CASE STUDIES

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MILD NEONATAL MALADJUSTMENT

"Curly" presented with a normal IgG after birth, but could not reliably latch to nurse, had a hard time getting around, and developed diarrhea shortly after birth. By the next morning his diarrhea had worsened, and was acting depressed and would not nurse. The mare was milked and we delivered milk to the foal via stomach tube. After an IV catheter was placed a 1L of dextrose was given. The Madigan Squeeze technique was then performed, in which time Dr. Arledge discussed options with the owner and the vets at Virginia Tech. The owner opted to bring the mare and foal into the clinic and they were admitted late evening. Plasma, fluids, anti-diarrheals, and antibiotics were given on arrival. Fluids and plasma dramatically helped his demeanor and willingness to nurse on his own.
He was treated QID with antibiotics, anti-diarrheals, gut protectants, fluids and was given another bag of plasma. Regular blood-work was sent our intermittently to ensure we were on the right track. Fecal samples were sent out to determine if we were dealing with something infectious - thankfully the results revealed nothing of the sort.
By the end of week three, his blood work was all WNL and he had become very spirited and was nursing regularly on his own.
After four weeks of round-the-clock care, Curly was able to be brought home and has since turned into a very big, strong and happy colt.

 
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SARCOIDS

Olive was first seen by our practice in June of 2019. At the time, she was a 5 year old miniature mule and had been battling sarcoids for 2 years. Dr.Arledge performed a procedure to make a sarcoid vaccine from frozen pieces of the scaroid in her neck. She aslo resected multiple sarcoids from her legs.
Chemotherapy agents were injected as well as used topically. Cryotherapy was also used. The sarcoids were so aggressive that Olive was referred to Blue Ridge Equine so that more of the sarcoids could be debulked under general anesthesia.
Olive was seen every 2-4 weeks over the next year in order to gain control of this difficult problem. In that time, tumors were removed from around her face and eyes, as well as from her legs. As soon as one are seemed to be controlled, another area became active!
The thing that became very apparent with this case was that it is very important to have a good working relationship between the owners and veterinarians. The treatment plan had to constantly be changed ad re-evaluated in order to stay ahead of the sarcoids.
Although sarcoids aren't metastatic tumors, they are very locally aggressive.
It took about a year to get these sarcoids under control. Today, Olive lives a great life on the farm as well as serving as an ambassador to children that have various health issues and cancers. She is a special little mule that makes everyone smile!

 
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BOT LARVAE INFESTATION

Dr. Arledge received an early morning call for an emergency colic. This horse had previously been on stall rest treating a bad hoof abscess and had a history of irritability. On arrival the horse was standing and trying to graze. He presented with a normal pulse and respiration rate and reduced gut sounds. Dry manure was found upon doing a rectal exam however, the horse had no palpable displacements. Dr. Arledge tubed the horse with water, mineral oil, epsom salts and electrolytes. The owner was instructed to monitor him for any changes or increased uncomfortability. They were to offer a small meal of soaked mash or grain that night with sucralfate as well as small feedings of soaked hay throughout the day. We were hopeful that by the next night the horse would be able to return to full rations. The horse was prescribed a BID treatment of sucralfate and Ulcerguard next week.
The horse was referred to Blue Ridge Equine Clinic 3 days after being seen as he was still showing signs of being uncomfortable and colicy. Blue Ridge performed a gastroscopy and found a bot-fly larvae infestation in the upper portion of the stomach. Deworming with ivermectin was advised and to keep the horse on an anti-ulcer treatment through this stressful time for him.
We are happy to report that this horse is doing great and is happy & healthy thanks to the combined work of the doctors!
This is also a great reminder to all clients to keep your horses on a regular de-worming schedule with fecal egg count checks, as well as being sure to remove bot fly eggs from your horse's legs during the spring and summer.

 
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EYE INJURY

An early morning call  came from a client who reported one of their horses had a huge laceration around and possibly involving the horses eye. This was an emergency due to the clients description of the laceration and possible involvement with the eye.
Upon arrival at the farm, a severe laceration was found medial to the right eye. It was in a “L” formation and upon exam it was discovered to have torn down to bone and involved some of the musculature behind the eye.  A fluorescein eye stain was placed in the eye to determine if any injury to the eye itself had occurred. The stain was negative, fortunately the eye was normal. The horse was sedated and the wound area clipped and scrubbed.  The wound was lavaged and surgically debrided. It was necessary to remove a portion of the cartilage at the orbital rim. As a precautionary measure ointment was placed in the eye and the process of suturing the area was begun. The wound was closed with 2 layers of sutures. A drain was also put in place to allow any excess secretions to freely exit the area. Banamine was administered and SMZ antibiotics were started.
The owner was instructed to apply a hot compress to the area 1 to 2 times per day. In addition the area was to be cleaned daily as well as keeping the drain open. Triple antibiotic ointment was to be applied daily under the wound site. The horse was to receive SMZ's twice a day and oral banamine given to help with pain and inflammation.
On recheck 5 days later the wound had begun to granulate. The wound was cleaned and lavaged. A gauze soaked with betadine was packed into the pocketed area where bone could be visualized.  Several recheck exams for suture removal and further debriding of the area were necessary.
Thanks to the owners dedication and compliance with aftercare instructions after approximately 8 weeks only a slight scar remains.

 
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FETLOCK INJURY

5 year old Quarter Horse gelding, primary use – barrel racing. Owner complaint of recent decline in performance, especially turning to the right.  Previous history of maintenance hock injections. On exam hoof tester negative, RF fetlock increased effusion to joint with good range of motion still present but pain of passive flexion of joint.  When trotted out horse was 1/5 lame on RF and 2/5 lame post fetlock flexion.  To confirm location of lameness intra-articular anesthesia of the RF fetlock with carbocaine was performed. Approximately 20 minutes post injection horse was negative to flexion of the fetlock joint and trotted sound.

Radiographs were taken and a chip fracture off the dorsomedial  aspect of P1 was evident.

When damage to the joint exists, as evident in this radiograph, we know that the cartilage surface and most likely the subchondral bone is compromised. In order to achieve the best prognosis for return to athletic performance surgery is most often recommended to remove the chip fragment to prevent further damage to the articular surface. The arthroscopic procedure also allows visualization of the joint surfaces to determine the amount of damage the joint has already incurred and aids in follow up treatment.

This horse was referred to Blue Ridge Equine Clinic for arthroscopic chip removal and debridement.  The corresponding cartilage surface had some mild scoring as a result of loose chip fragment. Post surgery stall rest with hand walking is required for up to 8 weeks to allow the joint to heal. Currently the horse is doing well, in a rehab program and will be back to racing later this year.