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The Veterinary clinics of North America. Equine practice.
Publisher:
W.B. Saunders,
Frequency: Three no. a year
Country: United States
Language: English
Start Year:1985 -
ISSN:
0749-0739 (Print)
1558-4224 (Electronic)
0749-0739 (Linking)
1558-4224 (Electronic)
0749-0739 (Linking)
Impact Factor
1.1
2022
| NLM ID: | 8511904 |
| (DNLM): | SR0053812(s) |
| (OCoLC): | 11078671 |
| LCCN: | sn 84006968 |
| Classification: | W1 VE929F |
Clinical presentation, diagnosis, and prognosis of chronic laminitis in North America. Chronic laminitis involves laminar morphologic changes resulting in digital collapse and can vary greatly in its clinical manifestation depending on duration, severity of lameness, and stability of the distal phalanx/hoof wall interface. Accurate assessment of the whole patient is mandatory and consideration must be given to signalment, occupation, and owner expectations, as well as history and etiology, which often predict the broad course of the disease. Diagnosis is made via physical examination with adjunctive serial radiographic evaluation and possibly venography. Eventual functionality o...
Therapeutic hypothermia (cryotherapy) to prevent and treat acute laminitis. Digital hypothermia successfully reduces the severity of experimentally induced laminitis. Continuous-distal limb cryotherapy may be a useful technique in clinical cases that are at risk of developing laminitis. This article examines the effects of hypothermia on tissue as well as the rationale, and suggested protocols for the usage of distal limb cryotherapy in the prevention and treatment of laminitis.
The pharmacologic basis for the treatment of developmental and acute laminitis. The treatment of laminitis has been fraught with confusion and controversy for several decades, mainly because of a lack of understanding of the pathophysiology of the disease process. However, recent advances in laminitis research have greatly improved our understanding of the disease process. This article discusses the various treatment options for laminitis in the context of the findings of recent scientific investigations of laminitis pathophysiology.
The use of the wooden shoe (Steward Clog) in treating laminitis. This article describes the use of the wooden shoe in the treatment of chronic laminitis. The shoe, designed to provide a solid base and full roller motion, offers mechanical advantages and enables reduction and redistribution of forces within the hoof capsule.
80 causes, predispositions, and pathways of laminitis. For most of history, the causes of laminitis have been based on observations. In the last 30 years or so, however, the number of theories has exploded, with only a few being confirmed by experiments. This article highlights these theories.
Equine venography and its clinical application in North America. The digital venogram uses contrast radiography to evaluate the soft tissues and vasculature of the foot, thus identifying pathology attributable to laminitis. Pathology can be detected before changes appear on plain-film radiographs. When used in conjunction with clinical and radiographic findings, information gained from a venographic study informs and directs treatment. Serial venograms assess the response to treatment and help determine prognosis early in the course of therapy. If the venographic contrast pattern does not improve, either the treatment needs to be altered, or the damage is s...
Microbial events in the hindgut during carbohydrate-induced equine laminitis. Equine laminitis is the most serious foot disease of the horse, often resulting in death or euthanasia. Laminitis has long been recognized as an affliction of horses, as has the association of this condition with the ingestion of carbohydrates. Research into the pathophysiology of this condition has been facilitated by the development of reliable models for experimentally inducing laminitis, and DNA-based techniques for profiling complex microbiomes have dramatically increased the knowledge of the microbiology of this disease. Recent studies have provided substantial evidence showing equine hi...
The anatomy and physiology of the suspensory apparatus of the distal phalanx. The equine hoof capsule protects the softer, more sensitive, structures within. Failure of the connection between hoof and bone (suspensory apparatus of the distal phalanx or SADP) results in the crippling lameness of laminitis. Active basal cell proliferation occurs principally in tubular hoof and proximal and distal lamellae. The remaining lamellae are virtually non-proliferative and the hoof wall moves past the stationary distal phalanx, by controlled activation and inhibition of constituent proteases. The lamellar corium derives most of its blood supply from the branches of the terminal ar...
Home care for horses with chronic laminitis. Home care for horses with chronic laminitis has been discussed rarely in the veterinary literature even though, at any given time, most of us have at least 1 chronic laminitis case in our care that is being managed at home by the owner. Almost all of our knowledge on this aspect of laminitis treatment has been gleaned through experience, by individually working through the medical, ethical, financial, and emotional challenges these cases can present. Much has already been presented on the medical management of the laminitic horse and on strategies for trimming and shoeing the laminitic foot. T...
Progression of venographic changes after experimentally induced laminitis. Venography (retrograde venous angiography) is a relatively simple and practical method for vascular assessment of the digits in the standing horse. The technique is a useful adjunct to routine radiography. The clinical use of the laminitis venogram has resulted in a more comprehensive understanding of the collateral pathology associated with distal phalanx displacement and abnormal hoof growth. The effectiveness of therapeutic procedures such as hoof wall resection, coronary band grooving, deep digital flexor tenotomy, and therapeutic shoeing can be assessed by serial venography. This article ...
Overview of current laminitis research. All cases of laminitis are characterized by failure of the attachment of the epidermal cells of the epidermal laminae to the underlying basement membrane of the dermal laminae despite the diversity of diseases that underlie the syndrome. The preponderance of evidence supports roles for inflammation, metabolic derangement, endothelial and venous dysfunction, and matrix degradation as causes of laminitis. Inflammation, oxidant stress, and matrix degradation may be factors common to each of these mechanisms that lead to the laminar damage of laminitis. The understanding of the pathophysiology and...
