Feb 7, 2017 | Radiographs, Ultrasound
I closely supervised the Docs this week in the Clinic, and I noticed two significant pieces of equipment being used on a regular basis: the ultrasound and x-ray. Being a curious cat, I sat them down and asked why x-ray this horse but not that one? Which led to: when do you use the ultrasound? Read on for some profound learning from a very wise cat.
Ultrasound
Both ultrasound and x-ray use waves of energy to make a pretty picture, kind of like a camera. The ultrasound uses, wait for it, sound waves. Sound waves go into the body and bounce off different tissues before coming back to the probe. The computer inside the ultrasound then turns the waves into an image. Lots of things affect the waves, but the biggie is how much water is in the tissue. This means things like muscles and babies make really pretty images because they are mostly water.
Tendons and ligaments can be easily seen too. While they don’t contain as much water as muscles, they are very tightly organized and surrounded by other tissues which do contain water (mostly, see more later). When tendons and ligaments do get injured, they dramatically increase the water (edema) in the area of an injury making injuries very easy to see (again, mostly, you’re going to have to keep reading).
What are ultrasounds bad at seeing through? Air, think lungs and gas filled guts, and hard stuff like bone and hooves. The Docs can still use the ultrasound to get an idea about the contours of lungs and bones. In fact, it’s one of the easiest ways to tell if a horse has pneumonia. Ultrasound is also a first line tool used to check for some bone fractures. The ultrasound can’t see through air though so only the very outside edge of the lungs can be checked. That air (well gas really) is very useful in the GI tract. In the image below our Docs used the gas/tissue interface to determine if this horse had the potential for hind gut ulcers.
The next place that would be really nice to see with the ultrasound is inside the hoof. There are some really important things in there that would be great to see with an ultrasound. Unfortunately, the hoof capsule is great at bouncing those sound waves. In a pinch, the hoof can be soaked for about 24 hours, then the outermost layer of sole pared down with a hoof knife, and the ultrasound very, very firmly held against the frog. This is a very limited viewing window, but can be useful to recheck after an MRI.
Another place sound waves like to be difficult is the back of the hock. In this area lives a very important structure called the proximal suspensory ligament. This ligament is a source of many curse words here at Springhill Equine. The ligament is between the splint bones, under some blood vessels, and right next to the cannon bone. To top it off it contains muscle and ligaments in a twisted, woven bundle. Sound waves bounce around like crazy which drives the computer inside the ultrasound machine crazy. The computer does it’s best to sort it all out, but often it fills in the blanks a little wrong, causing what’s known as an artifact. Moral of the story here is that imaging proximal suspensories is hard, and imaging is only part of the picture. Yes, that’s a pun, and I’m pretty proud of it!
X-ray
Moving on to x-rays. Technically, radiology. X-rays are the waves that are used to make a radiograph, just like visible light is the wave used to make a picture. OK, technical stuff covered. All those things ultrasounds hate, x-rays love. Radiographs are the best option for anything bone, or air filled (again there’s an exception, and I’m going to make you read the entire blog to find out what it is). X-rays shoot straight through bone and air to make a picture on a plate placed on the other side.
Radiographs are very much like the pictures you shoot with your camera. Think of the x-ray machine as the sun and the plate as your camera, with the subject of the picture being your horse. Radiographs are great at seeing changes in bone like arthritis, and changes in density. Radiographs are also great at looking at the whole structure of the lungs, instead of just the surface that ultrasounds see. And x-rays go right through that pesky hoof capsule to let us see the bones inside. What they can’t see are soft tissues. And this means it’s very often a team effort between radiographs and ultrasound to get a complete image of the inside of your horse.
I’m not making you read to the very end for the x-ray exception, only mostly to the end. Horses are big. They are nearly as big as I think I am. This is a problem for radiographs and ultrasound. Neither of these waves are strong enough to push through the big ol’ butt on a horse. From about where the back of a saddle sits to the start of the tail, horses are solid muscle, bone, and hay filled gut. This combination is able to scatter all the x-rays that hit before they can reach the plate and absorb all the sound waves so that deep ones can’t get back to the computer.
