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Equine

Learn more about our equine services and facilities

Get in touch - 01508 558228

Learn more about our equine facilities

Visits & Zones

The comprehensive services we offer are complimented by a widespread ambulatory service for equines.

Appointments can be booked by contacting the Brooke Equine Clinic - 01508 558228.

For routine visit appointments it is advisable to contact the clinic in advance of the day you would like us to visit, to help us in arranging a convenient time for your visit – we can get very busy at certain seasonal times when more animal problems will occur!

Emergency calls are always prioritised and this will on occasions necessitate delaying a pre-booked routine call to attend the emergency. We are always extremely grateful for the understanding of those clients inconvenienced by a delay when these emergencies occur.

Out-of-hours our dedicated, veterinary telephone answering service will handle your emergency telephone calls expediently. We deal with all our own out-of-hours calls and do not out-source to other veterinary practices. To enable us to do this we have three small animal veterinary surgeons covering our small animal clinics and two vets covering the farm and equine calls.

Additionally we have four equine zone visit days. These cater for pre-booked visits in certain areas on certain set days. In return for the convenience of allowing us to improve our efficiency and time management, the visit charge is reduced to £15.00 including VAT; a saving of more than 70% on a normal visit charge. Refer to the zone visit map to see which area you are in (or telephone our Brooke clinic to check) and the attached section for full terms and conditions for our zone visits.

Zone Days

Monday - 1,2,6     Tuesday - 3     Wednesday - 5     Thursday - 4

Payments

Invoicing

Our accounts for equine and farm animal clients are sent out at the end of each calendar month. Our payment terms are 28 days from the date of receiving the invoice. If you anticipate having difficulties paying your bill please contact our accounts department, 01508 530686, immediately after receiving your bill, do not wait for reminders to arrive.

We respectfully request that all small animal services and products are paid for at the time of purchase or consultation, or on collection of your pet following any inpatient procedures. We are unable to offer any credit facilities for small animal accounts.

Methods of Payment

Payment of your account can be made by cash, personal cheque or credit/debit card at reception, or by credit/debit card over the phone or by cheque in the post. Please include your remittance advice with any postal payments.

Equine Services

  • Lameness / Back Pain
  • Colic Treatments
  • Dental Surgery
  • Equine Insurance
  • Equine Passports
  • Foal Care
  • Opthalmology
  • Remedial Farriery
  • Sarcoid Treatment
  • Shockwave Therapy
  • Stem Cell Therapy

Lameness / Back Pain

The investigation of poor performance is a particular specialty of the practice, particularly where orthopaedic limb and back problems are involved. Changes in performance, behaviour, gait or willingness to exercise can all be related to back pain and/or lameness. Even if lameness is not readily visible to the owner, many horses with back pain or a drop off in performance are actually lame, frequently in several limbs simultaneously. A thorough orthopaedic examination of these cases by an experienced equine clinician is essential to identify or eliminate the presence of lameness.

Further investigation of orthopaedic problems involves the use of a number of diagnostic tools, including nerve blocking, radiography and ultrasonography. We have many years experience investigating equine orthopaedic conditions and are fortunate to have the facilities to undertake complex nerve blocking, along with radiographic and ultrasonographic imaging of affected areas.

Nerve blocks involve the injection of short acting local anaesthetic into a joint/tendon canal or around a nerve to desensitise an area to see if the lameness or gait abnormality changes. A series of nerve blocks may need to be carried out to localise the site or sites of pain.

Further investigations with radiography and ultrasonography can then be undertaken.

We offer an extensive range of treatments for an equally extensive range of conditions, commonly including conditions such as kissing spines, sacro-iliac injuries, suspensory ligament desmitis, tendonitis, joint pain, OCD, limb fractures and annular ligament syndrome. Please feel free to contact the clinic to discuss any aspects of orthopaedic injury, investigation and treatment options.