Laminitis treatment: a personal memoir. The author has completed 40 years as a veterinarian treating horses with laminitis. The article is a recollection of his experiences with laminitis and the various treatment methods he came across while trying to treat the disease.
Marketing your equine practice. The take-home message in marketing your equine practice is simple: understand your position in the target market and the buying behavior of your current and prospective customers. Time well spent on analysis and evaluation of options can maximize customer value in the services and products you offer. This allows you to capture profit and to attain your personal and professional goals as an equine practitioner.
Current economic trends in equine practice. Current economic trends in equine practice are trends of weakness. Most practices, after a decade of double-digit growth, have migrated to survival mode within a few months. Understanding that all regions and disciplines are affected differently, using the Porter five forces model, we can identify changes that must be made in our business models first to survive and then to position ourselves to prosper when the recession ends. If we are to avoid long-term damage to our practices, we must use cost control and work efficiency in addition to price concessions.
Customer service in equine veterinary medicine. This article explores customer service in equine veterinary medicine. It begins with a discussion about the differences between customers and clients in veterinary medicine. An overview of the nature of the veterinary-client-patient relationship and its effects on the veterinarian's services sheds light on how to evaluate your customer service. The author reviews a study performed in 2007 that evaluated 24 attributes of customer service and their importance to clients of equine veterinarians in their decision to select a specific veterinarian or hospital. The article concludes with an overview...
The transition from veterinary school to equine practice. The transition from veterinary school to equine practice can be challenging. This article provides suggestions and advice for new graduates in areas that include internships, associate positions, financial considerations, balancing personal and professional responsibilities, mentorship, continuing education, and professionalism.
Mergers and acquisitions involving equine veterinary practices. This article discusses mergers and acquisitions involving equine veterinary practices. Combining practices can be professionally and economically advantageous but requires a great deal of thought, planning, and implementation. If due diligence is performed and true business teamwork is undertaken, the benefits can be enormous and rewarding.
Equine associate employment agreements from the employer’s perspective. This article discusses equine associate employment agreements from the employer's perspective. It should also be of interest to prospective equine associates. The substantive issues and questions are the same, and neither employers nor employees are likely to get far unless they "walk a mile in the other's moccasins".
Medical records in equine veterinary practice. Quality medical records are the cornerstone of successful equine veterinary practice. The scope and integrity of the information contained in a practice's medical records influence the quality of patient care and client service and affect liability risk, practice productivity, and overall practice value.
Design of an equine ambulatory practice. In this article, the author discusses the design of an equine ambulatory practice. He suggests a more systematic approach to the design of an ambulatory practice that should answer the needs of group and solo practices. Today's practitioners must actively manage their practices so that their resources can be leveraged in such a fashion that a return can be realized on their capital investment and the hours spent in practice.
Ethics in equine practice economics. Ethics is a valuable standard for the structure of equine practice. It relies on sound moral character, beginning with the leaders in the practice. The leadership in each practice regularly needs to review its role in promoting ethical standards. This is not new information but deserves to be revisited with emphasis at this particular time in our society. Nothing less than commitment to grass root stability offers any hope to reverse those actions.
Practice evaluation and sale transactions: preserving value through economic turmoil. There are several options to value a veterinary practice (market approach, asset approach, and income approach) and several methods within these approaches. Examples of an income-based approach include excess earnings, discounted future returns, and single period capitalization of earnings. A qualified valuator will use his or her professional opinion and experience to determine the most appropriate method for one's practice situation. This article outlines the excess earnings method for which where the principal components of value are net assets and goodwill.
Design of a multifaceted referral equine hospital. There is no simple recipe for designing a multifaceted practice. However, keys to any design are the devotion of the people involved and proper positioning of such people in the organization. Anyone designing such a practice also must pay keen attention to details and a keep a finger constantly on the pulse of the business to ensure that it maintains a sound financial footing and a consistent vision. Little money is made from savings or pushing financials. Profits come mainly through building additional sales, maintaining a clear vision, and making shrewd investments. Like for every small busi...
Gender shifts in equine veterinary practice. This article examines gender shifts in equine veterinary practice. A significant gender compensation gap continues across the spectrum of professions, including veterinary medicine. Many styles of practice serve the disparate and sometimes conflicting goals of financial well-being, patient care, and physical family presence.
Enteroliths and other foreign bodies. This article focuses on obstructive diseases of the large intestine (large and small colons) caused by intraluminal bodies. Large intestinal obstructions from intraluminal bodies can be divided into the following categories: enteroliths or mineral concretions, bezoars (hair or plant material), and ingested foreign objects. Clinical presentation and treatment of obstructive diseases are presented in this article and are similar regardless of the cause.
Acute diarrhea in hospitalized horses. The development of diarrhea among hospitalized horses is a major concern for equine veterinary hospitals and referral centers. It is a potential complication of hospitalization for surgical or medical procedures and can contribute to the morbidity and mortality of horses with gastrointestinal and non-gastrointestinal diseases. Unfortunately, it can be difficult to pinpoint the exact cause of acute diarrhea or colitis, and in most cases, the specific etiologic agent is presumptive or undetermined. This article discusses the major etiologic agents of diarrhea in hospitalized horses, considers fa...
Update on recent advances in equine abdominal surgery. In recent years important advancements in colic surgery have led to improved prediction of survival rates, better survival rates, and decreased complication rates. This article describes several modalities to combat and prevent incisional hernia and intestinal adhesion formation in horses undergoing colic surgery. These modalities have had a positive impact on reducing complications in horses after surgery.
