Equine Services
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Ambulatory Service
Ballarat Veterinary Practice Equine Clinic offers a twenty four hours a day, seven days a week ambulatory service for clients. We provide first opinion examinations within a vast radius of the practice. Our on road veterinarians are equipped to provide a host of services from routine work such as reproductive services and dentistry, to more complex medical and surgical examinations. We have the backing of our base hospital for further diagnostics and treatment if deemed necessary. Scheduled callouts are arranged by contacting the office during office hours (Tele: 5334 6756), outside of which, an emergency consultation service is available (Tele:
Arthroscopy
Blood-Based Products
There are three major biological blood products in regular use in equine therapeutics. To date these product are autologous – they are only being put back into the horse that he blood was taken from to make the product.
1. Platelet Rich Plasma (PRP)
2. Stem cells
3. Interlukin-1 Receptor Antagonist Protein (IRAP)
PRP and stem cells are mostly used in the treatment of tendon and ligament injuries while IRAP is mainly employed to treat arthritic joints and maintain joint health in exercising horses.
Platelets are involved in clot formation, however they have also been found to release and attract growth factors that aid healing of all tissue throughout the body. PRP has a significant effect when tendons/ligaments are in an acute phase of injury and is believed to attract stem cells to the injured tissues to aid in healing.
Similarly, stem cells aid in healing by dividing into cells that are capable of repairing tendons and ligaments. The advantage of stem cells is that they reduce the amount of scar tissue formation and heal in a more organized fashion, increasing the strength of the healed tendon and ligament fibres. There are two techniques available to harvest stem cells, one can be done on site and takes about 3 hours. The alternative is to grow them in a specialised laboratory where it can take several days to grow up sufficient numbers for an individual treatment.
IRAP is used to treat osteoarthritis in the horse. Interlukin-1 is a potent inflammatory mediator and can induce osteoarthritic changes. The body has IRAP naturally to counteract this protein – IRAP. To concentrate this protein blood is collected, incubated for 24 hours and then processed to provide several small injections that can be given directly into an inflamed joint.
Bone Scanning (Scintigraphy)
Nuclear scintigraphy (bone scan) is a diagnostic imaging technique which uses a radioactive isotope to detect areas in the skeleton where active modeling occurs. The theory being that where bone is damaged and the body tries to repair that damage bone turnover will increase. These areas are recognised as ‘hot spots’ on the image. Scintigraphy is therefore extremely helpful for detecting painful sources of lameness in horses undergoing modeling such as the racehorse and is very accurate for showing “bone stress reactions or fractures”. Because the whole skeleton can be imaged, normally difficult areas to examine such as the spine, pelvis and hindquarters are easily viewed. Specific indications include the diagnosis of lameness where the site of pain is known but x-rays are negative and for the athletic horse where there are multiple sites of pain. Bone Scanning has become an integral part of lameness diagnosis at the Ballarat Veterinary Practice. To reduce cost and be more precise we always perform scinitgraphic examination after first conducting a thorough lameness evaluation which may or may not include nerve blocks and x-rays.
Scanning horses in training is possible with little disruption to their fitness programs. The procedure can be performed and the horse discharged within 24 hours. A whole body scan can be performed to evaluate known sites causing lameness and to identify other sites which may be resulting in reduced performance. Elite athletes can be "fine tuned" in this way by treating specific sites found to be affected. Alternatively a horse about to be spelled can be scanned to identify areas that may need treatment during the spelling process.
Horses are usually admitted on the day prior to the planned scintigraphic examination at which stage a lameness evaluation is conducted. On the day of the scan, the horse will be injected with the isotope, technetium 99. It takes approximately 2 hours to achieve good distribution of the isotope in the bones. Once the technetium has been absorbed by the bone the scan is performed. The gamma rays are collected by the gamma camera over a period of time, (generally 90 seconds per image). The image production requires that there is minimal movement of the body part being scanned, or the images produced will be 'blurred'. In order to produce high quality images all horses are sedated prior to scanning. The gamma camera is connected to a computer that uses the information collected to build up 2D pictures of the horse’s skeleton. These pictures are then analysed by the veterinarian.Depending on how big a part of the horse has to be scanned the examination generally lasts between 1 and 3 hours. Due to radiation safety horses are kept in isolation for 24 hours after the injection of the isotope.
As mentioned, nuclear scintigraphy is a highly useful diagnostic aid, but it should always be used in conjunction with a full lameness examination, therefore it may sometimes be necessary for your horse to stay slightly longer than the time taken to perform the scan.By combining the scanning results with other imaging modalities such as computed radiography, ultrasonography and using diagnostic analgesia (nerve blocks), a more precise diagnosis is possible. This enables a more accurate estimate of prognosis, which in many cases is critical when dealing with equine athletes.
