Latest News
Welcome Omar Maher, DVM - August 2008
New England Equine is pleased to welcome back Dr. Omar Maher to the clinic as a full-time hospital clinician and surgeon. Omar is well-known to us and many clients as he spent 2 years (one as intern and one as junior hospital clinician) with us while we were still at Rochester Equine Clinic. He came to Dover briefly in the move to NEEMSC, but went on to the University of California at Davis in 2005 for a residency program in Equine Surgery. Due to the massive caseload and clinicians at UCDavis, Dr. Maher's experiences were great and included training in the latest techniques in such areas as laparoscopy, laser and CT-guided injection. UCDavis is also known for complicated lameness conditions, using a methodical course detection technique (certain blocks and expanded imaging modalities) which Dr. Maher was able to experience firsthand.
Dr. Maher will be a great addition to the staff of New England Equine. Please feel free to contact him via phone or email omaher@newenglandequine.com about cases or conditions your horse may be experiencing.
Video Monitoring Equipment
We have recently had some wonderful technology installed in our hospital that permits constant monitoring of several intensive care and isolation stalls.
KD Secure, a technology company based in Cambridge, Massachusetts, with the support of Hamilton-Thorne Research of Hamilton, Massachusetts have installed video monitoring equipment that is accessible to us over the internet. We also have a portable camera that allows us to set up video monitoring anywhere in our facility or in surgery.
Joint Therapies
A New Technique for Fusing the Lower Hock Joints: Ethyl Alcohol Arthrodesis
Arthritis of the lower hock joints is a very common cause of lameness and stiffness. This condition may be called spavin, degenerative joint disease of the tarsal joints or hock arthritis. Common treatments for hock arthritis include phenylbutazone, topical applications of Surpass ointment, and intravenous or intramuscular joint medication such as Legend or Adequan. A more direct method for treatment is joint injections of hyaluronic acid and steroids. Injection of medications into the joints is probably the most common method of treating hock joint arthritis. The treatment goal is to reduce inflammation and pain so that the horse may continue full, comfortable activity. With continued use the affected hock joints will often fuse. When the joints no longer move, there is no longer any pain. The lower hock joints do not open and close like the fetlock joint, they are low motion joints that only "vibrate" on each step. When the joints are fused injections and other support measures for lower hock arthritis may cease as the pain has been resolved.
Natural fusion of arthritic joints of the lower hock may take years so various techniques previously used for arthrodesis of the lower hock joints include: drilling of the joints followed by bone graft placement or application of a bone plate, destruction of joint cartilage using a surgical laser, and injection of a chemical that causes destruction of the cartilage called monoiodoacetate (MIA). Most of these techniques speed natural arthrodesis, but also many cause at least short periods of severe pain. Also, the speed of joint fusion is not uniform from horse to horse. For example, drilling the joints may cause fusion in about 4 months on one horse, yet require over 10 months on another horse.
A new technique that destroys the cartilage and does not cause any significant level of pain is injection of the lower hock joints with ethyl alcohol. A research paper from the Western College of Veterinary Medicine in Saskatoon, Alberta describes preliminary work done on horses with this new technique (Shoemaker RW, et al. Am J Vet Res 2006;67(5):850-857). Researchers injected ethyl alcohol into 16 tarsometatarsal joints (lowest hock joint) of normal, sound horses. They injected 4 mL of either 70% or 95% ethyl alcohol. Horses had minimal or no lameness following the injections. One-half of the injected joints were fused by 4 months, with more joints fused in the 70% alcohol group. Fifteen of 16 joints were considered fused at 12 months post-injection. Radiographic follow-up revealed active boney response in the injected joint 4 months after injection.
Although the Saskatoon study was preliminary in nature and only involved research horses, with sound technique this protocol may be readily applied to clinical cases. Horses with marked osteoarthritis of the lower hock joints that are no longer responding to traditional treatments such as joint injections or young horses with juvenile onset arthritis (juvenile spavin) are candidates for ethyl alcohol facilitated arthrodesis. Our protocol includes performing the injections under general anesthesia and using radiography to confirm needle placement and to determine that the lower two hock joints do not communicate with the upper two joints. After several days of hospitalization, the horse is released and may be turned out. Follow-up examination and repeat radiographs would be taken four months after alcohol injection. Progress of joint fusion would be determined at that time and a rehabilitation exercise protocol would be recommended.
Dr. Davis and Dr. Kaneps are happy to answer any questions you may have on treating arthritis of the lower hock joints and this new joint fusion technique. Our hospital also uses other cutting-edge techniques for treatment of arthritis and soft tissue injury including: IRAP, fat-derived stem cells, joint injections, mesotherapy, platelet-rich plasma, equine physiotherapy, and shockwave therapy.