Equine Hospital Newsletter

Transcription

1 Equine Hospital Newsletter Spring/Summer 2012 Volume 5, Edition 1 Index Welcome...2 A Look Behind the Scenes...3 Second Chances...4 Wish List...5 Hoof Notes...6 Client Frequently Asked Questions...8 For appointments, call (970) , Mon.-Fri. 8 a.m. - 5 p.m. For off-hour emergencies, call (970) An equal access/ equal opportunity University The ESM Group Dr. C. Wayne McIlwraith, BVSc, PhD, DSc, FRCVS, Diplomate ACVS and ACVSMR Dr. Chris Kawcak, DVM, PhD, Diplomate ACVS and ACVSMR Dr. David Frisbie, DVM, PhD, Diplomate ACVS and ACVSMR Dr. Kevin Haussler, DVM, DC, PhD, Diplomate ACVSMR Dr. Melissa King, DVM, PhD Current veterinary residents: Dr. Dora Ferris, DVM Dr. Erin Contino, DVM Equine Sports Medicine Service Delivering Injury Treatment and Rehabilitation Getting back in the game following an injury is often the primary focus for human and equine athletes alike. So when the new ambulatory Equine Sports Medicine service at the Colorado State University Veterinary Teaching Hospital can return an injured equine athlete to full performance, it is the ultimate reward. The goal of this sports medicine specialty is not only to treat the primary injury but also to provide restoration and rehabilitation for the entire horse. As the VTH receives calls regarding pre-purchase exams, complicated or multilimb lameness exams, or the development of injury rehabilitation protocols, it literally sets the wheels in motion for the ESM team of specialists. This mobile service delivers sports medicine expertise to clients doorsteps throughout the state of Colorado. From Craig, to Carbondale, to Cortez, and even occasionally beyond state borders (to New Mexico this July for the National Junior High School Rodeo Finals), ESM offers equine clients state-of-the-art diagnostics and treatment for musculoskeletal, respiratory, cardiovascular, endocrine, and medical issues. On the road, the team s truck is loaded with equipment for lameness and follow-up exams, digital radiography, digital ultrasound, extracorporeal shockwave therapy, laser therapy, joint injections, therapeutic management of back pain, and for performing regenerative joint therapies (IRAP, PRP, and bone marrow-derived stem cells). An additional component of ESM is located at the CSU Orthopaedic Research Center, where equine patients receive aquatic therapy by exercising in the underwater treadmill. A Complete Relationship The ESM service opened for business in 2011 to provide equine athletes outside the hospital the same world-class care that they receive in-house, and is the result of a collaborative effort between the CSU ORC faculty and the VTH. The ESM s objective is to support the equine athlete throughout its life by offering the latest therapeutic, diagnostic, and rehabilitative techniques from birth, through adolescence, competition, injury, rehabilitation, and retirement. Maintaining this relationship and rehabilitating a patient translates into developing global treatment for the whole horse. And to formulate such a plan, the ESM team considers other factors, such as compensatory soreness and additional areas of weakness. The ESM clinicians also work with the horse s primary clinician in developing treatment or rehabilitation strategies, and can refer additional treatments for acupuncture and chiropractic to local practitioners. When advanced techniques are needed such as surgery or advanced imaging the horse can be referred to the CSU VTH or a facility of the client s choice. Pioneers in Equine Sports Medicine The American Board of Veterinary Specialties recently recognized the need to establish a sports medicine specialty (continued on Page 2)

2 Welcome Dear Friends, Clients, and Colleagues, Welcome to the spring/summer edition of the Equine Hospital Newsletter. As always, spring is a busy time of year for the Equine Hospital with colics, sick foals, and lame horses to keep us busy. We have also updated several things in order to maximize client service in the face of a busy caseload. You will notice when you arrive that there have been significant changes at the front desk. Sally and Celeste have reorganized client care, which we feel will improve the client experience at the hospital. Along with the high standard of care that occurs in the hospital, we intend to improve the standard of client care through the process. You will see from this newsletter that we have a new sports medicine program that has already enhanced the care of equine athletes. In addition, we have revamped the ambulatory service in order to expand offerings to our clients. We are excited to be moving into a new era in the College of Veterinary Medicine and Biomedical Sciences at CSU. We have had significant changes in leadership, the most prominent of which is the arrival of our new dean in July. The Equine Hospital plans on working closely with the new dean, who we anticipate will provide new and exciting insights in client care. As always, we appreciate the confidence you have in us to take care of you and