Equine Facilities

The practice  has  the space,   facilities  and equipment   which one  would expect in a substantial equine  veterinary practice.   A  brief mention of  the most used  equipment follows.
Radiography.    Most importantly there are  x- ray machines which are safe and powerful enough to take good quality radiographs  of the  limbs and head of a horse.  There is  additionally a portable machine which can be used for emergencies or for non-moving laminitic ponies.  However it is more convenient to take radiographs at the surgery.   The automatic x-ray  processor quickly enables us to see if the pictures we have are good enough for diagnostic purposes or referral,   or whether they need repeating while the horse is still available at the surgery.

Endoscopy.   A selection of  flexible fibre optic endoscopes enable us to look at the respiratory system and guttural pouches  of the horses  when  there is, for example,  noisy breathing or an unexplained persistent nasal discharge.   

Electrocardiography:   An ECG  machine is available for use as part of  a  further investigation  of  hearts where an abnormality has  first  been  heard with a stethoscope.   

Laboratory.      Laboratory equipment on-site  includes  computerised   ABC haematology, Vetlyte electrolyte  and both Synermed and Vettest biochemical analysers. The Synermed biochemical analyser is fully computerised, very accurate and one of around twenty installed in the UK.     Having this  equipment  immediately to hand is very useful,   as  it enables   blood  samples  to  be examined  the  day they are taken,    so that a diagnosis can be confirmed sooner.  The examination of  fresh blood samples  enables   more accurate and  meaningful results  to be obtained.   For cases of  involving blood loss, or after surgery it is possible to repeat blood counts as often as necessary to assess improvement or the need for more fluid administration.  

The laboratory also performs worm egg counts on  dung samples.  The results can be used in different ways – to assist in the reduction of unnecessary  anthelmintic treatments, to confirm that anthelmintic treatment has been successful (or not), or to confirm that anthelmintic treatment is again necessary.     Samples of hair are   examined microscopically  and  also  cultured  for fungal (ringworm) infections; and  also examined for mange mites and lice.            

Despite the extensive laboratory facilities, some samples are still sent to outside laboratories for example for serum protein electrophoresis which is used as an aid to the diagnosis of worm problems; and for the Tapeworm ELISA test.

Ultrasonography.    An ultrasound scanner is used for the early detection of pregnancy, and twins; and also for assessing amongst other things   the severity of damage  to sprained   tendons and ligaments. This latter can help in identifying the need for  treatments  other then a period of rest. 

Electrocardiography.   ECG machines are one way of  investigating further any suspected  heart problems which have been originally identified by the use of the stethoscope.

Local  &  Joint Analgesia.   One of the particular interests of the practice is the investigation of lower limb lameness.   As over 95% of equine lameness problems  involve the knee (carpal joint)  and the structures below,  lameness investigations commence with  nerve blocks of the lowest parts of the affected  limb.   The process works upwards until the horse is sound – the area containing the painful tissue has been localised. Between injections of local anaesthetic either around the digital nerves or into the joints of the lower limb, or both,  the horse is trotted on the generous trotting area, or lunged either  on grass, or on concrete if the lameness is very subtle.  

Opthalmascopes. Opthalmoscopes are routinely  used to examine the eyes of horses at pre-purchase examinations and insurance examinations.  Cataracts and ocular tumours do occur, but fortunately not commonly.  The commonest abnormalities of the horses’ eyes found are possibly the changes within the eye associated with  the uveitis  of  ‘periodic opthalmia’.

Laparoscopy.   Although one generally thinks of  endoscopy in the context of examining the upper respiratory system with flexible endoscopes,  it is also possible to use rigid endoscopes for examination of the abdominal contents.   This can be a useful diagnostic tool in colic cases; and sometimes enable surgery to be  commenced much earlier. Arthroscopy is another use for  a rigid endoscope. The cartilage of the joint can be examined, and damage such as ulcers and tearing identified. It may be possible to remove small pieces of damaged cartilage via the small hole made by the rigid endoscope
What Surgical  and Treatment Facilities Can They Offer?
 

Cryo-Surgery. Cyro-surgery with Liquid Nitrogen.     Sarcoid removal is an interest of the practice.     Many  skin  growths   are  treated by cryo- surgery, that is frozen   with   liquid nitrogen.      The latter is  applied to the affected  areas either by  spray or by contact with a frozen probe.  Some lumps  are surgically reduced and then sprayed.  Due to  the large  number of sarcoids treated  by the practice,  liquid nitrogen is almost constantly available despite the need for the  specialised storage system required to prevent  the gas  from  escaping.      Sarcoid removal or reduction,  although  frequently very time consuming, is  generally performed on the sedated horse whilst  it is still standing.   General anaesthesia is used if the sarcoids are  very numerous,  difficult to access,  deeply rooted or  close to valuable structures such as large blood vessels and nerves. 

Advanced Dental Care.      Several members of the practice have attended advanced equine dentistry courses  and worked with equine dental specialists from both France and the USA.  There is a selection  of   both  manual  dental instruments for removing teeth;   and electrical  rotary rasps and grinding tools from France, Switzerland and  the USA.   These  specialised  tools, along with the  selection of mouth openers (gags),  and the use of sedation,   enable our veterinarians to reach the parts which most equine dental technicians  cannot reach,  and extract  damaged or infected teeth.

General Anaesthesia.   A general anaesthetic enables longer  and more invasive procedures to be performed than would be possible using just sedation and local anaesthetic.   It  has never been easy to anaesthetise horses  safely.     Modern techniques for the  anaesthesia of horses  demand special facilities.  The  practice has a   fully  padded anaesthetic box,   which reduces the chances of the horses  injuring themselves.    The rubber covered floor and walls  enable  the horses, after receiving their injections,  to fall  but have a  fairly soft landing.
  
During surgery,   anaesthesia is maintained  via the  LANA  circle anaesthetic machine. This  machine works by  allowing the horse to breath a carefully controlled and measured mixture of oxygen and an anaesthetic gas,   such as Halothane or Isothane.   The mixture reaches the lungs of the horse through a  large  (endo-tracheal)  tube,  which connects the horse’s windpipe to the anaesthetic machine.     Oxygen is provided for the LANA anaesthetic machine  through the  in- built piped system (a series of narrow pipes running at ceiling level through the building)   from the remotely situated cylinders.    The absence of oxygen cylinders from the operating theatre makes for a cleaner environment.  When the horse breathes out   the  gases  expired by the horse  are ‘scavenged’ (sucked into tubes)  by an in-built  suction system,  and the gases are  taken to the outside of the building and released into the atmosphere.    This removal of the anaesthetic gases  helps to keep our staff   safe  -  and awake. 

Anaesthetic monitoring equipment is available to the veterinary surgeon whose responsibility it is to maintain the anaesthetic.   Various large  and  small  electronic   boxes  count the respiration rate,  the pulse rate; show an ECG  trace,  and also show the blood pressure and   the amount of oxygen and carbon dioxide   in the blood.   All of these parameters are recorded by the anaesthetist  on special recording sheets,  so that there is a permanent record of events. The practice also  has a portable biochemical analyser which can be used in theatre to assist in monitoring the horses’  fluid and electrolyte levels and likely requirements. 
The  recently  completed  air-conditioned   equine  operating theatre is lined with easily cleaned plastic and  a non- slip floor.    The lighting has an in-built emergency lighting system in case of power cuts.  The  Haico  operating table was imported from Scandinavia; and came highly recommended by several well known referral centres in the UK.     Horses are delivered to the  operating table,   from the anaesthetic box,  via an electric hoist which lifts  the patient,  and travels  with the patient, along a rail.