Colic Treatments

What is it?
Whilst colic is a very common condition, the vast majority of patients do not require surgical treatment, about 5-10% of all cases of colic end up on the operating table. Colic is a clinical sign, it is not a diagnosis; there are many different causes of colic, some are physiological i.e. they affect the gut activity, while some are anatomical i.e. they result in some sort of blockage or obstruction.
Most cases of colic respond to a single injection of pain killer or anti-spasmodic injection, usually these cases involve spasms or cramping of the gut, possibly with a build-up of gas within the intestine. Lungeing of some of these cases helps dislodge any trapped gas and the increased adrenalin levels helps to normalise the gut activity.

Investigating colic
Some cases of colic may need to be hospitalised following the first examination if there is any suspicion that the cause may be more serious. Once hospitalised, a series of further tests may be undertaken to help determine the cause.

Internal examination – a rectal examination is often undertaken to attempt to identify physical blockages, enlarged or displaced intestine.

Ultrasound examination – external ultrasound exam through the body wall may help identify lengths of distended small intestine, often associated with a surgical condition

Belly tap – the collection of body fluid that surrounds the outside of the bowels within the belly. This fluid changes when certain conditions, particularly surgical conditions, are present.

Bloods – blood sampling is usually used to assess the status of the circulation in terms of hydration and cardiovascular abnormalities.

The decision for surgery
The decision to operate on a patient with colic is not often very straightforward. Sometimes it is possible to identify the cause during the course of the investigation such as feeling enlarged intestine full of gas or fluid during internal examination. However, often the patient is operated on because it has failed to respond to medical treatment, or, the colic pain cannot be controlled by painkiller injections, or the patient’s condition has deteriorated despite medical treatment. For the surgeon, the exact cause of the colic and its severity may not be known until the abdomen is opened on the operating table.

Common surgical conditions
Surgical colic can be divided into several common general categories

Twisted bowel – can be the small or large intestine, often involves a fatty lump growing on the bowel wall on a long cord and wrapping itself around a length of gut, cutting off the blood supply. Any of the gut can be affected, from a few centimetres to several metres. Lengths of intestine may or may not have to be removed, depending on how long the gut has been trapped.

Displaced bowel – usually the large intestine, the bowel moves into an abnormal position, sufficient to stop the passage of food, liquid and gas, but not enough to cut off the blood supply. The bowel normally needs to be replaced into its normal position and may have to be emptied of solid, liquid or gaseous contents.

Physical obstructions (impactions) – These are normally caused by blockages of food such as straw, foreign material such as sand and foreign bodies such as plastic wrapping, or large worm burdens. They can also be caused by the growth of tumours in the gut wall. The bowel would usually need to be opened and emptied or a section of gut removed if a tumour is involved.

Torsion – similar to twisted bowel, but instead of being trapped by a fatty lump, the bowel is twisted around on itself, cutting its own blood supply off. The effect is similar and lengths of dead intestine may have to be removed.

Common medical conditions
There are many, many causes of non-surgical colic, some of which can initially be surgical problems such as a displacement, which can be treated successfully without surgery in some cases.

Spasmodic colic – Probably the most common cause of mild colic, this involves waves of cramp passing along the intestines, causing the patient to have repeated bouts of discomfort, interspersed with periods of normality. The cause is varied and non-specific patients usually respond to a single episode of painkiller injection, along with physical exercise.

Gas colic - Certain parts of the intestine can fill up with the normal gases that are produced in the equine gut. If the gas cannot escape, the patient can become extremely painful and may show signs of quite severe colic. Gas colic can lead to displaced and twisted bowel as the distended gut floats out of position. Painkiller injections combined with periods of intensive physical exercise such as lungeing, are necessary to release the trapped gas.

Parasites – Despite the widespread use of wormers, all the different species of intestinal worms are still relatively common, apart from the large red worms. Small red worms and tapeworms are both common causes of colic, which can range in severity from mild, intermittent discomfort, through to severe colic requiring surgical treatment. Unfortunately, inappropriate and incorrect usage of wormers has increased the incidence of resistance to the chemicals. We recommend regular worm egg counts (see separate display) and strategic use of wormers rather than blanket use of the drugs.

