What to expect-arthroscopy for removal of articular fragments:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Radiographs on USB, CD or email.
• Any previous veterinary reports.
• If your horse is to have stifle arthroscopy, please make sure the horse is accustomed to wearing a rug and please bring an appropriate rug for the time of year to accompany the horse.
• Several high quality feeds are provided at the clinic. However if your horse has special dietary requirements and you wish to supply your own feed, please bring this with you.
• Horses should ideally be presented in a clean state, free from mud and faeces.

 

-On admission:

• On arrival at the clinic your horse will be assessed by one of our surgeons.
• The horse will undergo a pre-anaesthetic check.
• A number of radiographs may be obtained and an ultrasonographic evaluation of the joint may be performed in order to determine the exact position of the fragment, in order to optimise the surgical approach.
• The surgical site and intravenous catheter site will be clipped.
• Your horse’s head collar and rugs will stay with the horse.
• All other possessions should be taken home.
• Usually the horse will have surgery the following morning, depending on the proposed schedule, but may also be on the day of admission.
• The surgeon will call you following recovery of your horse from anaesthesia to report on the surgical findings.
• Discharge from the hospital is tailored to the individual needs of the horse and client and will be either in the afternoon or evening following surgery or on the following day.

 

-At discharge:

• A full written report and medication (as needed) will be ready for collection.
• A post-operative exercise programme will be individually tailored to the specific needs of your horse, with restricted exercise periods in the post-operative period of between 4 and 12 weeks depending on the surgical findings and the joints which have undergone surgical treatment. This is crucial to the long-term success of the surgery and soundness of your horse.
• Instructions will be provided regarding bandaging/dressings, incision site care and suture removal.

-At home:

• Please make sure that the stable is kept very clean, with fresh bedding and that the stall is mucked out multiple times daily to avoid faecal contamination of the bandages and surgery site in the first 3 weeks post operatively.

 

 

What to expect-laparoscopy:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous veterinary reports.
• A clean rug must accompany the horse to add further protection to the surgery site following surgery. 
• Several high quality feeds are provided at the clinic. However if your horse has special dietary requirements and you wish to supply your own feed, please bring this with you.
• Horses should ideally be presented in a clean state, free from mud and faeces.

 

-On admission

• On arrival at the clinic your horse will be assessed by one of our surgeons.
• The horse will undergo a pre-surgical check.
• The surgical site and intravenous catheter site will be clipped.
• Your horse’s head collar and rugs will stay with the horse.
• Hay will be removed from your horse’s diet for 24 hours prior to the surgery in order to reduce the intestinal volume.
• The surgery will take place after this period of fasting.
• Key-hole surgery will be performed on your horse through small incisions in the flank region with the horse standing and under sedation. Local anaesthetic techniques will be performed at the surgery sites.
• The incision sites are small, which improves wound healing and the cosmetic appearance of the flanks.
• Depending on the procedure, the surgery will either occur on the left side, the right side or bilaterally.
• The surgeon will call you following surgery to report on the surgical findings.
• Your horse will normally be ready to discharge from the hospital 1-2 days following surgery.

 

-At discharge

• A full written report and medication (as needed) will be ready for collection.
• A post-operative exercise programme will be individually tailored to the specific needs of your horse.
• Instructions will be provided regarding incision site care, dressings and suture removal.
• Please make sure that the stable at home is very clean, with fresh bedding and that the stall is mucked out multiple times daily to avoid faecal contamination of the surgery site in the first 3 weeks post operatively.

 

 

What to expect-colic:

 

• Colic is a symptom of abdominal pain. 
• There are many causes of colic and no two episodes are the same. 
• It is always an emergency until a definitive diagnosis has been made.
• Some causes of colic can only be resolved with hospital medical treatment that cannot be carried out at home. 
• Others can only be resolved surgically. 
• However if the horse does not arrive at the hospital on time it may be too late to save him, even if an exploratory laparotomy is undertaken.

 

-On arrival at the hospital your horse will undergo a number of routine diagnostic procedures to determine whether or not your horse can be managed with medical treatment or whether the type of colic requires a life saving emergency surgery.

 

-If the horse can be managed medically, the clinician will discuss the treatment plan and length of stay with you. In general the horse will stay for 2-3 days and will be ready for discharge once back on a feeding routine.

