Advanced Diagnostic Services

Digital Radiology

With our DR system made by Eklin Medical Technologies, we can provide the following benefits compared to traditional radiographs:

• More consistent image quality
• Reduced number of repeat exposures because of ability to adjust brightness, contrast, magnification, and edge enhancement (less time per study = less sedation for horse)
• More efficient to identify small bone detail and soft tissue
• Images can be e-mailed immediately as .jpeg pictures to referring veterinarians
• Portable unit allows images to be evaluated at horse shows or stables with trainers and owners within seconds.
• Rules out fractures or catastrophic bone injuries at competitions or farm calls
• Radiograph results for time sensitive issues such as pre-purchase exams are known immediately.
• Radiographs can be burned to CD allowing owners or trainers to keep their radiographs with them at all times.

Digital Ultrasound

Ultrasound is a practical imaging modality to evaluate soft tissue injuries of the equine limb and other soft tissue structures in the body. It allows for visualization of tendons and ligaments, and to identify, confirm, and monitor soft tissue injury. Evaluation of tissue size, shape, echogenicity (whiteness or brightness of a structure), fiber pattern, and surrounding inflammatory reactions is possible with this machine. As with digital radiography, these images are stored electronically and available to e-mail to referring veterinarians as needed. They are also available for review to compare with new images obtained during a recovery period to determine rate of healing and prognosis.

Endoscopy

We use the flexible endoscope to diagnose and evaluate numerous nose, throat, and respiratory problems. The flexible endoscope has a camera chip at the end of a long, narrow tube, which allows for the visualization of certain conditions without invasive exploratory surgery. It is also useful for taking samples of the fluid in the trachea, lungs, or guttural pouches for diagnostic purposes.

Nuclear Scintigraphy

Nuclear Scintigraphy or “bone scanning” offers high sensitivity for detecting early bone disease and it is an ideal tool for diagnosing difficult or multi-factorial lameness. Your horse will need to go to Southern California Equine Foundation Inc. Nuclear Medicine Facility at the Santa Anita Racetrack. The horse is catheterized and injected with a radioactive isotope (Technetium) which aggregates in areas of bone remodeling (due to binding the Tc to Phosphorous, which bones need to make new cells). A specialized Gamma camera detects the gamma rays emitted by the radioactive isotope. Your horse is given a standing sedation only for this procedure and it takes approximately one to two hours to obtain all the images needed. The gamma camera is on a crane and can move all around the horse. This procedure allows for the evaluation the entire equine skeleton or just a specific region. The computer takes the information from the camera and generates an image of the horse’s bones. The areas of increased isotope activity, “Hot Spots,” are the areas that are currently undergoing increased bone remodeling (this can include growth plates, bone infection, fractures, stress fractures or trauma). It is more sensitive than radiographs in detecting lameness related to bone inflammation, as it allows us to see on a cellular level where the body is trying to “fix” itself. Once these “Hot Spots” identify where the problem is, then we can follow up with X-rays or Ultrasound to clearly identify what the problem is. Due to the radiation involved, albeit minimal, your horse will need to stay overnight in our facility before being released back home.

Shockwave Therapy

Extracorporeal Shockwave Therapy (ESWT) is an efficient noninvasive therapy used to treat common musculoskeletal and orthopedic disorders in equine patients. The unit generates focused shockwaves (positive pressure acoustic waves) of low and high energy that can be transmitted to deeper structures in the body. This energy stimulates the areas of interest to increase healing. Treatment sessions range from one to four times with an interval of 1 to 3 weeks apart, depending on the injury. Use of this treatment has led to astonishing results in the treatment of pain in the region of tissue located close to bones and in the healing of tendinopathies, desmopathies, fractures, and degenerative joint disease. Use of ESWT has also had some great success in treating chronic back soreness and kissing spine lesions.

Stem Cell Therapy

Stem cell therapy is designed to regenerate injured tissues using stem cells derived from the horse’s own body. There are multiple protocols for harvesting stem cell, from obtaining them from the bone marrow to collecting them from the adipose (fat) tissue. These cells have the ability to mature into bone, tendon, or ligament cells (depending on where they are injected), which can aid in the healing of injured areas that typically do not regenerate well.

Our practice employs the Vet-Stem system of stem cell collection and injection. Please visit the Vet-Stem website for more information and to look at some of the excellent research that has come about from this exciting new therapy.

This procedure is a two step process that can be performed in a standing, sedated horse at the barn or stable, which minimizes having to transport to a hospital. That also means fewer complications than general anesthesia. The first step is a small incision on the rump, next to the tail head, where the fat tissue is harvested. The area is then sutured closed. The fat tissue is then sent to Vet-Stem, where the stem cells are harvested, counted, and in some cases specially stored for future use, if enough cells were collected. The cells are then returned for immediate injection into the affected site. This is done with the horse, again sedated, at the barn, and is usually aided with x-ray or ultrasound to guide the needle to the direct location where the cells are needed. A lay-up program will be discussed with you, depending on the type and location of injury.

Common applications are strains or tears of suspensory ligaments, bowed tendons and other soft tissue injuries, chronic osteoarthritis, or fracture repair.

IRAP Therapy

Interleukin-1 Receptor Antagonist Protein Procession System or IRAP is designed to block the excessive production of interleukin-1 in joints affected by osteoarthritis. Osteoarthritis, or secondary degenerative joint disease (DJD) is a primary cause of lameness in the horse. Cartilage destruction, which leads to secondary DJD, occurs due to inflammatory mediators in the joint, such as interleukin-1. IRAP blocks IL-1 from binding to the tissues and causing damage.

To perform IRAP treatment, a sample of blood taken from the affected horse is incubated with substances that encourage healing, such as growth factors and anti-inflammatory aids. The sample is then “spun” to separate these beneficial substances in the serum from red blood cells. This serum is then injected into the injured joint, halting the inflammatory cycle and encouraging healing. Multiple samples are usually harvested and injected at one to two week intervals. Although research in IRAP therapy are still ongoing, the results are promising.

Platelet Rich Plasma (PRP)

Platelet Rich Plasma is an exciting new procedure that has emerged in the field of autologous (from the horse’s own body) therapy. Platelets are small cells within the blood that help with many functions in the body. They contain a variety of growth factors such as transforming growth factor beta, vascular endothelial growth factor, and platelet derived growth factor. These growth factors interact with the local cells and even send signals that initiate a variety of important events such as cell division and migration. Platelet Rich Plasma is that portion of the blood that contains these platelets and growth factors. By injecting PRP directly into damaged tendons and ligaments, we can help the body regenerate itself. Also, by using PRP in combination with Stem Cell therapy, we are providing a scaffolding for the stem cells as well as the growth factors to promote the Stem Cell function.

The procedure is fairly simple and requires a simple blood draw from your horse. The blood is then centrifuged and the platelet rich portion of the blood is harvested. Once harvested, it is injected (usually by ultrasound guidance) into the lesion.

Common applications are usually for tendons or ligament injuries. Other uses are currently being investigated.