Colic Surgery
At the Ballarat Veterinary Practice we offer a full service for equine colic cases, both in the first opinion as seen by our field veterinarians, and referral cases from other veterinary practices all over Victoria. Most of the cases we admit to hospital have been seen on farm by another veterinarian, and have shown little or no response to initial treatment including pain relief, sedation, and stomach intubation. The big question we then have to answer is does the horse require emergency surgery or can we effectively manage the case with intensive medical care? Every colic case admitted to BVP gets a standard diagnostic work-up in order to answer this question, including a full clinical and blood examination, as well as a blood blood lactate measurement. A rectal examination is then performed either by the attending veterinarian or the surgeon. In some cases this is diagnostic and a plan can be made, however in many cases an abdominal ultrasound is then performed. With all of this information, our client is then given the options for further medical or surgical treatment, including the costs and expected prognosis in each case.
On average at BVP we would perform 20-30 colic surgeries per year. The expected outcome varies depending on the cause of the colic and sometimes the prognosis changes once surgery is underway and the full extent of the problem is assessed. With a smooth uneventful post-operative period, a horse which has undergone colic surgery would be hospitalised for between 7-10 days, but this can be longer if complications occur.
Computed Radiography
At the Ballarat Veterinary Practice we have a computed radiography system which allows us to take comprehensive sets of x-rays in a minimal amount of time, and produce images which are of the highest quality available in veterinary medicine. Our radiography suite includes a dedicated imaging room with non-slip flooring, and adjacent processing/editing area. The viewing facility is available on 2 large computer screens in the adjacent office. On these images we can adjust the contrast, exposures and make many other fine adjustments to the picture, and magnify areas of interest. Measurements can be made to facilitate surgical planning, and original and edited radiographs can be printed, emailed or copied to CD for distribution to our clients.
We also have the ability to take radiographs whilst in surgery, and all radiographs can be viewed inside the operating theatre by the surgeons.
Gastroscopy
We can examine the equine stomach at our clinic. No longer are horses with vague digestive disorders treated symptomatically, gastric ulceration can be quickly diagnosed and treatment tailored to the extent and severity of identified lesions. Horses are starved for 12-18 hours prior to gastroscopy and under sedation, with a nose twitch applied, the mucosa of the stomach is viewed and recorded on videotape.
General Equine Medicine
Laboratory Services
Ballarat Veterinary Practice Equine Centre has its own well equipped laboratory as well as the ability to refer samples promptly by courier to a specialist laboratory when necessary.
“In house” we can offer a full blood profile on your horse. Haematology allows us to assess a patient’s white blood cell count, red blood cells and platelets. Our biochemistry machine enables us to look at electrolytes and muscle enzymes as well as assessing kidney and liver function. In addition we can quickly assess blood levels of triglycerides, blood gases and lactate.
Our vets are able to evaluate and interpret general health and performance horse profiles, making recommendations as required.
The clinic is able to process IRAP in-house, Platelet rich plasma and fibrinogen. We can also promptly measure the immunoglobulin levels in a newborn foal to assess the transfer of immunity from the mare’s colostrums.
Access to a regional laboratory allows us to offer a full pathology service including culture and sensitivity analysis and histopathology.
Lameness Assessment
At the Ballarat Veterinary Practice we cater for all breeds and types of horses that require a lameness evaluation. During a lameness work up, we take the time and have the facilities to assess the whole picture of your horse's lameness issue. The initial assessment includes the conformation of the patient, the base line lameness and may extend to lunging the horse in our lunging ring and on different surfaces.
Following that, it will be decided which further diagnostics will best suit the case. We offer a wide range of facilities to aid in the diagnosis, including regional nerve and joint blocks, radiography, ultrasound and scintigraphy (bone scan). We then design a treatment protocol which may include IRAP, shockwave therapy, surgery and/or corrective shoeing, all of which are available at our clinic. Follow up is also very important to us at BVP as we strive to return your horse back to their best.
Laparoscopy
Laparoscopy is a procedure that allows visualisation of the equine abdomen, without performing an exploratory laparotomy. The abdomen is insufflated (distended) with gas, usually carbon dioxide, and instruments are inserted through portals in the flank of the horse. A video camera attached to th eviweing laparoscope allows visualisation of the internal abdomen on a monitor. The advantages of laparoscopy over laparotomy are that the procedure can be performed standing, with no general anaesthetic required, it is relatively non-invasive and is associated with fewer complications.
Laparoscopy can be used both for diagnostic purposes and surgical procedures. Diseases that can be investigated include, chronic weight loss, chronic colic, intra-abdominal haemorrhage, neoplasia and peritonitis. Indications for surgical laparoscopy include, cryptorchid castration, ovariectomy, ruptured bladders, hernia repair, granulosa theca cell tumour removal and breakdown of abdominal adhesions.