Sand enteritis – As well as causing a blockage, requiring surgical treatment, smaller quantities of sand can accumulate on the bowel floor, moving back and forth as the gut moves, causing irritation to the gut lining, resulting in inflammation and recurrent bouts of colic. Treatment involves the use of a bulking agent called psylium, that is fed daily long term, while ensuring that the patient is not grazed on sandy paddocks, especially when the grass is short.

Gastric ulceration – Inflammation and ulceration of the stomach lining is frequently recognised in the horse population. However, the relationship with the occurrence of colic is not quite so clear, as many horses have ulceration with no history of colic episodes. Diagnosis requires the use of a long endoscope, usually about 3 metres in length, passed through the nostril into the stomach, to visualise the lining. The only effective treatment for gastric ulceration is a drug named Gastroguard, which reduces stomach acid secretion, allowing the lining to regenerate. Modifying the diet to include more roughage, along with trickle feeding a constant supply of feed, should reduce the risk of recurrence.

Dental Surgery

All the equine vets in the practice are experienced in routine dentistry using our extensive range of manual and electrical/motorized dental equipment. We carry out routine examinations and floating of teeth on a regular basis.

Some patients can be treated without the need for any form of chemical restraint (sedation), however it is worthwhile considering that it is difficult to carry out a thorough examination and rasping if a patient gets distressed or excited. Many owners have concerns about sedating their horses for what is considered a routine procedure. Modern sedatives are extremely safe drugs and very rarely cause serious side effects. They also work much more effectively at lower doses if they are used before the patient gets distressed and excited. It is therefore better to give a little sedative to patients that are likely to react at the start of the treatment, rather than waiting until they are already excited. The relatively low additional cost is usually well worthwhile and makes the whole procedure much more "enjoyable" for patient and owner.

Complex dental procedures can only be undertaken by a qualified veterinary surgeon. We are able to advise on all aspects of dental care including extractions, deformities/injury to teeth etc.

Equine Insurance

Please read this information prior to making a claim for the cost of veterinary fees from your insurer. The information applies to all companies currently providing equine insurance and does not relate to any specific insurer. Please read it carefully as soon as possible after deciding to make a claim and do not hesitate to ask your vet or Emma Cooper on 01508 558228 if you have any queries.

This information relates to insurance cover for the cost of veterinary fees and does not include information on "loss of use" or "mortality cover" claims.

How to Start a Claim

Simply call your insurer and inform them that your horse/pony has sustained an injury or has become ill and that you would like to make a claim. It is quite possible that you will not know the exact nature of the problem at this point, so do not worry about being too specific. Further information will be provided to the insurer on the completed claim form. The insurer should then send you a claim form or email one directly to us on brookeequine@chapelfieldvets.co.uk. When you receive it, complete the owner section promptly, ensuring that the policyholder signs/dates the completed form.

Your Policy Excess

Unfortunately most policyholders never read the finer details of their policy until they need to make a claim. As a result of this they often don't know what is, and what is not covered. Check your policy to determine your limit and any time scale allowed to make a claim - most policies provide cover for up to 12 months after the identification of an illness/injury, normally the date that the veterinary surgeon first attended the occurrence. However, it is important to remember that if an illness/injury is identified that subsequently appears to have been present for a prolonged period prior to the veterinary surgeon first attending the patient, the insurer may not honour a claim or may start it from when the owner first believed there to be a problem. This may compromise the care you are then able to provide and limit the finances available. Make a note of any exclusion in place on the policy - these are usually written in a separate section and might relate to previous injuries, pre-existing problems or illnesses. Some policies also have exclusions/limits on the cost of particular aspects of veterinary care such as hospitalisation fees, admin fees, clinical waste etc. It is very important that you let your vet know any limits/exclusions in place on the policy.

Whether or Not to Make a Claim

There is no benefit in choosing not to make a claim. Most policies require you to inform the insurance company of any illness/injury, irrespective of whether or not you make a claim. Exclusions may still be placed on future cover. Only if the total bill comes to less than your policy excess is it not worth making a claim, although you should still inform the insurers. The normal process of making a claim includes the insurance company reviewing the patient's previous records. A failure to declare information may invalidate a future claim.

