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Can we start a reference thread for the various diagnostic options and technologies?

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  • Can we start a reference thread for the various diagnostic options and technologies?

    It seems that everyone I know lately has been flailing around with bizzare equine "issues" that have been difficult to diagnose and, subsequently, treat. These range from the typical mysterious lameness to immunological disorders to my own horse's skewed tail. Vets from local clinics to very large hospitals have offered various suggestions as to how these issues can better be detected. I'm talking about MRI's, bone scans, blood samples, exploratory surgery, shockwave, etc. For most of the people I know, these "tools" are new to them and have not been well-explained (especially the cost).

    So how about starting a thread on the common and not so common options out there, what they show, what's involved, and typical costs? If we get enough information, perhaps it could end up in the reference forum?

    I'll start (and please, add to my comments!) with one a horse I know just went through:
    ---------------------------------

    Bone scan (Nuclear Scintigraphy)

    What is it? A process of injecting a horse with a radioactive / dye combination shot that results in a color-coded photo displaying injuries to the skeleton. The body is color coded by "activity", thereby showing hot points where the horse has pain or discomfort. Different sections of the horse can be imaged - front half, back half, just the legs, etc.

    What is done? The horse is injected iv with dye that attaches itself to all active bone cells and a radioactive compound. The drugs move through the blood stream and show skeletal damage and injury. Highly active bone will be more radioactive.

    It's a slow procedure, taking up to a couple of hours for certain images. The horse will be slightly radioactive for up to 48 hours after the procedure.

    Cost? Anywhere from $900 - 2500.
    "Whether you think you can or think you can't, you are right." -Henry Ford

  • #2
    Good idea tiramit!
    Member of the Baby Greenie Support Group, NO HORSES TO SLAUGHTER, warmblood (trakehner), GPA/TS, chicken jumpers, Disgruntled college student and OCD clique!!!

    Comment


    • #3
      Tiramit, fantastic idea! At the moment I can only think of things I'd like to know more about. Besides the ones you listed -- love to know more about MRIs for feet -- I would add treadmill tests and sacrum injections, and think LH's freezing machine should be on this thread.

      Comment


      • #4
        Great idea, Tiramit. Hopefully, it can be stickied to the top so it is available for everyone to use and add on to.

        How 'bout we also provide links to the different threads that go into detail on the pro's and con's of each treatment to really help people find all the discussions on each topic?

        It would also be nice to have people chime in with where each test can be performed, as far as they know, in case someone wanted to pursue a certain test near where they lived.

        For instance, I was quite surprised to find out that none of the vet hospitals in Lexington, Ky have put in a MRI (yet), although there is a talk and one may be available in the near future. The closest MRI right now is in Va.

        In fact, Rood and Riddle is just now building a new wing for an in ground tread mill for diagnostic purposes.

        Rood and Riddle does offer nuclear scanning -- a full body scan is approximately $1200 - $1500.

        Lower limb ultra sound is $150

        Shock wave treatment is $300/session.

        The new carbon dioxide (CO2) treatment for *freezing* (taking down to zero degrees centigrade) hot splints and recent soft tissue injuries is $40/session with minimum of 7 - 10 sessions recommended. More detail on this procedure can be found here.
        "He lives in a cocoon of solipsism"

        Charles Krauthammer speaking about Trump

        Comment

        • Original Poster

          #5
          Good ideas! We can add more as we think of them.

          Here's another, more basic technique:
          -------
          Flex Tests:

          What is it? A quick method detecting lamenesses by stressing joints for a few minutes (someone holds the leg up high and tight, thereby stressing the joints) then asks the horse to trot off on level, firm ground. Usually the first step (after initial observation) in the lameness search. Often part of a pre-purchase exam.

          How much is it? The cost is usually part of the vet's evaluation fee, so no additional charge.

          Reliable? Somewhat. It can't catch everything, but will show the more obvious lamenesses. Some otherwise sound horses will "fail" a flex-test. Often followed by a vet's suggestion to x-ray a joint or joints in a leg.
          "Whether you think you can or think you can't, you are right." -Henry Ford

          Comment


          • #6
            Great idea!!

            EPSM Muscle Biopsy

            A muscle sample is taken and analysed for Equine Polysaccharide Storage Myopathy. This is a muscle disease, common across the breeds, that results in a horse not being able to utilize carbohydrates as energy in the muscle. A horse testing positive should be on a fat-supplemented diet. Horses with EPSM may show a variety of hind-end lameness, lack of energy, weight loss or muscle atrophy among other problems.

            Muscle sample may be taken by your vet at the clinic or your facility. Labs that I know of are Oregon State University and Cornell, I'm sure there are many others.

            Cost $200-400 -- I don't have my final bill yet..