Laryngeal Surgery
Laser Surgery
Ballarat Veterinary Practice offers laser surgery for the excision of soft tissue structures and lesions. Laser surgery is performed with the horse standing and sedated in most cases. Non compliant horses will sometimes need a general anaesthetic. The most common application for the laser at Ballarat Veterinary Practice is in upper respiratory tract surgery when the laser cable is passed down the endoscope and direct vision of the tissue and laser beam are visible. Procedures include removing the vocal cords and aryepiglottic folds, sterilizing chondritis lesions and excising sub-epiglottic cysts. Other applications for the laser include removal of squamous cell carcinomas and sarcoids.
Nerve Muscle Pedicle Graft
The nerve muscle pedicle graft is a technique used to innervate a muscle that has lost its natural nerve supply. In horses it is used primarily to reinnervate one of the muscles responsible for opening the larynx of horses that are afflicted with the condition commonly known as "roaring". In this condition the horse has a partly or totally paralysed muscle on one side of the larynx usually the left side and it renders most horses unsuitable for high speed exercise such as racing.
The nerve muscle pedicle graft as a technique of muscle reinnervation has been investigated since the early 1970's when it was tested in dogs as a model for use in people. The first people to be successfully reinnervated were reported on in 1976 by the pioneer of laryngeal reinnervation Dr Harvey Tucker form the Cleveland Clinic in America. The first research undertaken in horses was at Cornell State University in New York State. Dr Norm Ducharme and colleagues were the first to describe 3 different ways to attempt laryngeal reinnervation in the horse.
Between 1987 and 1990 Dr Ian Fulton and a team of researchers at Michigan State University were able to show using treadmill studies that effective laryngeal reinnervation was possible in horses that were experimentally created "roarers". Since 1990 Dr Fulton has been performing the nerve muscle pedicle graft in both racing and pleasure horses. The technique has been shown to allow at least 60% of race horses to go back and win races. Dr Fulton has operated on over 300 horses with this technique.
Ongoing research at Michigan State University is trying to improve the success rate and time for muscle function to return using peripheral nerve stimulation. This project is being conducted by Dr Phil Cramp as a resident in Equine Surgery at Michigan State. Other research that is ongoing involves using growth factors being used at the time of surgery and is being undertaken by Dr Kate Steel at Melbourne University in collaboration with Dr Fulton.
For more information on this procedure please contact Dr Ian Fulton or Dr Brian Anderson at the Equine Clinic.
Orthopaedic Surgery
Ballarat Veterinary Practice offers a full range of orthopaedic surgical services. Procedures range from elective arthroscopy to the emergency repair of fractures. Examples of arthroscopic procedures include; diagnostic arthroscopy to help verify radiographic/bone scan findings, chip fracture and bone cyst removal and the treatment of OCD. In addition to arthroscopy, Ballarat Veterinary Practice also offers tenoscopy (looking inside tendon sheaths) and bursoscopy (looking inside bursae like those at the point of the hock).
Fractures of the lower limb bones including the pastern and fetlock region in the horse can be devastating, however Ballarat Veterinary Practice offers internal fixation with plates and screws to repair these fractures. Examples of fractures that can be repaired by surgical intervention include fractures of the first phalanx (long pastern bone) and cannon bone condylar fractures.
Angular limb deformities are a common occurrence in foals and need to be corrected early in life to improve conformation. Ballarat Veterinary Practice offers periosteal stripping and transphyseal bridging with both transphyseal screw placement and screw and wire technique to correct the more severe angular limb deformities.
Poor Performance Examinations
If your horse is not performing to its potential then the Ballarat Veterinary Practice can help. At BVP we have one of the most extensive “poor performance” examinations available. The areas that are examined are broadly catagorised into general health, lameness, respiratory and cardiovascular.
1. An assessment of your horse’s general health is conducted while a complete history is taken. At this point a full blood profile may be recommended.
2. A comprehensive lameness examination is conducted including flexion tests and lungeing. This may reveal an abnormality which can be further investigated using nerve/joint blocks, computed radiography, ultrasonography and/or scintigraphy (bone scan).
3. To investigate the upper airway a video endoscope is used to assess the nasal passage, guttural pouches, pharynx/larynx and trachea. If any abnormalities are detected further diagnostic procedures can be conducted including a lung wash, computed radiography, sinoscopy and exercise endoscopy.
4. The cardiovascular system is investigated initially by auscultation of the heart at rest. Following this it is possible to assess the heart rate and rhythm after exercise, conduct an electrocardiogram or an echocardiogram.
The “poor performance” examination can be completed in a short period of time if the clinic presentation and history or indicative of a common problem. However, the poor performance may be caused by very subtle changes in which case more of the procedures outline above may be required to diagnose the cause. Our veterinarians will explain each procedure and its cost before it is conducted.
