Thursday, December 30, 2010
Wednesday, November 10, 2010
Friday, September 10, 2010
Strangles - Year After Year
Why do some ranches have to deal with strangles year after year? Some people would say that it is due to bad luck, bad management or too many horses. The real issue is understanding how strangles is maintained in a group of horses and how it can show up on a ranch for many years. Some people are unaware of how many different ways strangles can be transmitted. Many ranches have successfully cleared up this financially crippling headache.
Strangles is caused by the bacteria Streptococcus equi. Strangles can be spread by both direct and indirect transmission. Direct transmission is a result of nose or mouth contact. Indirect transmission is a result of contaminated drinking buckets, feed, stalls, bits, halters, people and many other objects. This may actually be the most common way it is spread. Due to its ubiquity, strangles can be spread through one’s entire barn or a horse show quickly. The first step to fighting the disease is being able to recognize the symptoms. The first clinical signs may be not eating well, fever or change in attitude. Other signs to watch for include nasal discharge, coughing, swelling/abscesses underneath the jaw or difficulty breathing. Not all horses will show the classic abscesses under the jaw. Upon seeing these signs, it is best to isolate the affected animals and contact your veterinarian for further diagnostics and treatments.
There are a couple of ways a farm can have a problem with strangles year after year. They bring sick horses onto their farm without proper isolation or they have horses that are shedding the bacteria without being sick. The horses that are showing no clinical signs of strangles but shedding strangles are usually the cause of repetitive outbreaks. These horses are harboring the bacteria in their guttural pouch (the horse’s inner ear) due to not clearing the infection completely. At ESMS, we are seeing more and more horses with this problem. These horses look, act and work normal but are the reason for the continued outbreak in young horses.
The way to resolve this problem is by screening all horses on the farm by either upper airway cultures or by scoping the upper airway and guttural pouches looking for purulent material (pus) in the guttural pouches. This will allow you to identify the horses that are shedding the bacteria and begin to resolve the problem. This is only the first step at fixing the problem but it gives you the necessary starting point. Other steps that will need to be taken are as follows: isolating affected animals, disinfecting everything that came in contact with that horse (especially water sources) and paying close attention to horses that were around infected horses.
This article only touches the surface of what to consider when strangles emerges but, hopefully it provides a little information on how you can help prevent the spread of strangles on your farm. by Dr. Skeet Gibson
Tuesday, August 24, 2010
Complementary Medicine
Complementary or alternative medicine is being increasingly used in conjunction with conventional western medicine in the human and veterinary fields. At Equine Sports Medicine & Surgery, we use chiropractic care and acupuncture with the western medicine you are familiar with to produce a desirable outcome in the health of your horse. It is a process of taking two different views of possible treatment plans for your horse and using the strengths and weaknesses of each one to our advantage.
Acupuncture in the horse began thousands of years ago in China. Valuable farm animals were treated using stone needles to acupoints transposed from human points. Today, Certified Veterinary Acupuncturists (CVA) use modern steel needles, transposed human points and ancient equine acupoints found in a few surviving texts. This combination allows the CVA a wide range of points to select for treatment using dry needle, electrical acupuncture or aqua puncture. Through modern research we now know that acupuncture works through the nervous system, endocrine system and the immune system to balance the body’s organ system to achieve wellness.
Modern chiropractic technique is purely an American invention. O. D. Palmer of Canada founded the Palmer School of Chiropractics in Iowa in 1897. In 1980, formal chiropractic training for veterinarians began with Sharon Willoughby, DVM, DC. Her program was based on human chiropractic technique, which later evolved into the American Veterinary Chiropractic Association. A true chiropractic adjustment is a precise, low amplitude, high velocity thrust with only the hands on a specific area of the spine.
Chiropractic and acupuncture can be used to treat musculoskeletal and neurologic disorders as well as internal medicine disorders. These treatment modalities are safe and effective when performed by a formally trained and certified veterinarian.
- by Dr. James Simpson
Wednesday, July 21, 2010
ESMS Virtual Tour
Come join Bob Tallman as he takes you on a tour of Equine Sports Medicine & Surgery in Weatherford, Texas. Meet a few of our doctors and get a glimpse of our facility and the services we have to offer. For more information, please visit our website: www.equinesportsmedicine.com.
