Hello!
I am in my third week here in Littleton. The summer is already flying by. Most of my time has been spent in the ICU so far. I will usually work 3 days in the ICU and then do one day of surgery and one day in the field with an ambulatory doctor. In the ICU I am responsible for cleaning, lots of cleaning, stocking, doing treatments like feeding, handwalking, icing, giving IV and oral meds, and anything else the patient needs. I also get to assist doctors with whatever they need and get to see a lot of ultrasounds, x-rays, abdominocentesis, and general discussion about cases. I feel like I am really getting the hang of things here, which is wonderful because I feel like I’m helping more and learning more.
I think the most efficient way for me to blog is to discuss one interesting case from each week so things don’t get repetitive. I will discuss the case and then some general differentials and details about that general category of disease.
Today was a field day for me, meaning I got to ride around with one of our awesome vets and their tech all over the Colorado countryside. A lot of what we did today was dental work. Believe it or not, horses need routine dental care, just like you and I. It keeps them healthy, happy, and performing at their best. Performing dental work in horses is called "floating their teeth". It involves a good dose of sedation, usually Dormosedan, which is an alpha 2 antagonist that takes about 5 minutes to take action. Before the horse is sedated, a physical exam is done on them to make sure they are in good overall health and can safely be sedated. We listen to their heart, lungs, gut sounds (borborygmi), take a temperature, evaluate their overall weight and attitude, and ask the owner about any issues. After they are sedated, we place a oral speculum in their mouth. The speculum allows the doctor to get a better view of their oral cavity, but it also keeps the doctors hands and fingers safe from possible bite injuries. The doctor also has a head lamp for good lighting and a hand mirror to see all of the occulsal surfaces. The horses head is either held by an assistant or placed on a stand. The doctor can then start the float.
Tools for a float include mostly different size, textures, and shaped files. The files are used to smooth down rough points of the horses teeth, which I will explain more shortly. Some doctors prefer hand files, while others prefer power files that are attached to drills or specially made power tools (google power float for more details:). The important thing to remember with power tools used for floats is that their needs to be adequate irrigation to prevent too much heat and thermal damage, along with a vacuum system to remove debris that could be harmful to human and equine respiratory systems.
The whole reason a horses teeth need to be floated is due to their anatomy and eating habits. Horses teeth are different than human because they continue to grow all of their lives. Horse also chew their feed in a lateral motion and their upper arcade of teeth are wider then their lower arcade. The combination of these factors lead to "points" on the horses teeth that need to be rasped down. If they aren't filed down, they can create ulcers in the mouth that are very painful, they can limit the horses ability to eat, and they can impact performance because it is painful for the horse to have a bit in. Other issues can arise in a horses mouth that need to be addressed also. Some horses have poor confirmation that leads to unusual wear that also needs to be filed and corrected. A horse usually needs its teeth floated 1 time per year, but that can vary depending on the horse and circumstances.
Occasionally horses will need teeth extracted. First the doctor will do an oral exam and then take radiographs to access the health of the periodontal bone and root of the tooth. If they tooth is intact enough, it can be extracted orally. If the tooth is too diseased to safely be extracted orally, a tooth can be removed via the maxillary sinus. This morning we were able to do a recheck on a horse that had had this surgery done. It was a fascinating process to see.
Routine dental care for our equine patients is vital to keep them performing and feeling their very best. I have loved getting to see and help with floats. Please let me know if you have any questions (denneyk1@msu.edu). Stay tuned for more cases and interesting procedures :)
Best,
Kaity
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