            From my reading only a very few horses would be in a gray area. They either show muscle distinctions or not, and the "treatment" is a low cost dietary adjustment.

            A very good diagnostic tool for that unexplained lack of power, mysterious not-quite-right in the hind-end. I am very glad I did my horse. He may have more problems but I know I HAVE to provide a high fat diet if I want him to become stronger.

            Comment


            • #7
              Bea,

              When I had a horse checked for ulcers, the endoscope was passed through a nostril, not the mouth.

              And it can only see ulcers in the stomach, not the intestines, and so can miss many ulcers.

              There is a generic version of Gastroguard out (it has been out for years, actually) and costs 1/2 the price of Gastroguard. Many trainers at racetracks use it and will testify that it works just fine -- The manufacturer of Gastroguard push the "FDA tested" part, but that is their deal to keep people spending double what they have to. God love 'em.

              I paid $400 for the endoscope. I guess I got taken. But R&R is very expensive on many things. They have to pay the salaries of the big guys somehow. Damn. That's why this thread is so good. We can find out what others are paying for a test, and, within an acceptable range, what that test should cost.
              "He lives in a cocoon of solipsism"

              Charles Krauthammer speaking about Trump

              Comment

              • Original Poster

                #8
                Endoscopy (nickname: scope or "scoping" a horse)

                What's it for? Used to search out respiratory issues, ulcers, or other ailments in the horse's system.

                What does it involve? Horse is tranquilized and a long fiber optic endoscope is eased through a nostril to the area of concern. The vet can then view the area through the endoscope and, if he or she likes, take a sample or flush fluids through a special tube. Horses who are in for gastric scoping should fast prior to the visit to ensure a clear view of the stomach. An example photo.

                What are the costs? Cost ranges from $150-400.
                "Whether you think you can or think you can't, you are right." -Henry Ford

                Comment


                • #9
                  <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by Tiramit:


                  Bone scan (Nuclear Scintigraphy)

                  What is it? A process of injecting a horse with a radioactive / dye combination shot that results in a color-coded photo displaying injuries to the skeleton. The body is color coded by "activity", thereby showing hot points where the horse has pain or discomfort. Different sections of the horse can be imaged - front half, back half, just the legs, etc.

                  What is done? The horse is injected iv with dye that attaches itself to all active bone cells and a radioactive compound. The drugs move through the blood stream and show skeletal damage and injury. Highly active bone will be more radioactive.

                  It's a slow procedure, taking up to a couple of hours for certain images. The horse will be slightly radioactive for up to 48 hours after the procedure.

                  Cost? Anywhere from $900 - 2500. <HR></BLOCKQUOTE>


                  Just wanted to add that a bone scan also has a "soft tissue phase" that will show hot spots in areas like ligaments, suspensories, etc. not just the bones. This is good for diagnosing those hard to pinpoint lamenesses. Then normally what would happen is the vets would follow up with an ultrasound of the area in question. If during the bone phase, they find a hot spot, they would then follow up with an x-ray. If the x-ray doesn't show up with anything, but an injury or abnormality is still highly suspected you would then follow up (depending on the body part) with an MRI or CT. I'd love to hear more from someone who has done that. So the nuclear scan a tool that leads them in a particular direction, rather than something like an u/s or an x-ray that would tell you exactly (hopefully) what is going on. Regarding the "slightly radioactive" part, even though when humans have this test they are sent home right away, govermental laws usually require that the horse has to be kept at least overnight and the manure disposed off as hazardous waste. You are also not allowed to visit with your horsie until he/she is ready for pick-up. So be ready to say your goodbyes for 24-48 hours when you pull up to the clinic.

                  Comment

                  • Original Poster

                    #10
                    Sure thing - I updated my previous post.
                    "Whether you think you can or think you can't, you are right." -Henry Ford

                    Comment

                    • Original Poster

                      #11
                      Allergy testing in horses:

                      What does it involve? The horse is tranquilized, and a series of shots each containing a different suspected allergen is injected under the skin of the neck (can be up to 75 shots). The shots are spaced out and skin reactions (bumps and swelling) are evaluated on a class scale by size. Readings are taken at 15 and 30 minute marks, then again at 4 hours and lastly at 24 hours from the initial injection time. Vets may also pull any scabs from the body and send them off for additional testing.

                      Based on the reactions, a serum is ordered with a maximum of 15 allergens in it (multiple serums can be given). The horse's response to the serum is also evaluated to ensure the appropriate mix of allergens. The horse may be re-tested after time.

