Weeks 2-4 Cleveland Equine

Weeks 2-4 at Cleveland Equine Clinic

Its been a busy few weeks! There have been a decent number of 12-14 hour days on the road these past few weeks just with the regularly scheduled appointments. Luckily a lot of the time is spent driving, so there is plenty of time to decompress and talk with the vet between appointments. I apologize for not posting more regularly, but since I am covering a few weeks at once I tried to divide this up based on type of appointment instead of going chronologically.

Lameness: I am beginning to feel more comfortable with lameness exams in terms of knowing which limb is lame and what grade. Forelimbs are definitely easier for me than hind limb lamenesses. Each exam follows a similar progression:

·       Forelimbs, hindlimbs neck and back are palpated – check for stifle laxity, Churchill response and note shoeing

·       Horse is evaluated in motion: trot in a straight line and turning, lunge left and right, flexion (proximal and distal) of all limbs

·       If a lameness is detected a block is performed to localize the issue (performed proximal to distal with some variation depending on where the vet suspects the lameness is derived from)

·       Radiographs of affected area (or ultrasound is soft tissue is suspected)

We see a very wide range of clients. Some farms we go to because the owner or rider has picked up on a very mild gait deficit they want checked out. Other calls are to horses that the owner just noticed getting lame, but are actually already quite far in the progression of their developing lameness. I have been impressed by the consistent standard of care that every patient receives. Whether a horse is performing in shows across the country or hanging out as a backyard pet, every treatment option presented. Then the owner and the vet work to create a plan that is realistic and likely to be successful for that specific patient.

Pre-Purchase exams: A similar philosophy is applied to the prepurchase exams done by the clinics. Whether the horse is being sold for thousands or hundreds the same packet is filled out for every horse. It covers a physical exam (auscultation of heart/lungs/GI, temperature, etc.) basic lameness exam (palpation, lunging, flexion tests, hoof testers), neuro exam (cranial nerve function, etc.), looking at the eyes, ears, mouth and anything else the vet deems necessary to develop an initial impression of the horse. Then the vet will call the potential buyer and discuss any reservations (for example, if the horse has a slight right front lameness lunging to the right, or if there was a negative slap test, which evaluates arytenoid function). The vet might suggest taking radiographs of the foot or an endoscopic exam. At this point it’s up to the potential buyer if they want to add on to the pre-purchase exam (some buyers want radiographs or every foot and the hocks regardless of if any lameness is detected), but Cleveland Equine will do any diagnostic test the buyer wants and give a professional opinion on every finding.

Repro: I have ridden with the vets the specialize in repro a few times now.  A lot of what we do at this point in the year is preg checking (owners in this area of Ohio usually want later spring foals to ensure the snow is gone). I generally hold the ultrasound and, depending on which appointment post breeding it is, the vet looks for a vesicle (14 days post breeding) or a heart beat (25 days post breeding) or does a general check (40 days post breeding). At the 14 day ultrasound it is important to check for twins. The mare that is owned by the clinic had two vesicles when we checked her, and I watched one of them be pinched. Depending on how large and close together the vesicles are this can be a difficult procedure, but it was cool to see the clearly collapsed vesicle next to the circular, fluid filled one on ultrasound after the vet successfully pinched one. I’ve also witnessed a live cover (stallion and mare breed as opposed to artificial insemination) in less than ideal conditions. It’s important to remember that not every client will have the ideal set up for the procedures that need to be done.

Wound repairs: Wounds are one of my favorite types of calls. Depending on how fractious the horse is, I can help hold/restrain during the appointment. The tech cleans the wound before the vet applies a bandage +/- sutures.  I’ve learned some hallmarks of good bandaging, like even pressure, security and padding. I’ve also learned the differences in medications that should be used based on the goal. For example, using silver sulfadiazine with a steroid and antibiotic like entoderm to decrease proud flesh versus using the silver sulfadiazine with dermagel to granulate the wound in. I saw the progression of one wound on dorsal metatarsal 3 of a friesian yearling over a few weeks. The common digital extensor tendon had been completely transected, and the bone was visible. Although initially sutured, the tension was too great, and they had ripped out after week one. With weekly bandage changes, antibiotics and stall rest the bone stayed healthy and granulation tissue began to form. The owner is doing the bandage changes by herself now that the wound is under control.

Another wound we’ve been treating is from a Clostridium infection that developed after an owner gave a vaccine in the gluteal muscles. It’s been difficult to manage due to its location, but the patient is doing well. One complication has been the constant need to apply Vasoline to the hind limbs because drainage from the wound has been blistering the skin.

Castration: I saw one castration and witnessed the importance of after care when we had to go back 10 days later because the incision site was infected. The horse had been let out in a round pen, but no one checked to make sure he was moving around. A standing castration heals from the inside out and needs to be able to drain, so it is important for the patient to be walked. We drained the infection and dispensed Baytril – aka enrofloxacin (remember this antibiotic cannot be given to horses less than 2 years old because it affects bone/cartilage development). For the castration Dorm and Torb were given for sedation and Carbocaine to block incision site.

These have been some of the most common types of appointments I’ve seen. I’ll continue to take note of particularly interesting cases in the coming week!