The Paperwork

Unless an illness/injury involves only one or two visits, after which the condition has healed, there is often considerable paperwork to complete, involving communications between the policyholder, the insurer/broker and your vet/admin. Staff. It is important to remember that having insurance cover does not equate with any guarantee that the costs of veterinary investigations and treatment will be covered. The contract is between the policyholder and the insurer/broker. At all stages of the claim the policy holder remains liable for the payment should the insurer fail to pay the costs.

You should fill in your part of the claim form and forward it to your vet for completion and return to your insurers. Do not wait to return the claim form. If treatment is ongoing over several months, you should immediately forward any subsequent invoices you receive to the insurer. This includes all veterinary invoices and any others such as costs of physiotherapy or remedial farriery.

Making Payments

It is the policyholder's responsibility to ensure that the insurer receives a completed claims form and all relevant invoices. If the insurer fails to make payment within a reasonable period of time, our practice policy is to allow two months grace, then we may request that the policy holder pays the claim in full and claims the costs back from the insurer. We reserve the right to request payment in full at any time from the policyholder. You have the option with many policies to pay the bills and be re-imbursed by the insurer or have your vet paid direct. If you chose to pay your vet and claim back the costs you should pay for each invoice within 30 days of receiving the bill each month. If you choose to have your vet paid directly then you should only pay the excess to your vet upon receipt of your first invoice, along with any extras that are stated as not being covered on your policy e.g. hospitalisation/livery fees.

Fixed Excess

If you have a fixed excess then simply make this payment to the clinic when you receive your first bill along with any extras which are not covered. When you send in any payment for part or all of a claim please make sure you inform the admin staff that the payment relates to the current claim.

Variable Excess

If you have a policy with variable excess plus any non-insured items, then you will not know the total amount of the excess until the claim is complete. In order to avoid building up a large excess if the treatment is ongoing over several months and to allow you to pay the excess as it accumulates on these claims, you will need to make a payment to your vet each month you receive a bill. If you need assistance in calculating this amount each month please contact Emma Cooper on 01508 558228. Then simply make your payment to the clinic each month in the same way you would normally pay your bill.

Whichever type of excess you have, do not wait until the claim is complete before paying your excess each month. This way you will avoid accumulating a substantial bill at the end of the claim.

Claim Assessment

The insurers will assess the claim once they have received the completed claims form and will start to make payments only once the claim has been approved and invoices related to the claim are submitted. Usually the bulk of the costs are at the start of the claim. Once the insurer has made all payments there may be some remaining unpaid amounts on the account. From experience these usually relate to non-insurance items such as vaccinations or exclusions to individual parts of the cover such as hospitalisation/livery fees. Any excess, non-insurance items or excluded items should be paid monthly as described above rather than allowing them to build up over several months. You should check all payments made by the insurer, but usually these remaining amounts will need to be paid by the policyholder.

Complex conditions or those requiring ongoing assessments and treatment over several months are very common. Payment of such claims is frequently made on several occasions during the claim period. The process of making a claim should be relatively straightforward. However, when the claim extends over a period of time and involves at least three parties, things can get complicated. Keep a copy of everything you send to the insurance company. It is useful to keep in regular contact with their offices to monitor the progress of the claim. You are entitled to know the status of the claim and any payments due. Unfortunately, due to data protection laws, we cannot obtain this information, so it is very important that the policyholder takes responsibility for ensuring that the claim is settled as promptly and efficiently as possible. If you have any queries or concerns about any aspect of the claim then please do not hesitate to contact your insurers or Emma Cooper at the Equine Clinic on 01508 558228. It is much better to resolve any issues promptly before they become a real problem months down the line.

Key Points

Technically an insurance claim for veterinary fees can only be made once the fees have been paid by the policy holder (i.e. a loss has occurred). As such Chapelfield Veterinary Partnership Ltd (CVP Ltd) requests payment of all invoices within 30 days of their receipt.

However, CVP Ltd will allow delayed payment of insured fees, until settled by the Insurer, if prior arrangement is agreed by the accounts department and only where the timescale is reasonable - we consider this to be within 60 days of the policy holder receiving the invoice. Please ensure invoices are forwarded to insurers promptly. We reserve the right to request payment in full at any time from the policyholder.

