was removed and the nostril opened up so it was no longer restricting airflow.

Week 8 at Littleton Equine

This Monday I spent the day with Dr. Toppin. We had a referral for a 19 year old Quarter Horse gelding with a shoulder injury.  The owners found the horse with the injury after being out in pasture for a few days so we assume that he was kicked by one of the other horses. The referring veterinarian pulled pieces of bone when exploring the wound and recommended they came to Littleton for shoulder radiographs to know the extent of the damage. The leg was extremely swollen all the way down the leg to the fetlock.

 

Based on radiographs, we could see 2 bone chips off the humerus with the larger piece being the deltoid tuberosity. Dr. Toppin was able to pull out the small piece of bone, but the larger piece of bone was still attached to too much muscle to pull out. He recommended that the gelding stay so one of the surgeons could perform a standing surgery to remove it. Tuesday night Dr. Murray along with Dr. Robinson removed the piece of bone. Dr. Murray was nice enough to let me put on sterile gloves to feel the bone chip and the humerus. The chipped piece was very sharp and the humerus was very rough. No wonder the sweet guy was so painful!

He was such a good patient during the procedure and his entire stay in the hospital. His little girls were so excited he was able to go home Thursday! 

On Monday,  we also went to do a recheck on the paint gelding that had pericarditis. I am happy to report that he is doing wonderful! His heart looks great on ultrasound and his heart rate is down to normal. It was so nice to follow up on him after caring for him during his stay in ICU.