We can get some hints about what’s going on in there, but getting a clear picture is like trying to figure out what it looks like at the bottom of the Marianna’s Trench in the Pacific Ocean: it ain’t easy. Make stronger waves you say. Sadly, physics says no. If you make the wave stronger it can’t go as deep, if you make it weaker it can’t reach the other side. There is no easy answer here. A good physical exam, watching your horse do what it does, and then evaluating the problem are the best answer for low back pain and high hind end lameness in horses. Luckily I know a couple of awesome veterinarians with a ton of horse sense to back up their medical knowledge 😉
Until next week,
Tony
Jan 31, 2017 | Breeding, Foals
For the record, I did not choose to jump on the phantom for this week’s photo. I was forced to pose there by my humans- hence the look of displeasure on my face. That being said, my Breeding & Foaling Seminar this month was one of the best-attended educational events I have ever hosted! But in case you were one of the 2 or 3 cats who forgot or couldn’t make it here to see me, I’ll give you a re-cap.
If you are considering breeding your mare, there are several stallion factors to consider. These include but are not limited to: germs, bloodlines, history of breeding success, and legal jargon. Make sure your stallion of choice checks all the boxes before committing to breed to him. If you need help deciphering a breeding contract or remembering what diseases he should be tested for, ask our vets! That’s why they went to 8+ years of school after all.
Breeding a mare is a lot like baking a soufflé. In the cookbook, it sounds easy: just follow the recipe and voila! But in real life, lots of things can go wrong. Mares don’t like to read the cookbook. Failing to come into heat, not ovulating in a timely manner, reacting to the semen placed in her uterus, or fertilizing twins…these are just a few of the things mares try to do to make the docs bang their head against a wall.
Let’s say your soufflé comes out perfectly: after one cycle, you end up with a single, beautiful, round little embryo at the 14-day pregnancy ultrasound. Fast-forward 11 months, and now you are ready to welcome your new bundle of joy! But when?
This is another point where mares can be tricky. Their “due date” is just an estimate, and can easily range from 320-360 days gestation, or even longer. In the docs’ opinion, the best way to know when your mare is going to foal is to test her milk pH daily. When it drops to 6.4, there is a 98% chance she will foal within the next 72 hours. I like those odds! You can also use the good old signs like bagging up, relaxation of the vulva, and waxing of the teats.
So your mare is in labor, now is the time to panic, right? Yeah…no. Stage 1 of labor can last several hours and is characterized by acting restless, pawing, not eating, and flank-watching. Stage 2 is the exciting part- it begins with the mare’s water breaking, and ends with a foal on the ground! This stage of labor should last NO MORE than 20 MINUTES. Don’t forget about Stage 3: passing the placenta. The docs will appreciate if you save that stinky sucker in a bag or bucket until they can get out there to evaluate it.
Mares rarely need help with labor, but it’s important to know what is normal so you can identify when something goes wrong. Might I point out that cats NEVER need help having kittens (or so I’ve heard). This is where the 1-2-3 rule comes into play. A normal foal should stand within 1 hour of birth, nurse within 2 hours, and the mare should pass her placenta within 3 hours. If the foal misses any of these milestones, what should you do? You guessed it- call the docs!
Well, that’s my story. Of course there is no way to put into words the best part of the seminar that you missed: me! But you guys are such quick learners, you are all going to do great!