At the start of a claim the policyholder should contact the Insurer and request a claim form promptly.

Claim forms will then be sent to your Insurer along with relevant invoices and clinical records.
All non-insured costs and fixed or variable excesses must be paid to CVP Ltd according to our normal 30-day terms. Our accounts department reserves the right to request copies of insurance policies, if required, if any outstanding non-insurance fees are not paid in full within 30 days of receipt of invoice.

With ongoing claims over two or more months, some insurers require a new claim form to be attached to each subsequent invoice; some just require follow on invoices. Check with your insurer.

Please be aware that many years of experience has taught us that documents occasionally go missing during processing and transit, resulting in delays in the processing of claims. We advise that you keep copies of all documents and that you contact them regularly (weekly) to check on the progress of your claim.

Please contact Emma Cooper at Brooke Equine Clinic 01508 558228, if your insurer requests further information or if you have any queries.

Equine Passports

It is illegal to own a horse, pony or donkey without being in possession of a valid passport for that animal. Passports can be obtained very easily from a number of breed societies. We supply equine passports which can easily be completed during a routine visit by the attending veterinary surgeon. Always have your passport available for inspection/completion during all routine visits so that vaccinations can be recorded and any drugs that may need to be listed can be added to the medicines section if necessary.

Foal Care

Whilst foals sustain a similar range of injuries and suffer similar ailments to adult equines, there are several conditions particular to the young and growing foal that require prompt recognition and specialised treatments.

We care for a large and growing population of foals in Norfolk and north Suffolk which are susceptible to a number of conditions, some examples of which listed below:

Examples of illness commonly affecting foals:

Very young foals

Antibody deficiency – failure to drink sufficient colostrums – treated with plasma transfusions which we carry out at home premises

Joint ill – life threatening joint infections from the blood stream – these require emergency surgical treatment

Growing foals

Angular limb deformities – changes in the angulation of the joints can be corrected by both medical and surgical means if treatment is undertaken before the growth plates close.

Contracted tendons – excessive contraction of the tendons on the back of the legs can affect foals of all ages. Prompt diagnosis and treatment, possibly involving surgery to cut the affected tendon, is essential to a successful treatment outcome.

OCD – joint swelling and variable lameness can result if the joint cartilage does not develop correctly. The hock and stifle are most frequently affected with OCD and surgical treatment to remove the abnormal fragments in the vast majority of cases is very successful.

As a part of our services we offer a young foal check, which is undertaken on the first day. The mare and foal are both examined to check for any signs of ill health. The placenta is examined to make sure it has been completely passed. If necessary an enema is given to the foal to avoid a meconium impaction, a common cause of constipation. We also frequently blood test new born foals to measure antibody levels to ensure the foal has drunk a sufficient amount of colostrum. If the levels are too low then a plasma transfusion can be given to help prevent any life threatening infections.

Opthalmology

Eye injury and disease is fairly common in equine practice, in part because of a horse’s flight response causing it to react quite violently to a sudden noise or unexpected object. Horses will pull their heads back or swing round quite suddenly and bang the facial area into fixed objects in the stable or poke the eye on branches or blackthorns in the hedgerow.

Examining an eye
When a veterinary surgeon undertakes an eye exam, it is usually necessary to have access to a stable or exam room with subdued lighting so that the pupil will dilate, allowing close inspection from front to back. Light sedation is often beneficial as patients with a sore eye will react to bright light, which can be quite painful. Horses also have very strong eyelid muscles, making examination very difficult. Local anaesthetic nerve blocks also help reduce the pain and immobilise the muscles, making it easier to examine the eye thoroughly. 
Visual examination of the eye is undertaken using an ophthalmoscope, which allows the vet to look at each layer and chamber in turn, from the cornea at the front, through to the retina at the back.

Staining the eye surface
We routinely apply a stain to the surface of the eye, to look for evidence of damage to the cornea. Normally, the stain does not stick to the cornea. Where there is damage to the surface, the stain will stick, outlining the area damage.