Pre-Purchase Examination
Pre-purchase examinations are conducted regularly at the Ballarat Veterinary Practice. We follow the guidlines set out by the Australian Veterinary Association. This involes carrying out a 2-stage or 5-stage examination. A 2-stage examination invoves a full clinical examination including general health check, lameness examination and flexion tests. A 5-stage examination involves a 2-stage examination and also assesses your horse during and post exercise. We also conduct upper respiratory tract endoscopy, electrocardigrams, tendon ultrasounds, reproductive tract assessments, radiography, scintigraphy and drug screening if required. Please contact us if you would any more information on
Referral Surgery for Emergancy Cases
We offer a twenty four hour service 365 days a year for vets wishing to refer any form of equine emergency, be it medical or surgical. At all times we have a specialist surgeon, an anaesthetist, a nurse and two other vets on call. We have a fully equipped surgery and frequently perform anything from colic surgery to emergency wound or orthopaedic surgery. We have vets able to provide intensive care and monitoring of cases throughout the night, a vital requirement for many equine emergencies. We are easily accessible from the Western Freeway and just over an hours drive from Melbourne. Vets who are unsure if a case needs referring are welcome to call any time for advice. If you have any questions or have a case which you would like to refer please contact us on
Shockwave Therapy
Shock wave therapy is proving to be a new and exciting way of treating bone, ligament and tendon injuries in horses. The treatment applies numerous high frequency impulses to the injured tissue whilst the horse is sedated. The shock wave therapy stimulates the horse’s own repair systems to create better and faster tissue repair. Extracorporeal shock waves are acoustic waves generated outside the body which create high energy waves in tissue. Shock wave therapy enhances blood flow and cellular metabolism, which helps to stimulate ligament and bone growth and decrease overall rehabilitation time following injury. The treatment also has the benefit of reducing pain in many chronic injuries such as splint bone fractures and chronic tearing of tendons and ligaments. The course of shock wave therapy is usually administered every 2-3 weeks over a 6 to 9 week period on an out-patient basis. Conditions which may benefit from this treatment include sesamoiditis, splints, tendon and ligament injuries (such as high suspensory desmitis), back problems, bony reactions and some cases of fractures.
Ultrasound
Ultrasound imaging in Veterinary Medicine has provided practitioners with a unique diagnostic tool for diseases of soft tissue. It is a safe, non-invasive and often, portable imaging modality that allows visualisation of any soft tissue including, but not restricted to the lungs, heart, tendons, abdominal organs and the reproductive tract. Ultrasonic sound waves of specific frequencies create sonographic images identifying different tissue types and densities, shapes and integrity, as well as the presence of air and fluid.
Ballarat Veterinary Practice boasts a portable reproductive ultrasound machine which can be used at our clinic or on your property if you have a suitable crush available for rectal reproductive examination and pregnancy diagnosis. The clinic is also equipped with a state of the art Ultrasound machine that is used exclusively in house and has the capacity to store images as well as print them immediately. This machine also has Doppler flow ultrasound used for more advanced cardiovascular assessment.
Video Endoscopy for Respiratory Diagnostics
One of the more common problems we see at the Ballarat Veterinary Practice is performance horses which are making abnormal respiratory noise during work. The first line of assessment in these cases is resting endoscopy, where we can visualise the airways from the nostril to the lower trachea. Our endoscope is attached to a large video screen, which allows real-time viewing of the entire procedure by our veterinarians and our clients. Every procedure is recorded to a CD. Respiratory tract endoscopy is also used in the case of suspected bleeding, and other abnormal nasal discharges, coughing or respiratory compromise.
A valuable addition to our diagnostic work-up of abnormal respiratory noise is the use of video endoscopy whilst the horse is running on a treadmill. Many upper respiratory tract problems are only evident during work and treadmill endoscopy allows a more thorough evaluation of the problem and the extent to which it is affecting the horse’s performance. Most horses adapt to the treadmill easily with a few ‘training sessions’.
Our video endoscopy equipment can also be used to do gastroscopy in the case of suspected oesophageal or stomach problems (commonly ulcers), and can even be passed into the bladder to help us assess problems with the lower urinary tract, and into the rectum for colonoscopy.
Yearling Sale Radiography
Ballarat Veterinary Practice is home to some of the leading sales & racehorse veterinarians in Australia. We provide a comprehensive service on all aspects of the pre-purchase examination of the Thoroughbred yearling including physical, radiological, and endoscopic evaluation. At the sales our service includes physical examination, conformation appraisal, pre-sale interpretation of radiographs and upper respiratory tract endoscopic evaluation. We also provide computed radiography and video endoscopy to sale vendors at our purpose built equine hospital for all pre-sales requirements.