your animals. If at any time you have questions or concerns, please feel free to contact us. Regards, Chris Kawcak Sports Medicine, continued from Page 1 designed to focus on keeping the equine athlete healthy. The CSU ESM service is one of the founding programs to be accepted in the American College of Veterinary Sports Medicine and Rehabilitation. Four faculty members of the ORC are charter members of the ACVSMR, including Dr. C. Wayne McIlwraith, Dr. Chris Kawcak, Dr. David Frisbie, and Dr. Kevin Haussler. They started the CSU ESM service to provide veterinary residents with the experience necessary to fulfill the requirements for board certification. The ESM staff includes the four ORC faculty members, one technician, and two residents. Dr. Kawcak manages the service, and Dr. Melissa King is the primary clinician. Dr. King has more than 11 years of experience in private practice, and holds a PhD in equine sports medicine and A Day in the Life of the ESM Staff The first patient of the day is Ajax, who arrives bright and early at the Orthopaedic Research Center. Ajax has been undergoing aquatic therapy daily to rehabilitate his stifle. He has problems with upward fixation of his patellas ( locking stifles ), and underwater treadmill exercise helps strengthen his muscles to overcome the locking in an environment that doesn t cause additional stress on the joint. Then the ESM truck heads out for appointments, starting with a longstanding patient that recently suffered a severe hind limb suspensory injury. He is on stall rest with hand walking, and his lesion was initially treated with shockwave therapy and an injection of bone marrow-derived stem cells. Today, his leg is treated with a regional limb perfusion of stem cells, a new procedure that has shown clinically to have positive results of healing tissues and decreasing lameness. After four more weeks of hand walking, this patient will start a regimen of increasing work and exercises to promote core strength and balance. The next stop is a barn with several horses. Cole is a new patient that has been mildly lame for six months, despite rehabilitation. She is one of only a handful of clinicians in the world to have expertise in equine rehabilitation. ESM not only provides its clients and patients with the latest techniques, but it also offers an exciting learning opportunity for veterinary students who have the option of working with ESM as a student rotation. Veterinary residents enrolled in this recently developed specialty training program can experience the challenges and rewards of practicing sports medicine in a practical setting, while adhering to the strict guidelines of the newly established American College of Veterinary Sports Medicine and Rehabilitation. For more information or to schedule an appointment, call the ESM Client Care Coordinator, Amanda Mills, at (970) joint injections and rest. Today is his first visit with ESM, and his lameness will be worked up with diagnostic blocks, radiographs, and ultrasound, and he will be examined for compensatory lameness issues to determine if other soreness or pain is contributing to his continued lameness. Mason has had severe back pain for several years. The source of the pain was diagnosed with a bone scan, and he has been treated with muscle relaxers, acupuncture, heat, and chiropractic. Most recently, he has responded very well to laser therapy and injections in the painful areas in his back. The day s final appointment is with a client and her farrier to take radiographs of Gem s feet. Gem has had a negative palmar angle of the coffin bone (usually seen in horses with low heels), which caused a hyperextended coffin joint and pastern joint. This conformation dramatically increases the pressure of the deep digital flexor tendon on the navicular bone and may result in significant lameness. Radiographs after the last two shoeing resets show that her angles are improving; she may need only one more set of radiographs to confirm that her foot alignment is returning to normal. 2

3 A Look Behind the Scenes: Radiology Nothing can make a horse owner s heart sink faster than a step of lameness at the start of the show season, or a sudden ailment when a horse just isn t right. These are the moments when horse owners wish their horses could talk. Yet, even if these horses could identify where it hurts, diagnosing the problem often requires a look below the surface to discover the cause of the pain. And with the right combination of equipment, diagnosis, and care, horse owners have a better chance of getting their horses back on the road to healing and their normal, active lives. A Team at the Forefront of Technology At Colorado State University s Veterinary Teaching Hospital, equine clients receive the benefit of the best diagnostic capabilities in the industry today. This technology includes digital radiography (X-ray), ultrasound, nuclear scintigraphy (nuclear scan), computed tomography (CT scan), and magnetic resonance imaging (MRI). Many of these imaging modalities are