 

-If the horse requires surgery, a life saving abdominal exploratory laparotomy will be performed. Depending on the type of colic, it may be that the intestine is out of position and needs to be replaced correctly, or that a more complicated surgery needs to be performed, with untwisting of intestine and removal of devitalised tissue, a procedure known as a resection.

 

-If surgery is performed, the horse will require intensive care with hospitalisation for approximately 5-7 days. This may be longer, depending on how sick the horse is on presentation at the hospital. The horse will receive general supportive care and restricted feeding programme in the post-operative period. This period of intensive care is just as important as the initial surgical procedure itself and is crucial to the horse’s well being.

 

-Colic is just a symptom of abdominal pain and not a diagnosis. The cause of the colic and the length of time it has been present, are the most important factors that will determine whether or not your horse has a successful outcome. We can treat and cure almost every colic case if we see the horse on time, while the vital parameters and physiological status is still stable.

 

 

What to expect-castration:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous veterinary reports.
• Several high quality feeds are provided at the clinic. However if your horse has special dietary requirements and you wish to supply your own feed, please bring this with you.
• Horses should ideally be presented in a clean state, free from mud and faeces.

 

-On admission

• On arrival at the clinic your horse will be assessed by one of our surgeons.
• The horse will undergo a pre-surgical/anaesthetic check.
• The horse will be examined to make sure that both testicles are present within the scrotum. 
• There are many ways to castrate a horse and the optimal surgical approach to suit your horse will then be discussed with you, including closed sutured, closed non-sutured, inguinal or scrotal approached for conventional castrations and laparoscopic approaches for cryptorchid horses where the testicle has not descended and remains in the abdomen.
• The intravenous catheter site will be clipped.
• Your horse’s head collar and rugs will stay with the horse.
• The surgeon will call you following recovery of your horse from anaesthesia to report on the surgical findings.
• Your horse will normally be ready to discharge from the hospital on the day following surgery.

 

-At discharge

• A full written report and medication will be ready for collection.
• A period of controlled exercise for 2 weeks will usually be followed by a gradual return to previous levels of exercise.

 

 

What to expect-functional upper airway examination:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous endoscopy images on USB, CD or email.
• Any previous veterinary reports.
• Several high quality feeds are provided at the clinic. However if your horse has special dietary requirements and you wish to supply your own feed, please bring this with you.
• Horses should ideally be presented in a clean state, free from mud and faeces.

 

 

-On admission

• On arrival at the clinic your horse will be assessed by one of our surgeons and internal medicine specialists.
• The horse’s upper airway is a highly tuned and complicated system. Therefore it is vitally important to fully evaluate the functionality of the region prior to any medical or surgical intervention. Signs of exercise intolerance and/or a respiratory ‘noise’ cannot just be fixed with one type of surgery and it is crucial to evaluate where the problem is coming from, prior to embarking on a treatment plan to best suit your horse.
• A resting endoscopy will be performed as part of an initial evaluation of laryngeal function.
• A dynamic/exercise (wireless endoscopy while horse is exercised/ridden) endoscopy will be performed as appropriate to fully evaluate the functionality of the larynx and pharynx.
• Surgical intervention can include:

• Laser ventriculocordectomy
• Classic ventriculocordectomy (hobday procedure)
• Prosthetic laryngoplasty (tie-back)
• Tie-forward
• Epiglottic fold resection

• Your horse will normally be ready to discharge from the hospital 1-2 days following surgery, but may be 5-7 days depending on the procedure or procedures that have been performed.

 

 

-At discharge

• A full written report and medication (if needed) will be ready for collection.
• A post-operative exercise programme will be individually tailored to the specific needs of your horse. Most horses require a 4-6 week period of convalescence, followed by a gradual return to previous levels of exercise.
• Instructions will be provided regarding incision site care, dressings and suture removal.

 

 

What to expect-MRI:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous diagnostic images (Radiographs, ultrasound and bone scan results) on USB, CD or email.
• Any previous veterinary reports.

 

-Your horse’s shoes and all traces of metal will be removed from the feet (both either front or back shoes have to be removed) prior to entry into the scanner.

-The scan is performed under standing sedation on an out-patient basis.

-If no further examinations are to be performed, then the horse will be ready to go home following the scan.

-A full written specialist report will be available after the exam.

 

 

 

What to expect-gamma scintigraphy:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous diagnostic images (Radiographs, ultrasound and bone scan results) on USB, CD or email.
• Any previous veterinary reports.