-Tony
Jan 17, 2017 | Abscesses, Farriers, Hoof Care, Lameness, Leg issues, Q & A, White Line Disease
Last Wednesday evening was an atypical night for me. There was pizza, which is always a plus. But then about a half dozen big burly men with a bunch of tools showed up, pulling trailers with–get this–built-in furnaces! The docs called them Farriers. Turns out all you have to do is let them know there will be pizza, and they will come from far and wide. Beth brought in her horse, Princess Chubby Butt, to be the test subject. The docs learned how the farriers approach a problem foot, and the farriers learned why things are not always as they seem on X-rays. It was a great learning experience for everyone…OK, I’ll admit even I learned a thing or two.
It turns out if you ask 6 different farriers the same question, you get 6 different answers. In fact, it is widely accepted that if you ask 20 different farriers the same question, you will get 20 different answers. Luckily, we have a bunch of great farriers in our area, and although they may have different opinions about the right way to approach a problem, none of them are wrong. If your horse was experiencing a foot lameness, it used to be commonplace for your vet to blame your farrier, and for your farrier to blame your vet. But here at Springhill Equine we are trying to change that!
We see the vet, farrier, and horse owner as a team, and we try to come up with a solution by putting our heads together. Whether the problem is laminitis, club foot, navicular disease, arthritis, thrush, etc… you need a vet and farrier working together to get the foot going in the right direction. Farriers are often grateful to see what’s going on inside the foot with the aid of X-rays, and I know the docs are grateful to have somebody else in charge of hammering nails into the horse’s foot!
All in all, our first vet/farrier team building/brainstorming meeting (event name pending) was a huge success, and we hope to have more in the future. Oh, and Princess Chubby Butt is loving her fancy new shoes! If you are ever looking for a farrier, there is a long list of names in the desk that I like to sleep on, and we would be happy to find one to meet your horses’ needs.
Until next week,
Tony
Jan 10, 2017 | Breeding, Foals
Ah, a New Year…a fresh start, new resolutions, exciting plans, and new horizons. Oh, and baby horses! Yes, it may still be ridiculously cold outside, but believe it or not breeding season is almost here! Now is the time to plan: get out pictures of your favorite mare and favorite stallion, pin them next to each other on your cork board, and envision what the resulting foal will look like- and what it will be able to do! Do you want the highest jumper? The fastest barrel racer? The most muscled halter horse? Or the leanest racehorse?
The other important part of planning your breeding adventure is how to get your mare in foal, or where to have your stallion collected. This is where I can help! Here at Springhill Equine we have a complete array of breeding packages for your mare and stallion. We can take care of everything from a breeding soundness exam (making sure your horse is reproductively healthy), to collection, to artificial insemination, all the way through foaling.
I have talked to you humans before about what responsible breeding is. You can always look back at my blog and read archived Tuesdays with Tony entries, because what better to do in your free time? But determining that your mare or stallion has several traits that are worth passing on, and very few traits that are undesirable, is only the first step. Now you need to think about what goes into breeding and foaling, and whether you have the time, money, and patience to take on the challenge!
The docs tell me that there are several factors that come into play when trying to get a mare in foal. These include age, parity (how many foals she has had before), anatomy, history of reproductive failure, metabolic imbalances…the list goes on! In short, just because you want to breed your mare doesn’t mean she will be able to get pregnant. Older, maiden mares are the hardest ones to get in foal, and this is a common challenge our docs face each year. It seems that after a certain age, if a mare’s reproductive organs haven’t been used, the body begins to shut them down. There is no exact number for mares, but “older” is generally defined as over 10 years old. I would like to point out that cats, like a fine wine, only get better with age.
Already expecting a little bundle of horsey joy this spring? I can help with that too! Don’t miss my next come see Tony event on Tuesday January 17th, a Foaling & Breeding seminar for all you need to know to be well prepared before your baby arrives. If you still don’t feel 100% comfortable, we offer reasonable foal-out rates here at our clinic where we have 24/7 stall camera monitoring, and a veterinarian will be present at your foal’s birth.