of the same caliber as the technology used in human hospitals. Yet, perhaps even more important than access to this state-of-the-art equipment is the team of highly trained professionals within the CSU Radiology Section who are interpreting the results. The Radiology Section is where you can find Drs. Alex Valdés-Martínez, DVM, DACVR; and Myra Barrett, DVM, MS, DACVR. They re the dedicated equine radiologists, and two of a team of six boardcertified radiologists and four veterinary residents-in-training for board certification, who interpret the imaging results, and work collaboratively with CSU equine clinicians, residents, and referring veterinarians (rdvms) to accurately diagnose and set a course toward healing for your horse. While many clients typically don t have the opportunity to meet Drs. Valdés-Martínez and Barrett, or the other members of the Radiology Section, they are an essential part of your medical team. It s only when we accurately understand what is causing the problem that we can begin to suggest treatments that will lead to healing, notes Dr. Valdés-Martínez. Our job as radiologists is to use imaging modalities to look beneath the surface of the horse and find the anatomical explanation of how the horse is presenting. Radiology Team CSU Radiology Faculty with board certification by the American College of Veterinary Radiology. Richard Park (section head) Alex Valdés-Martínez Myra Barrett Angela Marolf Elissa Randall Susan Kraft The Perfect Partnership for the Right Diagnosis Horses, like humans, aren t perfect. All horses have anatomical abnormalities, but these findings don t necessarily explain the root cause of the problem, and can make problems easy to misdiagnose. Getting the right diagnosis requires an expert with a high degree of experience to perform the exam and accurately capture and interpret images of the potentially injured site. Without proper training, it can be easy to misinterpret images, especially with ultrasound. It has the highest degree of error. If the examiner doesn t properly position the probe, it can appear as if there is a lesion where there isn t one and vice versa, explains Dr. Valdés-Martínez. And nothing can be more frustrating for a horse owner as the wrong course of treatment. It is precisely this careful partnership between the veterinarians in the clinic, with Imaging Capabilities their eyes and hands on the horse s body, and the veterinary radiologist, who is an expert in reading and interpreting the imaging results, that leads to the best chance your horse has Dr. Valdés-Martínez for a complete recovery. And no other veterinary hospital in the area has the depth of this collaborative expertise. Identifying with the Equine Athlete Although not a self-described horse person (Dr. Valdés-Martínez didn t grow up with horses or even really have them on his radar until veterinary school), horses became a personal and professional focus in the late 1990s when he began to treat competitive show jumpers in private practice in his native country of Mexico, and then later in San Diego, Calif. As a seasoned athlete with a passion for baseball, soccer, swimming, tennis, and mountain biking (to name a few), Dr. Valdés-Martínez understood the strain that the pursuit of physical perfection places on the body, especially joints and tendons. He saw a piece of himself in equine athletes that (continued on Page 7) Digital Radiography: Provides excellent detail of bony structures. Digital technology enables immediate views, the ability to retake images, and to transmit images electronically to rdvms. Available in the VTH and/or with CSU s Equine Field Service and Equine Sports Medicine Service. Ultrasound: Offers excellent views of soft-tissue structures. As an operatordependent modality with the widest margin of error, the technique of examiner is of key importance. Images are also digitally rendered. This service is available at the VTH and/or with the Equine Field Service and Equine Sports Medicine Service. Nuclear Scintigraphy: Used for diagnosing musculoskeletal lesions. This technology detects early changes in bone metabolism to reveal the injured site. The entire horse can be imaged at one time during a standing, sedated procedure. MRI: Provides high-resolution multiplanar images of limbs up to carpus and hock. Horse must be anesthetized for this procedure. CT: Provides high-resolution, multiplanar and three-dimensional images of limbs up to stifle as well as head and neck. Horse must be anesthetized for this procedure. 3