Ultrasound
We use the same technology as is used for pregnancy diagnosis and tendon scanning to look at the internal structures of the eye. This is particularly useful when the patient has a painful eye which it is reluctant to open, or when the injury causes the eye to become very cloudy or filled with blood.

COMMON EYE PROBLEMS

Corneal ulcers – One of the commonest eye problems involves trauma to the surface of the eye, the cornea. Superficial and deep abrasions and puncture wounds often result from blunt trauma or when sharp objects such as branches or bits of straw scrape the surface layers off the cornea, resulting in pain, inflammation and secondary infection. An orange stain is dropped onto the eye, which turns green and sticks to areas of damage. Treatment involves topical anti-inflammatory and antibiotic drops. Left untreated, ulcers can progress to cause more severe inflammation deeper in the eye.

Uveitis / Moon blindness – Inflammation of the inner structures of the eye around the pupil is called uveitis (YOU-VE-EYE-TUS) and is a relatively common serious cause of eye injury, which can lead to blindness. One form of uveitis, known as moon blindness can result from the immune system attacking the body’s own tissues, causing recurrent episodes of internal inflammation. Treatment should be prompt and aggressive to avoid cumulative damage to the eye and progressive blindness. We would normally hospitalise a patient with uveitis and insert special tubing through the eyelid to allow the frequent application of several drugs every few hours without causing discomfort and leading to a head shy patient.

Eye tumours – Cancer of the eye and surrounding structures tends to occur in older animals and is more common in those lacking pigment around the eye. Any of the structures can be involved but the third eyelid and conjunctiva are the usual sites of tumour growth. If treated early, many of these tumours can be cured without the need to remove the eye. In our practice we use a combination of surgical removal of the tumour, along with the injection or topical application of a variety of chemotherapy drugs.

Detached retina – Separation of the retina from the back of the eye will cause blindness and usually results from head or facial trauma. Diagnosis of this condition may only be possible using ultrasound examination of the eye as shown in the image.

Eyelid lacerations– Being relatively prominent tissues, the eyelids are very susceptible to trauma when horses turn their heads suddenly, pull back through a fence or have a disagreement with a field mate. Eyelid wounds should always be reconstructed promptly and carefully, ensuring that the edge of the eyelid where the lashes exit, is re-aligned to create a smooth edge. Failure to do this will result in long term problems with the tear film spreading across the eye surface.

Fractures of the orbit – The bones forming the eye socket form a frame around the eye itself, absorbing any direct impact in an effort to protect the eye from damage. Ultrasound examination of the area can help diagnose the fractures, which are often difficult to see on X-ray. Most fractures will heal well, although some may need to be surgically reconstructed with steel wire if the bones have been displaced too much.

Blindness – Partial blindness in horses is relatively common and affected patients cope extremely well with one functional eye. Loss of sight in one eye can be due to eye trauma, cancer or severe infection or inflammation, resulting in a shrunken non-functioning eye, or necessitating surgical removal of the eye, a procedure that we would normally undertake with standing sedation and local anaesthesia, avoiding the risks of a general anaesthetic.

Remedial Farriery

Many causes of lameness involve the foot and treatment programs frequently include remedial farriery and the use of special shoes and shoeing techniques as part of the initial treatment and the long term management of lameness. When treating foot conditions we are happy to liaise with your normal farrier, but can also involve several highly experienced remedial farriers who work in the area and offer exceptional expertise when treating some of the more difficult foot problems encountered.

Our equine vets are happy to meet with the farrier to discuss treatment options either at our clinic or at home on the day of shoeing. Any X rays that have been taken are also available for the farrier to view prior to deciding on the most appropriate method of shoeing.

Sarcoid Treatment

What are they?
Sarcoids are a very common type of skin tumour affecting male and female horses, ponies and donkeys. They affect all ages apart from young animals under about 2 years. Some animals appear to be genetically susceptible to developing sarcoids.

Where are they found?
Sarcoids are usually found on the skin of the head and neck, between the front legs and in the groin area, although they can appear anywhere on the body. Whilst they can spread within the skin, they do not spread to the internal body organs.

