Follow Veterinary Practice News on Twitter at @vetpetnews. Equine veterinarians whose portable equipment is showing its age may want to go shopping now for the latest in blood analysis, digital imaging, ultrasound and laser therapy machines. One major reason: Technology has changed greatly, permitting more accurate and less-invasive diagnosis and treatment compared with was available just 10 years ago. Portable and compact blood analyzers, some hand-held, are one example. Today, they can perform full chemistry and electrolyte panels, check blood gas and test fibrinogen or lactate. With just a few drops of blood, results are available in less than 15 minutes, and sometimes in seconds, without the need to collect, store and transport samples to the clinic for analysis. “Point-of-care results have tremendous benefit for the veterinarian, patient and owner,” said Craig Tockman, DVM, director of professional services at Abaxis North American Animal Health of Union City, Calif., which makes blood analyzers. “The doctor has the ability to communicate immediately with the owner, providing for better compliance and customer service, including face-to-face discussion of prognosis and treatment options not available with results sent later that day or even the next.” Most blood analyzers can be powered by a mobile clinic’s auxiliary outlet. Optional printers spit out hard copies. “Immediate results allow the doctor to either make a diagnosis or determine the need for additional tests,” Dr. Tockman says. “Medications can be altered without a second visit. Treatments can be changed on the spot. Compliance is increased. Stress is reduced for the owner as well as the patient, since multiple visits are reduced. “The owner saves money by reducing the number of barn calls. The veterinarian is more effective and can make more calls each day.” Take a Look Inside Technological advances have greatly enhanced portable computed radiography (CR) and direct digital radiography (DR) equipment, says Joni Watkins, a consultant for Sound-Eklin of Carlsbad, Calif., which makes digital radiograph and ultrasound equipment for veterinary and human medicine. Excellent image quality and the ability to view and retake images in the field make today’s portable equipment a good investment over older equipment, Watkins says. Using either CR or DR, practitioners can diagnose and treat on a single visit and with only one dose of sedation, says Watkins, an experienced equine X-ray technician. Portable CR allows equine practitioners to take intra- and extraoral radiographs and process the images at the farm within minutes. Because portable DR uses electricity and not the phosphorus cassettes that CR requires, images take just seconds to process. Patients are subjected to a lower dose of radiation with DR, and images are usually of higher quality than with CR. DR equipment is especially useful in diagnosing distal extremity injuries, from the elbow down, Watkins says. Practitioners can view abnormalites from multiple angles, reducing the risk of missed diagnoses. CR and DR units are available in different wattages and with improved radiation safety for patients, staff and horse owners. Most new units plug into the veterinarian’s laptop. Touch screens allow for easy navigation through acquistion and review. Also a welcome improvement: Some models have line voltage compensators and surge protectors for use at barns and farms whose wiring doesn’t quite match up. The machines are compact and lightweight, about 15 to 25 pounds, allowing for easy portability and storage in a truck or the back seat of an SUV. “The units are on wheels and roll easily between barns, much like rolling a piece of luggage through the airport,” Watkins said. Jack Easley, DVM, MS, Dipl. ABVP (equine), points out that the excellent contrast between bones, teeth and air make the horse’s head an ideal area for radiographic evaluation in equine dentistry. “The quality of dental services can be enhanced by using both CR and DR techniques in clinical examinations,” he says. Dr. Easley owns Equine Veterinary Practice in Shelbyville, Ky., and serves on the American Association of Equine Practitioners’ Dentistry Committee. Ultrasound, Too Many tissue injuries that once had to be diagnosed at the hospital or clinic now can be identified during a barn call. Portable, battery-powered, laptop-based digital ultrasound units display high-quality, high-resolution images. From palm-sized scanners to standard-sized portable units, image quality has vastly improved as technology advances. Sally Vivrette, DVM, Ph.D., Dipl. ACVIM, says portable ultrasound provides more timely and accurate diagnoses without having to wait for a horse to be transported to a referral hospital. Dr. Vivrette, a mobile equine practitioner and owner of her own practice, Triangle Equine of Cary, N.C., uses ultrasound regularly to diagnose lameness or reproduction issues, as well as for examining chests and wounds and searching for foreign bodies. She fits her ultrasound unit behind her SUV’s front seat. “The portable ultrasound also allows for periodic follow-up examination,” she says. “We can modulate exercise programs and track the gradual progression of healing as the horse gets back to its training routine, easily monitoring the healing of tendons and ligaments.” Vivrette also considers her one- and three-meter endoscopes important portable tools for the mobile equine veterinarian. She uses them not only for routine and emergency upper airway 威而鋼 and stomach examinations, but in pre-purchase exams, too. Cathy Hebert, marketing director for VetImaging Inc., of Irvine, Calif., agrees that a portable ultrasound can help make an equine practitioner’s practice more effective. “The portability lets equine veterinarians scan more frequently, generating more revenue while strengthening client confidence and loyalty,” she says. “Plus, because the units have improved image optimization and scan in seconds, retakes are fewer and efficiency is increased.” Hebert says developments in software-based image processing make the latest ultrasound equipment incomparable to yesterday’s models. Easily updated through software changes, today’s portable units also offer superior high-resolution image quality. She also says visualization technology lights up the needle on the ultrasound screen, crucial to safe needle interventional procedures—an advancement invaluable with stem cell therapy. Obstetrics and theriogenology ultrasound are benefitting from technological advances as well, she says. Among the developments with the rectal tranducer are improved ultra-high-resolution 2D and Doppler imaging technology. Shine a Light Laser therapy is successfully treating many musculosketetal injuries in performance, show, race and backyard horses, says Darrel R. Kramer, DVM. The therapy laser causes a photochemical response that makes the cell go into hyperdrive, he says, increasing cellular metabolism and cellular respiration rate. Dr. Kramer owns an equine practice, with a concentration on chiropractic care and acupuncture, in Casa Grande, Ariz. “It is especially good for pain relief,” he says of the therapy laser. Kramer uses his therapeutic laser every day. He first started using an LED laser unit in 1993 and upgrades his equipment regularly. His current unit weighs four to five pounds, so “I carry it on my shoulder and can move around the horse easily.” “I’ve read in the veterinary journals that most equine practices are including laser therapy for treatment,” Kramer says. “There’s nothing like it for treating post-op pain.” Laser therapy breaks and halts the inflammatory cycle, he says, creating an analgesic effect when the cells release endorphins. He attributes much of a treatment’s success to the practitioner’s technique. “Today’s equipment may be stronger and more versatile,” he says, “but veterinarians will get better personal results and keep improving their technique as they gain more experience using the laser unit.” Want more Veterinary Practice News? Go here. <HOME>