4 4 Second Chances Every horse deserves a good partner and every rider deserves a horse that will match their needs and inspire their dreams, says Barbara Mason of Equine Partner Network Inc. based in Cheyenne, Wyo. We ve devoted our lives to making that happen. Barb and her husband, Larry, aren t a rescue operation. They are horse lovers who believe that every horse deserves a second chance. Along with their regular veterinarian, Judy Merriott, DVM, Barb and Larry depend on the Colorado State University Veterinary Teaching Hospital to help them deliver that chance to as many horses as they can. Many of the horses we get are in desperate need of good veterinary care, says Larry. We couldn t do what we do without Colorado State. Dermot, a 2002 registered Paint, is just one recent example. Barb and Larry purchased Dermot from the Colorado Horse Auction in the spring of It wasn t exactly love at first sight, says Barb. There was just something about him. Then, when he loaded himself into the trailer, we knew we made the right pick, adds Larry. Quiet and reserved at first, Dermot blossomed under their care. In training for dressage, Dermot seemed to excel at everything. He just loved his work, says Barb. Suddenly, everything changed. Dermot went off his food. His personality shifted from eager and friendly to listless and depressed. Barb quickly called Dr. Merriott. We didn t even have a chance to get back to the farm. Judy loaded him into a trailer and told us to meet her at CSU. Blood tests indicated that Dermot had high levels of BUN and creatinine, both toxins that would normally be filtered out by his kidneys. From the blood tests, urinalysis, and his clinical presentation, it was clear that Dermot was suffering from damage to his kidneys, says Dr. Gabrielle Landolt, CSU equine veterinarian, board-certified in Equine Internal Medicine. While straightforward to diagnose kidney problems with a blood chemistry panel, the causes of kidney disease can be challenging to pinpoint. The most common cause of acute kidney damage is improper use of nonsteroidal anti-inflammatory drugs such as phenylbutazone (bute) or flunixin meglumine (banamine). This was not the case in Dermot s situation. It s critical for owners to consult their veterinarians before using these medications, cautions Dr. Landolt. Especially in the case of horses suffering from dehydration. Nonsteroidals, such as bute and banamine, can add insult to injury and have severe complications for horses, including kidney failure and/or death. Regardless, with any indications of kidney distress, such as difficulty urinating, dehydration, or colic symptoms, it s important to get help. We were 30 minutes from putting him down, recalls Barb. But then Dr. Landolt and Dr. Merriott together told us that Dermot had a chance. People often hear kidney disease and think it s a death sentence, adds Dr. Landolt. But if you catch it early, especially in the midst of acute damage, kidneys actually have a good chance of regenerating lost cells. Medically, our job is to support these horses with IV fluids, electrolytes, and nutrition to buy their kidneys the time needed to heal. In Dermot s case, he was simply too good a patient not to give him a chance. The ultrasound also indicated that the damage was not past healing if Dermot could be properly supported. Immediately, Dermot was admitted to the hospital and given IV fluids and heavy loads of electrolytes, and started on a low-protein, low-calcium diet, aimed at getting him back on his food without taxing his kidneys. It was really hard to visit him with all the IVs hanging and the catheter in his neck, recalls Barb. But everyone was so supportive and positive, the students and nurses especially. We knew he was getting the best possible care. Finally, after nine grueling days, Dermot was released from the hospital. After more than a year of rehabilitation, remaining on his special diet of grass hay, simple low-protein grain, and a salt lick to encourage lots of self-hydration as well as plenty of rest, Dermot was back. He was ready to work again, says Barb. He would gallop up to the fence every time I came to the barn. Soon after, Lisa Esqueda and Dermot Barb and Larry began the task to find Dermot his next home. Today, Dermot resides with Lisa Esqueda in Michigan, where you can find them preparing for a full circuit of shows with the Tri-County Horse Association. From this experience with Dermot and with our other horses, says Barb, we would not live more than 75 miles from a veterinary teaching hospital. We plan where we can live around this rule. It s the depth of knowledge, says Larry. You pay for one doctor, but you have 12 looking at your horse. It s really incredible that we have all these world-class experts right here. We also love working with the students, says Barb. It s great to know that we are helping the next generation of vets who will treat our horses. Barb and Larry hire CSU veterinary students to ride and care for their horses as a means to help students with the expenses of veterinary school, which can top $100,000 by the time they graduate. As for Dermot, the chance Barb and Larry, Dr. Merriott and the CSU team took to cure him has more than worked out. I believe Dermot came into my life by divine intervention, says his new rider, Lisa. How else would I be so lucky to have the opportunity to share my life with him? Barb and Larry Mason are the founders of Equine Partner Network Inc. In addition to partnering horses and riders, they offer educational seminars on many topics.