Types of sarcoid
There are about six different types of sarcoid which vary in appearance and growth patterns, from flat flaky patches to large, ulcerated pedunculated growths.

How do they spread ?
Sarcoids do not spread between animals but can be spread by flies in summer from one area of skin to another, usually when there is an open wound. For this reason it is important to protect wounds on animals that already have a sarcoid elsewhere on the body.

Diagnosis
Sarcoids vary greatly in appearance, in some cases resembling warts, areas of proud flesh or even a patch of ringworm. To confirm a diagnosis of sarcoid, a tissue sample or biopsy can be taken and examined at the laboratory. However, sampling a sarcoid can stimulate it to grow, so they are often treated without taking a biopsy first and should always be treated promptly if a biopsy result confirms the presence of a sarcoid.

Treatment
There are many treatment options available, depending on the type, location and size of the sarcoid, the temperament of the patient, the owner’s financial budget and the particular experience and preferences of the veterinary surgeon.

At CVP we treat sarcoids in a number of different ways, using a variety of topical chemical creams and drugs injected directly into the sarcoid (Chemotherapy), various surgical methods, including surgical removal and cryo-surgery. Cryo-surgery involves freezing the sarcoid tissue using liquid nitrogen spray, which has a temperature of -196°C.

Success rates
The success rate for treating sarcoids is overall normally around 70 -75%, but any sarcoid can recur at the original site or new sarcoids can develop nearby or elsewhere on the skin.

In the past, many sarcoids that were small and inactive were left untreated and monitored for growth. It is now considered better to treat a sarcoid at the earliest opportunity to increase treatment success rates and reduce the chance of further sarcoids developing.

The 6 different categories of sarcoid

1) Verrucose – Usually irregular patches of slightly raised, crusty or flaky skin

2) Fibroblastic – Consist of red/yellow ulcerated, proliferating masses, that bleed readily and may be covered in a crusty discharge, attracting flies in the summer. They may become quite large and hang down from the body

3) Nodular – Usually smooth, firm, fibrous lumps within or under the skin. They can be found individually or in groups

4) Occult – A smooth, flat area of hair loss often with well-defined margins with relatively normal looking skin

5) Malignant – Widespread infiltration of different types of sarcoid covering a considerable area, with little evidence of normal skin, usually seen in genetically susceptible individuals

6) Mixed – These contain any combination of the different types of sarcoid, occurring at the same location at the same time

Treatments

Cryo surgery – This can be carried out under sedation or under a short anaesthetic. The sarcoid and an area of visibly normal skin around the sarcoid are frozen with liquid nitrogen spray. The resultant scab is large and thick and usually separates over the next few weeks, leaving a raw wound that then heals like a normal wound.

Scalpel surgery – Cutting off a sarcoid is generally reserved for a very small number of cases, as it is very difficult to determine where the sarcoid “roots” end. Closure of the wound is difficult as a large area of tissue is often removed.

Rubber banding – A very cheap method of treating some sarcoids, rubber rings can be very effective as long as an area of normal skin is included within the area constricted by the rubber band.

BCG injections – A very effective means of treating certain sarcoids around the eye. A course of three BCG injections is usually given over a period of about a month. The sarcoid then gradually shrivels up and disappears over the following 2-3 months.

  

Topical chemotherapy – A number of creams are available to treat sarcoids. By far the most effective is developed and supplied by the University of Liverpool Sarcoid Department, the cream being called LUDES. Used only by a veterinary surgeon, LUDES cream is applied about five times over about a fortnight, causing considerable initial reaction. The sarcoid then dries up and the scab may take several months to fall off completely.

Shockwave Therapy

Shockwave therapy or extracorporeal shockwave therapy (ESWT) is a relatively recently developed treatment first applied to human sports injuries and being increasingly used in the treatment of a number of conditions in specialised equine veterinary practice and sports medicine.

Since purchasing the equipment about 3 years ago the equine vets at our practice have treated well over a hundred patients suffering from a number of orthopaedic injuries, using shockwave therapy as either the sole treatment or in combination with other therapies.