To watch the video click HERE.
To watch the video click HERE.
Monday, July 12, 2010
Lameness Therapy in the 21st Century
Lameness therapy in the 21st Century
by Dr. Reese Hand
Dealing with lameness in the horse has been around for a long time. Historically, therapies have varied little. Medication types, uses, and frequency have changed but all traditional therapies are targeted at reducing pain and inflammation. Therapies for the 21st century are not only targeting pain and inflammation, but they are zeroing in on regenerating and primary healing.
Injuries to joints and tendons involving the lower limb accounts for upwards of 80% of the injuries most commonly dealt with in the horse. Due to the competitive level of the equine athlete today, when one gets injured the owner is not looking to simply heal the injury but to restore it to pre-injury status in order to be competitive. Today, two advanced therapies give injured horses the chance to restore to pre-injury status.
Stem cell therapy is the process of harvesting undifferentiated cells and injecting them into the area of injury. Although this process is much more complex, simply speaking they become the environment they are placed in and help restore injured tissue back to normal tissue by regeneration and minimize scar tissue which will limit function. Stem cells can be placed into all types of soft tissue and joints to help repair injured tissue. Reports of 76% healing of suspensory tears, 56% healing joint disease and 77% resolution in tendon injury are common. (Vet-Stem Inc.)
PRP (Platelet rich plasma) is also a forefront therapy to minimize scar tissue from traditional healing and maximize tissue healing and restoration. PRP is a process of concentrating the platelet cell from whole blood and injecting it into injured joints and soft tissue. Platelets contain growth factors which the body uses to heal injured tissue. Using PRP, growth factors are concentrated upwards of 150 times what the body would be able to send to injured tissue. This substantial increase is what leads to restoration and not just healing.
Whether your horse is the next futurity hopeful or just a friendly companion, if they are injured be assured therapy to heal has taken on a new look. We hope your horse never has the need for advanced therapy, but if it does, we are prepared to provide the most up-to-date and best care possible to restore your horse to pre-injury level.
Friday, June 18, 2010
Notes from The Doctor's Desk - June 18, 2010
Hyperbaric Oxygen Therapy for Horses
by Fairfield T. Bain, DVM, MBA
Diplomate, ACVIM, ACVP, ACVECC
Internist/Pathologist
Hyperbaric oxygen therapy is certainly not new, but it is relatively recent on the scene in equine medical care. It has a long history in human medicine – most widely known for its use in treatment of decompression sickness (aka “the bends”) for divers – more recently for a variety of medical conditions. Hyperbaric oxygen therapy is an FDA-approved medical therapy for certain conditions in human medicine.
Figure 1. Indications for hyperbaric oxygen therapy for humans (courtesy Duke University – http://hyperbaric.mc.duke.edu/indications.htm)
Air or gas embolism
Decompression illness
Carbon monoxide poisoning and smoke inhalation
Clostridial myonecrosis (gas gangrene)
Crush injury, compartment syndrome and other acute traumatic ischemias
Enhance healing in selected problem wounds
Exceptional blood loss or severe anemia
Necrotizing soft tissue infections (subcutaneous tissue, muscle, fascia)
Refractory osteomyelitis
Radiation tissue damage (osteoradionecrosis and soft tissue radionecrosis)
Compromised skin grafts and flaps
Our horse patients have many conditions similar to those on this list – especially wounds with poor blood supply, those with severe trauma to the skin and underlying tissue, or those with large skip flaps, soft tissue infections (ex. tendon sheath infections), and bone infections (osteomyelitis). We have treated a variety of other conditions including birth asphyxia, peripheral nerve injury (brachial plexus injury), intestinal injuries that compromise the blood supply (colon torsion and small intestinal strangulation), and spinal trauma.