5 Colorado State University The Equine Hospital Gifts to the Equine Hospital at Colorado State University s Veterinary Teaching Hospital are used to support clinical care through equipment purchases, enhance the Professional Veterinary Medical Program for our students, provide funding for clinical research programs, and provide discretionary funds to the Equine Hospital section head that are used where most needed. If you would like to make a donation in support of the Equine Hospital s needs and goals, please complete the form below and return with your gift. If you have any questions on making a donation to the Equine Hospital, please contact Judea Franck, Associate Director of Development for the College of Veterinary Medicine and Biomedical Sciences, at judea.franck@colostate.edu or at (970) Online giving also is available at cvmbs* Enclosed is my/our check for a gift of $ q My contribution is in memory of: (Payable to Colorado State University Foundation Equine Hospital) This gift is from: q me q my spouse and me q my partner and me Name q Please charge this gift in the amount of $ to my/our: q Visa q MasterCard q American Express Spouse s/partner s Full Name Address Print name as it appears on your card. City State ZIP / (mm/yy) Card Number Exp. Date Home Phone ( ) q Home q Work Signature Security Code q A matching gift form is enclosed. Please apply this gift to: q Advances in Equine Health Fund # q Equine Medicine Clinic Services and Research Fund #53943 Please return this form with your gift to: Colorado State University Veterinary Teaching Hospital, c/o CSU Foundation, P.O. Box 1870, Fort Collins, Colorado The Campaign for Colorado State University 57383/V1217 Wish List for the Equine Hospital This list contains items, both large and small, that will enhance our ability to provide quality care for our equine patients. If you are interested in donating to help fund any of these items, please contact Judea Franck, associate director of development for the College of Veterinary Medicine and Biomedical Sciences, at (970) , or at judea.franck@colostate.edu. Carbon Dioxide Laser Function: This laser is used for surgery and is beneficial because it causes the patient to experience less bleeding and pain. It also reduces the risk of infection and allows for a quicker recovery. Estimated cost: $55,000 Colic Care Fund Function: This emerging fund is the vision of one of our clinicians. The goal is to assist clients who need financial help for their companion s colic surgery. This surgery can provide a positive outcome for a horse that needs this emergency, lifesaving procedure. Estimated cost: Any amount is accepted. Dynamic Respiratory Endoscope Function: To evaluate the upper respiratory tract in horses while they are working, without the need for a treadmill. This tool allows us to evaluate a horse when it s under saddle or harness. Estimated cost: $65,000 Electronic Brachytherapy Function: A form of radiation therapy that can be used to treat both superficial tumors and tumors in difficult to reach regions (e.g., the sinus, eye). It s safer, more portable (it can be used outside the VTH), and offers lower equipment and treatment costs than some other methods. Estimated cost: $150,000 Equine Patient Warmer Function: Keeps a patient s body temperature stable during surgery. Estimated cost: $1,500 Impulse Oscillometer Function: To evaluate respiratory function. Estimated cost: $12,000 Support a Clinical Research Project Function: To support a clinical study performed by a current veterinary student or resident. Estimated cost: Any amount is accepted. 5

6 Dr. Mark Stetter Dr. Mark Stetter becomes dean of the College of Veterinary Medicine and Biomedical Sciences in July. He has more than 23 years of experience in veterinary medicine, and joins Dr. Mark Stetter Colorado State University from the Walt Disney Co., where he was director of animal operations. Dr. Stetter replaces Dr. Lance Perryman, who will complete his tenure as dean in July. Dr. Perryman has been dean of the college since October To read more about Dr. Stetter, visit homepage_cvmbs/news newdean-stetter-mark.aspx. In 2007, he moved to Iowa and was part of a large-animal practice for three years. In 2009, Dr. Miller and his family moved back to Colorado, where he practiced general equine medicine and also specialized in equine reproduction and embryo transfer. Dr. Miller joined the Equine Field Service team in December He brings growth and opportunity to this program, and is looking forward to serving patients and the community. Celeste Cannon Celeste Cannon is a new face behind the largeanimal reception desk. Her love of horses started at a young age when she participated in the Westernaires. She followed Celeste Cannon this passion and graduated from CSU with a bachelor s degree in equine sciences, and also attended veterinary technician school at Front Range Community College. Her experience includes working as a horse