                      What does it cost? The test alone is about $250 - 400.
                      "Whether you think you can or think you can't, you are right." -Henry Ford

                      Comment

                      • Original Poster

                        #12
                        bumped up for the weekend crowd!
                        "Whether you think you can or think you can't, you are right." -Henry Ford

                        Comment


                        • #13
                          <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by Tiramit:
                          bumped up for the weekend crowd! <HR></BLOCKQUOTE>
                          And cleaned. Thanks to AmandaDVM I found out MRI will be available at Fairfield Equine in CT by end September. No pricing available yet. They have it available at New Bolton but not Cornell. Would love to hear if anyone has experience with this procedure.
                          Tiramit, I wonder if you'd be willing to do blocking? Another basic procedure like flexions it would be good to have here.

                          Comment


                          • #14
                            Lord Helpus, I read an article (forgive me, I can't remember where...) that soon, ulcers will be able to be detected either by testing the blood or urine .... the bottom line is that the process will be easier and less expensive.

                            Comment


                            • #15
                              Really good point, MB. I read that too, here's the relevant bits.

                              "Diagnosing equine gastric ulcers might soon be a procedure that's short and sweet. Until recently, ulcer detection depended on using an endoscope to peer at the stomach lining. Now, a team of researchers at Texas A&M University, led by Noah Cohen, VMD, PhD, and J. B. Meddings of the University of Calgary's Gastrointestinal Research Group, says gastric ulcers can be identified and assessed for severity using a simple test for sucrose in the urine. This method has already proved reliable in diagnosing ulcers in humans, rats, and dogs.

                              With results this conclusive, and a testing protocol established, it should take very little time for veterinarians to incorporate urine testing--a much simpler, cheaper, and less invasive technique--into their diagnostic routine for gastric ulcers.

                              There's also potential to use sucrose levels in the blood of suspected ulcer cases to indicate the presence of ulcers. This convenient possibility is currently being explored by Texas A&M and Mississippi State University researchers.
                              Furthermore, researchers at the University of Adelaide in Australia are investigating the use of a sucrose breath test, which has successfully detected gastric ulcers in humans and dogs. Essentially, an individual who doesn't absorb sucrose properly should have detectably higher levels of hydrogen and methane in his exhaled breath. If this holds true for horses, it could provide another simple, efficient, and inexpensive way to diagnose gastric ulceration and, with any luck, help veterinarians catch ulcers faster and treat them earlier."

                              Comment

                              • Original Poster

                                #16
                                A happy update - I sent a friend of mine this link and, after reading Welshcob's post, she is going to have an EPSM test performed on her horse. Welshcob's description fit my friend's horse, who has been to many different vets for tests and treatments but is still not quite right.

                                Thanks Welshcob!
                                "Whether you think you can or think you can't, you are right." -Henry Ford

                                Comment


                                • #17
                                  <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by Tiramit:
                                  Allergy testing in horses:

                                  What does it involve? The horse is tranquilized, and a series of shots each containing a different suspected allergen is injected under the skin of the neck <HR></BLOCKQUOTE>

                                  But you can also get an allergy test done through a blood test - cost $150 (but this was several years ago, so it's probably more now).

                                  Subsequent desensitization serum based on specific profile of horse: $70/vial. You use three vials over the course of 3 months (they are in gradually increasing concentration - you start out with frequent shots/low concentration and move up to less frequent administration/higher concentration) . Then maintenence vials last about 5-6 months. And you learn to give SQ shots in order to get through the first 3 months or you will go broke paying for vet visits!
                                  Your crazy is showing. You might want to tuck that back in.

                                  Comment


                                  • #18
                                    Dune, I had a nuclear scintigraphy done on a horse at Las Colinas in Irving, TX a few weeks ago. It was $850 for the whole body scan. The bone scan led us to the problem area and then we ultrasounded her ankle and definitively found the problem. This was after numerous other vets had flexed, injected, etc. all the wrong areas. Too bad we did not do the bone scan when I wanted to a few months ago. I might have a sound horse by now and be a couple of thousand $$ to the better.

                                    Comment


                                    • #19
                                      OK, I will give you a teaser -- going to get an MRI on my horse's front feet at the Dupont vet hospital in Leesburg VA on Thursday.
                                      I have not had the heart to ask the cost (am only hoping my farrier was joking when he said 10k today) because it is really the only thing we haven't done yet, and I am at the end of the road with my horse's mystery lameness.

                                      He has some variety of sore heels in front, and I won't bore you with the history, but we can't pinpoint what's wrong and can't seem to make it stay right for a sustained period of time.

                                      So, off to MRI-land. I will report back on cost, time involved, and what we discovered after Thursday.
                                      The big man -- my lost prince

                                      The little brother, now my main man

                                      Comment


                                      • #20
                                        <BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Originally posted by asterix: OK, I will give you a teaser -- going to get an MRI on my horse's front feet at the Dupont vet hospital in Leesburg VA on Thursday. <HR></BLOCKQUOTE>
                                        Ooooo.... good luck, take notes, and report back! On Thursday evening! And here's really hoping your farrier was joking.

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