Shockwave therapy is a non-invasive treatment; the probe is applied directly to the skin over the affected area. Due to the local sensation of slight discomfort and vibrations from the compressor, most patients are lightly sedated to minimise distress and for operator/equipment safety reasons. The treatment works in two ways; desensitisation of local nerve ends provides effective and quite prompt pain relief and reduction in muscle spasms, while also stimulating tissue healing by promoting blood flow to the affected area.

The equipment is portable so treatment can be undertaken either in clinic or at home. An initial course involves three treatments, at fortnightly intervals, with each treatment taking around 10-20 minutes to complete, depending on how many or how large an area is involved. Depending on response to treatment, some patients will have further individual sessions over the following months whilst undertaking a graduated exercise regime.

The primary indications for its use in the equine population of Norfolk and Suffolk include:

Primary back injuries: These include muscle and ligament strains and sprains, kissing spines (impinging dorsal spinous processes) and sacro-iliac injuries.

Back pain/muscle spasm secondary to primary lameness: Many horses with single or multiple limb lameness have pronounced muscle spasms along the back, particularly under and just behind the saddle. Any horse with back pain should be assessed by an experienced equine vet for evidence of mild lameness.

Ligament injuries: The suspensory ligament is the most frequently injured and treated ligament, particularly injuries involving the top portion of the ligament where it attaches to the cannon bone just below the knee and hock (proximal suspensory desmitis). Forelimb suspensory ligaments and to a lesser extent hindlimb injuries can respond well to treatment. We have also successfully treated damaged check ligaments, annular ligaments (fetlock), patellar ligaments (stifle) and collateral joint ligaments (mainly pastern and coffin joints).

Tendon injuries: Injuries to the lower leg, primarily involving the superficial and deep digital flexor tendons are treated with shockwave therapy in a similar manner to ligament injuries. Improved quality of healing in terms of the ultrasonographic appearance of the tendons can be seen, although a prolonged period of graduated exercise is still essential to minimise the risk of recurrence.

Angular limb deformities in foals: Recent studies have found that shockwave treatment can be helpful in treating foals with abnormal bending of the limbs, either from birth or as an acquired condition during the first year of life. Limb deviations usually involve the growth plates close to the knee, hock and fetlock joints in the fore or hind limbs and can lead to permanent deformities if left untreated, preventing any form of athletic career. Treatment of the growth plate with shockwave therapy appears to slow down the rate of growth on the affected side of the leg, thereby allowing the other side of the limb to catch up. This treatment can be used in conjunction with remedial hoof trimming and special glue on shoes. We have treated several foals successfully over the last two stud seasons which would otherwise have required surgical correction of the deformities at considerably greater expense and risk to the foals.

Stem Cell Therapy

Cutting Edge Treatment For Tendon And Ligament Injuries

Our equine department has been treating horses with potentially career ending tendon and ligament injuries using the most advanced technique available, involving the injection of stem cells directly into injured tissues. Damaged fibres are replaced with new ones rather than weaker and less elastic scar tissue that would otherwise be produced.

Working in partnership with biotechnology company Vetcell (www.vetcell.com), the treatment involves the collection of a sample of bone marrow by one of our equine vets from the breast bone or pelvis under standing sedation. The sample of marrow is taken by courier to Vetcell's Edinburgh based laboratory, where the stem cells are separated and placed in a special culture medium. Here they multiply for 2-3 weeks until approximately 10 million viable cells are produced. The liquid suspension of stem cells are returned to our clinic where the patient is treated on a day outpatient basis.

The stem cells are injected, under sterile conditions, directly into the core of torn fibres using ultrasound guidance, allowing very accurate placement of cells. Once injected, the stem cells, under the influence of substances produced by other tendon or ligament tissue, develop into new tendon or ligament fibres. The end result is a structure which is much more resistant to re-injury compared with tissues treated using all other currently available therapies.

We are very pleased to be able to offer this service to all our clients.

If you would like to discuss stem cell therapy with any of our equine vets, please do not hesitate to contact the clinic.

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