trainer, as a technician for a large-animal veterinarian, and as a small-animal technician, before finding this wonderful position in large-animal reception at CSU. In her spare time, she enjoys mountain and road biking, and spending time with her cats and her fabulous fiancé, Troy. 6 Dr. Brian Miller, DVM The Equine Field Service program is excited to have Dr. Brian Miller as its new ambulatory clinician and program coordinator. Dr. Miller received a BS in animal science from CSU, an MS in Dr. Brian Miller reproduction physiology from Kansas State University, and graduated with a DVM from CSU in Following graduation, Dr. Miller completed an internship in Equine Field Service at CSU. After his internship, he started an ambulatory equine practice in Northern Colorado. During that time, Dr. Miller worked at Texas A&M to receive advanced training in stallion fertility. Kris Perry Kris Perry, CVT, VTS (Equine Veterinary Nursing) Kris Perry is one of the equine critical care nurses at the VTH. In December 2011, she completed the course work necessary to earn certification through the American Association of Equine Veterinary Technicians and Assistants AEVNT Equine Certification Program. She is now one of 12 new Academy Specialized Equine Nurses in the nation. Her specialty is Vet Tech-Equine Veterinary Nursing. Equine Symposium Raises Money for ERL The Student Chapter of the American Association of Equine Practitioners hosted a very successful Equine Symposium March 24 and 25 at the Veterinary Teaching Hospital. Sponsors included Boehringer Ingelheim, Arthrodynamic Technologies, Pfizer Animal Health, Platinum Perfor- Front row: Madison Cloninger, Carey L. Beacom, Marianne Marshall, Lauren Luedke, Samantha Delbecq, Courtney Doddman; Back row: Dr. Patrick McCue, Dr. Ryan Ferris

7 Hoof Notes, continued from Page 6 mance, Merial, Sound-Eklin, and Arenus. The weekend event provided students and veterinarians with both a continuing education opportunity and the chance to network. For this inaugural year, the event served as a fundraiser for the CSU Equine Reproduction Laboratory rebuilding fund. The SCAAEP plans to donate $5,000 to purchase monitors and a computer for the student workspace at the ERL. The group plans to host another event in March csuequinesymposium@gmail.com for more information. Resident Updates Dr. Alexander Daniel, Surgical Resident Dr. Alexander Daniel recently joined the team at CSU for a three-year surgical residency program. After graduating from the Royal Veterinary College, London, Dr. Daniel spent four Dr. Alexander Daniel years working in a private practice equine referral hospital in California. There, he developed an interest in advanced imaging and has published two papers on MRI of the equine limb. At CSU, Dr. Daniel is continuing his research into the benefits of MRI in horses, and also has a strong interest in alternate biological therapies such as stem cells. Outside of work, he enjoys all forms of exercise and has been preparing for several obstacle course style runs later this year to raise money for breast cancer research. Dr. Jennifer Hatzel, Equine Theriogenology Resident Dr. Jennifer Hatzel received her DVM from Western University of Health Sciences in California; and completed an internship at Peterson and Smith Equine Hospital in Florida, and a specialty fellowship in 2009 in Neonatal Intensive Care at Hagyard, Davidson, and McGee Equine Hospital in Kentucky. She then pursued an MS at the College of Veterinary Medicine at the University of Florida, where she studied equine theriogenology. She has been at CSU s ERL since June Her research is focused on evaluation of heat shock protein 10 as the early pregnancy factor in mares. She and her husband, Jeremiah, have two dogs (Sedona and Satchel), a kitty (Sphinx), and her longtime equine companion, Winchester. Research Projects Equine Herpesvirus Type 1 Drs. Gabrielle Landolt and Gisela Hussey are conducting a new research study to unlock how equine herpesvirus type 1 hides from the horse s immune response, causing neurological damage and death. This project will investigate the effect of equine herpesvirus type 1 on the immune system, focusing on the lining of the respiratory system. If we can crack the equine herpesvirus secret to getting through that gateway and compromising the immune system at that Behind the Scenes, continued from Page 3 experience painful muscle tears, tendon and ligament issues, joint disease, etc. Greatly enjoying the atmosphere of the horse world, Dr. Valdés-Martínez went to work at the San Luis Rey Equine Hospital a highly regarded equine hospital in California and Louisiana State University to advance his equine veterinary skills. He then completed his radiology residency at the University of Pennsylvania and received his board certification from the American College of Veterinary Radiologists in He joined the faculty at CSU that fall, and continues to serve as an expert for equine