Other decisions to be made before breeding include: When do I want my mare to have her baby? Will she be bred by live-cover, or AI (artificial insemination)? Will I be using fresh semen, or frozen? Is my stallion trained to a phantom? How much am I willing to invest in making this baby? Where will the mare have her foal? Am I prepared to care for a pregnant mare/breeding stallion/newborn foal?
Our amazing doctors and staff are here to guide and help you every step of the way. Well, for the stallion collection I will be standing a safe distance away under the trees, but for everything else I like being up close and personal, especially the foaling.
Don’t forget that during the month of January we are offering $10 off a breeding package or stallion collection. Sign up now to save later! Also, I know I will see all of you next Tuesday 😉
-Tony
Click on the picture for more info.
Jan 3, 2017 | Injuries, Lacerations
Whenever a horse comes into the clinic with an injury, it reminds me how glad I am to be a cat. Horses don’t have nine lives like cats do, so you’d think that they would be a little more careful! They are also not as smart as cats, at least in my opinion. You are welcome to disagree, but I will point out that I’ve never scratched my eyelid off (knock on wood)!
I’ve been running the clinic here at Springhill Equine long enough to see some trends develop, and I thought that a good way to start the New Year would be to share some of my insights with you, my loyal fans. There are things that make all your horses unique, and then there are things that make them all similar. The similarities are what we’ll look at today.
Some things are preventable, and some things are not. For example, you can’t prevent your horse from rolling and jamming his foot through the fence; that’s just something that a lot of horses do. You also can’t prevent your horse from being a complete jerk, and getting kicked by one of his pasture mates as a result. Sometimes those things just happen, and we do our best to patch them up when they do.
Other injuries are a little more preventable. Horses are going to develop itches on a pretty regular basis, whether it’s on their eye, or ear, or chest. You can’t control the itch, but you can limit what they have to scratch it on. Things like barbed wire, old rusted-out car bodies, nails sticking out of posts and walls, broken gates with sharp edges, ancient farming implements, broken buckets, and all other sorts of things can be removed from the horse’s pasture, paddock, and stall. Even if the horse has been grazing around it for years without a problem, it only takes one instant in time to produce a dramatic injury. I see it all the time.
I’ve watched the docs sew a lot of eyelids back on, and remove a lot of them that couldn’t be salvaged. A lot of those come off while they were scratching on gate latches, metal feed/water bucket handles, nails, and barbed wire. I recommend doing an inspection of every space that your horse has access to at least once every few months. Things change, nails work their way out of boards, the horse sharpens the edges of things she scratches on constantly, they break a bucket or a board, and so on. Basically, if you wouldn’t want a two-year-old kid messing with it for safety reasons, you probably don’t want your horse messing with it, either.
Replacing that strand of barbed wire on the top of your fence with an electric wire is a really good idea. Barbed wire is a great thing for a horse to scratch on, and they will abuse it until it abuses them. New barbed wire is dangerous because that’s when it is the sharpest. Old barbed wire is dangerous because it’s rusty. The cost of replacing it? About the same as a weekend emergency visit from your veterinarian.
Speaking of fences, keeping your fence up and in good repair is another great way to prevent injuries. Some of the more serious injuries the docs see happen when the horse gets into a place that it’s not supposed to be. Remember Coby, the horse that managed to get inside the old horse trailer and then fell through the floor? He’s not the only one that’s managed to get into trouble. Just this past weekend, Dr. Lacher saw a horse that got through the fence and got her leg trapped in some stuff on the other side of it, and did some serious trauma to the muscle, nerves and veins. She’s going to be recovering in a stall for months as a result of it. It happens on a regular basis, and for most horse owners, it’s the first time something like that ever happened.
So, take my advice (it’s really good advice, as it’s coming from a cat): learn from the experiences of others. You don’t have to learn everything the hard way! Clean up your horse’s area, and inspect it on a regular basis. Don’t assume that it’s fine now because it was fine last year. Be proactive about safety, instead of reactive. As my grandcat always said: an ounce of prevention is worth a pound of cure!
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