 

-The horse will be admitted to the hospital on either the day before or the morning of the scan. Horses will be discharged 24-48 hours following the scan depending on whether further investigation or treatment has been requested.

-The horse can either be admitted solely for the scan, or as part of further evaluation and treatment of orthopaedic problems.

-A radio-active isotope will be injected into the horse by intravenous injection.

-The isotope is attached to a marker, which binds to regions of increased bone turnover. A gamma camera will then be used to detect the intensity of the uptake throughout the horse’s skeletal system. Regions of increased activity/inflammation will show up as ‘hot spots’. The technique can also be used to identify certain soft tissue injuries.

-The horse will stay in isolation protocol for one day following the scan. This is to allow for decay of the radioactive isotope and is dependent on the half-life of the product used. The isotope is not dangerous for your horse in any way, but for humans repeated exposure to the isotope once excreted by the horse in urine should be avoided. 

-The horse will be ready to go home the day after the scan or further orthopaedic evaluation, imaging and treatment will be undertaken at this time if necessary.

 

 

What to expect-emergency admissions:

 

-The hospital is open to emergency admissions 24 hours a day, 365 days a year.

-Appointments for emergency admissions can be made via our out of hours emergency line.

-A team of European Specialists in Surgery, Internal Medicine and Diagnostic Imaging will be available to deal with the specific needs of your horse including life saving surgical intervention.

We offer:

• 24 hour on site monitoring of the horses by 2 fully qualified hospital veterinarians.
• A fully equipped purpose built Intensive Care Unit (ICU).
• State of the art anaesthetic monitoring, diagnostic, medical and surgical capabilities.
• Unique assisted recovery system developed by De Bosdreef with head and tail ropes with specially designed locking systems designed to decrease and prevent injuries sustained during recovery from anaesthesia.
• A pre-surgical insurance policy to cover anaesthetic risks can be attained on site prior to any surgical procedure performed under general anaesthesia.
• Visiting hours for in patients are between 8.30-19.00 (Monday to Friday), between 8.30-12.00 on Saturdays and between 10.00-12.00 on Sundays. 

 

Dental cases-what to expect:

 

-Items to bring to the clinic prior to admission:

• Horse’s passport
• Any previous diagnostic images (Radiographs, CT, bone scan results) on USB, CD or email.
• Any previous veterinary reports.
• Full head tack including the different bits used (ie. in training, competition etc.).
• The horse should be ridden prior to admission to the clinic. If the consultation is planned in the afternoon, the horse should be ridden in the morning. If the consultation is planned in the morning, the horse should be ridden the evening before. This allows us to see recent damage to the gingiva/mouth caused by the bit.

 

 

-On arrival at the clinic your horse will be assessed by one of our surgeons.

-A detailed history will be obtained.

-The horse will be fully assessed under standing sedation, including oral examination with intra-oral endoscopy. Further diagnostic procedures including radiography, nasal endoscopy, CT and sinoscopy will be performed as necessary.

-In cases where dental extraction (normally standing/ occasionally under general anaesthesia) or tooth filling (normally standing/ occasionally under general anaesthesia) is indicated, the horse will be hospitalised and treatment will be carried out the day following admission to the clinic.

-If an infected tooth needs to be removed, this will be performed under standing sedation utilizing a variety of techniques.

-If the horse has an associated dental sinusitis, the horse will most likely need prolonged hospitalisation with daily sinus lavage for 7-10 days.

-If sinoscopy or sinus lavage is performed this will be performed via a direct trephine hole in the horse’s head overlying the sinuses. 

-In some cases where a larger field of access is required, a sinus flap may need to be performed to gain access to the region of interest.

 

 

 

Gastroscopy-what to expect:

 

-The procedure is usually performed on an outpatient basis. 

-In order to fully evaluate the lining of the stomach, the stomach needs to be empty. We therefore ask that horses presenting for gastroscopy have no access to food for 12 hours and no water for 6 hours prior to the procedure. If this cannot be performed at home, then the horse may be admitted to the hospital the day prior to the gastroscopy, where food and water intake can be restricted as necessary. 

-The oesophagus, stomach and proximal duodenum can all be fully evaluated. 

-Biopsies of regions of interest can be obtained as necessary.

-Treatment programmes will be tailored to the individual needs of your horse.