cases, teaching students and residents the art and science of interpreting images, and performing radiological exams. It s a personal interest for me to help diagnose and treat these equine athletes and to see them return to competition, notes Dr. Valdés-Martínez. And it s especially rewarding to work at CSU, where we have access to the best equipment and colleagues with a depth of knowledge and experience. Dr. Valdés-Martínez and other members of the radiology department often combine imaging modalities to make an accurate diagnosis, especially in cases when the cause of pain and lameness proves difficult to pinpoint. Radiographs provide excellent detail of bony structures and ultrasound provides a detailed view of softtissue architecture, and sometimes these images are enough to understand the injury. Yet, the three-dimensional images captured by CT and MRI, or the nuclear scan, which point of entry, we may be better able to find treatments and preventive measures to stop the outbreaks of the virus, said Dr. Landolt. Clinical Trial: The Effectiveness of a New Anti-Inflammatory Agent on Clinical Characteristics of Horses with Severe Gastrointestinal Disease Dr. Diana Hassel is conducting this clinical trial for adult horses (less than 1 year old) that have surgical disease of the gastrointestinal tract or diarrhea. The study will characterize the efficacy of phenylmethimazole, a novel and potent anti-inflammatory agent, in reducing signs of endotoxemia and inflammation (high heart rate, pain, reddened mucous membranes, fever) in horses with severe colic or colitis (diarrhea). can detect bone damage at the cellular level (revealing the site of injury much earlier than what would show up on X-ray), provide the advanced imaging necessary in some cases to make a diagnosis and begin a course of treatment. Adding to the high level of sophistication is the fact that all imaging modalities produce digital results that can be viewed side by side on any computer monitor throughout the hospital or on the desktop of your rdvm when the images are sent via or on a CD-ROM. Sitting beside a computer monitor, Dr. Valdés-Martínez pulls up the image of a radiograph onto a large monitor in the radiology suite. On the same screen, he opens images from a nuclear scan of the same area. While the radiograph reveals only a slight grayness at the point of the hip, it s obvious on the nuclear scan where a dark black grain reveals the lesion to the bone. It s the hard-to-diagnose cases where advanced imaging proves the most helpful, notes Dr. Valdés-Martínez. While the radiograph only vaguely suggests this as a possible site of injury, the nuclear scan confirms the diagnosis. We could have made a guess, but instead we know with certainty where to treat and how to give this horse the best chance of making a successful recovery. And it s the hope of a successful recovery that the entire team at CSU VTH likes to see most. 7

8 Veterinary Teaching Hospital Equine Service College of Veterinary Medicine and Biomedical Sciences 1620 Campus Delivery Fort Collins, CO Client Frequently Asked Questions At CSU s VTH, we are passionate about providing quality care for our equine patients. Our state-of-art facility and professional faculty and staff allow us to examine, diagnose, and treat a wide array of equine diseases. In an effort to offer excellent customer service, we d like to answer some of the most common questions to help with your visit. Q: Can you bill my insurance company? We do not commonly bill insurance companies. However, on rare occasions, clients can discuss the billing system concerning insurance with both the clinicians and the hospital management. We can provide a detailed invoice at the end of your visit. Your full payment for your horse s care is necessary before your horse leaves the hospital. Our doctors can fill out insurance forms faxed from your insurance company, and you then work with your insurance company. Q: What forms of payment does the VTH accept? We accept cash, single-party checks, VISA, MasterCard, Discover, and American Express. We also accept CareCredit, which is a payment option for health care services. CareCredit offers financing and monthly payments, no upfront costs, and no prepayment penalties. Check at the front desk for contact information. Q: How much can I expect to pay for a deposit? A deposit is required for any horse that stays overnight. The deposit amount is typically half of the lower end of the estimate. Q: How much does the state of Colorado support the Equine Hospital? The Equine Hospital is solely funded through the care we provide for our patients. We do not receive direct operational support from the state. These policies have been put in place since the income generated by the hospital is essential for maintaining the highest standard of care. Without these standards, the Equine Hospital could not provide state-of-the-art diagnostic and therapeutic techniques.