Weeks 4-6 at Stevens Equine

Well, horse show season is officially in full swing!  The past few weeks have flown by and have been filled with long days of a lot of lame horses and some interesting cases.  Other than today, the past several days have been very hot and humid so we have had to administer fluids, electrolytes, and some B vitamins to a few horses to help hydrate them and perk them up a bit.  Other than that, there has been the usual mix of lameness examinations that are often followed up with either more in-depth diagnostics of ultrasonography or radiographs and intra-articular injections or other treatments.

As usual for horses, there have been several cases lately where horses have gotten lacerations in creative ways.  One horse got its leg caught in an arena fence, one caught its lower eyelid on something in the stall, and two got their leg entrapped in the stall door bars.  I am always amazed to see how they find unique ways to maim themselves, but fortunately all of those were able to be sutured and/or bandaged and treated with anti-inflammatories and antibiotics so are recovering well.

Although I have bought and sold horses several times before, I was able to participate in my first pre-purchase exam the other day.  It was interesting helping to assess the condition of several of the horse’s systems and to evaluate its health and potential suitability as an eventing horse.  This horse was an ex-racehorse, and it was very interesting listening to Dr. Stevens look through its racing record and explain the different components of it and their potential implications to the interested buyer.  It made a lot of sense, and is not something that I would have thought to pore through other than out of sheer interest.

There have been a few horses that have been afflicted with laminitis over the past few weeks, and it has been neat learning about that and its correlation with Equine Metabolic Syndrome.  Dr. Stevens assigned me to read the ACVIM Consensus Statement on the condition, so I learned a tremendous amount about both EMS and PPID (Pituitary Pars Intermedia Dysfunction).  Both are conditions that I have always been interested in yet had not read about in-depth, so it was great learning about the diagnosis, treatment, management, predilections, etc. of them.  I highly suggest reading the ACVIM paper on it if anyone is interested, because it was full of great information and was a very user-friendly report.

Lastly, I was able to watch a very interesting procedure the other day.  It is called intravenous regional limb perfusion, and was performed on an older horse that has had ongoing lameness issues for a while that had been unresponsive to other treatments.  We did radiographs of his distal forelimbs a few weeks prior to this particular procedure, and noted an area of abnormal radiolucency on his right front distal cannon bone that was a degenerative bone lesion that Dr. Stevens thought may respond to treatment with Tildren.  Tildren is a first generation bisphosphonate that is often used to treat orthopedic conditions of the distal limb in horses.  In order to use a lower overall dose and to deliver a higher amount of the drug to the site of the lesion, he used intravenous regional limb perfusion as well as administration via an intravenous jugular catheter for systemic application.

Basically what was done was that the horse was given a low four-point block to prevent any uncomfortable sensation in his lower limb during treatment then an Esmarch bandage was applied just below the carpus.  The Tildren was subsequently injected into the limb via a butterfly catheter into the palmar digital vein then the site of venipuncture was covered with a temporary compression wrap and we waited for 30 minutes before removing the tourniquet.  That allowed sufficient time for the drug to leave the vasculature and enter the tissues.  It was really interesting to watch, and I learned that it is a procedure that is also commonly done to deliver antibiotics at a high concentration to distal limb lacerations or septic joints.

Again, I hope that everyone is having a great summer and is enjoying their hands-on learning!