So, how does hyperbaric oxygen therapy work? It works using the principles of gas under pressure. It is a mode of therapy in which the patient breathes 100% oxygen at pressures greater than normal atmospheric pressure. In the hyperbaric chamber, the animal is exposed to almost 100% oxygen under increasing pressure. Some physics lessons are needed to understand what is happening during HBOT treatments. At sea level, breathing air we are exposed to a pressure of 14.7 pounds per square inch (psi) or 760 millimeters of mercury (mmHg). The air we breathe is comprised of 79% nitrogen and 21% oxygen, meaning that it contains a pressure of approximately 160 mmHg of oxygen (21% x 760 mmHg). In hyperbaric medicine, pressure is measured in Atmospheres Absolute (ATA). At sea level, we are exposed to 1 ATA (“normal atmospheric pressure”). In diving, with each 33 feet (or 10 meters) of sea water, the pressure increases one atmosphere. Thus, at 33 feet of sea water (fsw), the absolute pressure is 2 ATA. At 66 feet of sea water, the absolute pressure is 3 ATA. This comparison to depths in sea water is important since these are the relative pressures that a patient is exposed to for clinical hyperbaric oxygen treatments. The critical feature of oxygen under pressure is that the amount that can be breathed into the lungs increases exponentially. Using 100% oxygen, at 2 ATA the animal is breathing in 2 atmospheres worth of 100% oxygen – or 760 mmHg x 2 = 1520 mmHg. At 3 ATA, the animal is breathing in 3 atmospheres worth of 100% oxygen – 760 mmHg x 3 = 2280 mmHg – an incredible 14 times the amount one would breathe in room air at sea level. In medical applications of hyperbaric oxygen therapy, 3 ATA is the maximal pressure that a patient would be treated (due to the increased risk of oxygen toxicity seizures at that concentration of oxygen) with most treatments being between 2 to 2.5 ATA. This high concentration of inspired oxygen has several valuable effects in the body: it causes constriction of blood vessels – reducing swelling, it stimulates tissue healing – increasing cell division in the endothelial cells that line blood capillaries, increasing division in fibroblasts – the cells that make collagen in a variety of tissues. The importance of the effect on blood vessels is that new capillary blood vessel growth is critical in tissue healing in a variety of injuries and increases the body’s ability to deliver antibiotics into areas that previously had poor blood supply. Hyperbaric oxygen also reduces inflammation and may have immune-stimulating effects. It also has been shown to enhance the effects of certain antibiotics – especially those that do not work well in low oxygen environments (especially the aminoglycoside family of antibiotics such as amikacin and gentocin) known to occur in severely infected tissues. Much of the basic research showing these effects has actually been performed in animal models of human disease, and now, we are able to use this information for our horse patients.
What happens when the horse enters the hyperbaric chamber? For the first one or two treatments, the animal may need sedation for the new experience. It is not really any different than riding in a horse trailer or van. The most commonly available equine chamber is an open room design that allows the horse the comfort factor of being able to move around, thus being more relaxed. The technician constantly monitors the horse using a series of video monitors from different perspectives. The pressure is gradually increased – delivering oxygen into the floor of the chamber and gradually removing the air through the roof over several cycles. After about 15 minutes, the treatment pressure (usually 2.0 – 2.5 ATA) and maximal oxygen concentration (usually around 94%) is reached. The total time in the chamber varies from 45 to 60 minutes. The treatment protocols – time of treatment, maximal pressure, and number of treatments depend upon the condition being treated. We have tried to follow the experience in the animal models and in human medicine for our horse patients. In general, a horse might receive up to 10-12 treatments for a bone infection.
Another issue worth considering is the response of the horse patient to pressure. Horses have guttural pouches – a distensible air pouch within the auditory tube. The openings readily open on swallowing and apparently allow ease in equalization of pressure. While disorders of the sinuses or guttural pouches could create an air-trapping scenario, this rarely seems to be the case in the horse patient.
As you might expect, these chambers are large structures and require an environmentally-controlled building to house them. Most chambers operate using liquid oxygen as it is the most cost-effective supply.
One important thing to understand is that hyperbaric oxygen therapy is a supportive or adjunctive treatment. The condition is still being managed with other medical treatments – such as appropriate antibiotics for a bone or tendon sheath infection. Hyperbaric oxygen therapy should be viewed as something to enhance tissue healing. Our goal is to shorten the recovery time in injuries and illnesses – the result being improved survival rates for devastating illnesses like colon torsions, and less time in the hospital overall.
For those interested in more information and training in hyperbaric medicine, the following resources are available:
Veterinary Hyperbaric Medicine Society - http://www.vet.utk.edu/vhms/
The Veterinary Hyperbaric Medicine Society is a recently formed organization to foster communication between facilities and to collate information specific to veterinary applications of hyperbaric oxygen therapy.
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