Meddleton Equine Hospital

Meddleton Equine, Inc Has the ONLY Equine MRI in New Mexico

MRI image of a horses foot

• MRI is now the gold standard for diagnosis of many injuries causing lameness.
• MRI is often the only way to diagnose an elusive or complicated lameness.
• Now, for the first time, equine MRI is available to the New Mexico horse community without extensive travel & accommodation expenses!
• MRI shows both bone and soft tissue in more detail than any other imaging modality.
• MRI can help reduce diagnostic costs and inappropriate treatment costs.
• MRI can help to reduce time wasted pursuing the cause of an elusive lameness.
• MRI can now be an essential component of a pro-active, pre-emptive treatment plan.

With its advanced technology, we are able to produce beautiful, high resolution diagnostic images. Unlike x-rays, which only show bone, and ultrasound, which only shows soft tissue, MRI shows both and in more detail than any other imaging modality. We are able to image the horse’s leg from the knee-down or from the hock-down.

Through the use of MRI, Veterinarians have now discovered causes of lameness that we previously never knew existed.

It is not unusual for a horse owner to spend hundreds, even thousands of dollars trying to get a diagnosis for a difficult lameness. It is also common for an owner to lose several weeks or months of training and riding time after trying several courses of treatment.

MRI is often the only way to pinpoint certain causes of lameness such as bone bruising, cartilage damage and injuries to very small ligaments & soft tissue structures.

With the option of doing an affordable MRI here in New Mexico, we can instead immediately pinpoint a diagnosis and move directly to the appropriate treatment, making MRI cost effective.

Please call for current pricing. The price of an examination includes interpretation by a Veterinary Radiologist with a specialization in Equine MRI. For those with insured horses, most insurance companies will cover the cost of MRI examinations.

Digital radiography is on of the biggest innovations in equine diagnostic imaging to have entered private practice in the last decade.

When compared to conventional (film) radiography, it has several distinct advantages:

• Superior quality imaging of bony structures and improved imaging of soft tissue structures.
• Immediate results via instant visualization of x-rays on a computer screen (no need to develop film, affords the ability to treat on the farm immediately after diagnosis).
• Ease of image sharing with Board certified Radiologists, surgeons, or other Veterinarians.
• Decreased radiation exposure due to fewer retakes
• Radiographs can be digitally enlarged and manipulated to provide optimal contrast and brightness.

Meddleton Equine has been equipped with Sound DR digital radiography technology since 2006. Digital radiography (along with digital ultrasound) is generally the first diagnostic step after a lameness examination has localized the source of pain to a specific area. Digital radiography is available in hospital or through our mobile medical service.

Digital ultrasound is complementary to digital radiography and allows for high quality visualization of soft tissue structures (radiography is used to evaluate bone).

Digital Ultrasonogrphy provides:

• Higher quality imaging
• Ease of file sharing with Radiologists and referring Veterinarian.
• Ability to obtain immediate consultation with experts

When to use it?

• After lameness exam and nerve blocks to localize the source of pain
• After radiography (in most cases)
• If there is obvious swelling or palpable pain in specific areas
  • Flexor tendons
  • Suspensory ligament
  • Check ligament
• Anytime soft tissue injuries are suspected
• To evaluate the abdomen or lung surface
• To help guide a needle aspirate or biopsy
• To guide the deposition of selected therapeutic agents (tendons and ligaments)
  • A-cell
  • Stem Cell
  • PRP

Soft tissue lesions inside the foot are not generally accessible with ultrasound and will require MRI for specific diagnosis

Meddleton Equine is fully equipped to perform diagnostic Videoendoscopy

Videoendoscopy vs. traditional fiber optic endoscopy offers:

• Higher quality images
• Digital recording of pictures or video for rapid consultation with surgical and internal medicine specialists
• 3 meter Videoendoscope offers a view of the stomach and esophageal lining
• 1 meter Videoendoscope is used to visualize the respiratory, lower urinary, and uterine tracts

Gastroscopy

• The only test to definitively diagnose gastric ulcers
• Indicated for horses with recurrent clinical signs consistent with gastric ulcer disease
• Minimally invasive
  • Outpatient procedure
  • Performed with sedation in the standing horse
  • Only preparation is a fast of 12 hours (may require a muzzle)
• Definitive diagnostics often prevent unnecessary treatment costs
  • A treatment course ranges from $1200-1800
  • Gastric ulcers can be ruled out for a fraction of that cost

The Meddleton Equine Hospital is available for colic surgery, and other emergency surgeries with 24 hour care, treatment, and intensive care monitoring. We are also available for medical treatment of colic, critical care patients, or hospitalization cases.

Horses treated at the Meddleton Equine Hospital will benefit from the latest in colic diagnostic technology (ultrasound, endoscopy, 3 meter gastroscope, on site laboratory), equine anesthetic monitoring technology, the safety of the Air Pillow Recovery System, and 24 hour intensive care monitoring and treatment. The Meddleton Equine Hospital is fully staffed for 24 hour surgical and intensive care needs.

We also have Dr. Wendy Ray Miller, DVM, MS, DACVS Board Certified Equine Surgeon available for surgery by appointment for elective surgeries such as arthroscopic surgery and throat surgery.

Dr. Wendy Ray Miller, DVM, MS, DACVS

Equine Surgeon: Equine Sports Medicine & Surgery, Sunland Park, NM 2007-2009
Surgical Residency: Kansas State University 2007
Large Animal Surgical Clinical Fellow
Oregon State University School of Veterinary Medicine: 2004
DVM: Colorado State University: 2002

The term "ACVS Diplomate" refers to a veterinarian who has been board certified in veterinary surgery. Only veterinarians who have successfully completed the certification requirements of the ACVS are Diplomates of the American College of Veterinary Surgeons and have earned the right to be called specialists in veterinary surgery.

Veterinarians wishing to become board certified must

• complete a three-year residency program
• meet specific training and caseload requirements
• perform research and have their research published

This process is supervised by current ACVS Diplomates, ensuring consistency in training and adherence to high standards. Once the residency has been completed, the resident must sit for and pass a rigorous examination. Only then does the veterinarian earn the title of ACVS Diplomate

Athletic horses, like human athletes, put a lot of stress and strains on their bodies and will be more likely to have spinal misalignments. These are the horses, whether a dressage or hunter/jumper, working horse, barrel racer, race horse, or an eventing horse, that are asked to give their best performance, time and time again. And usually they will. Chiropractic adjustments can help assure they are performing at an optimal biomechanical advantage, and in comfort.

Chiropractic for the Equine Athlete

Click on image to view photo gallery

• Athletic horses, like human athletes, put a lot of stress and strains on their bodies and will be more likely to have spinal misalignments
• Many subtle performance problems can be alleviated through Chiropractic
• Chiropractic adjustments can help assure they are performing at an optimal biomechanical advantage, and in comfort.
• Conditions such as a subtle lameness or abnormal gait, asymmetrical sweating, immune disorders and behavioral problems often respond to chiropractic therapy.
• Click on the following link for more information about Chiropractic for your horse: [Link to Chiro articles]

Chiropractic Science

• Chiropractic science focuses on the alignment of the spine (vertebrae)
• Nerves that supply every organ in the body, every muscle, and every tissue, originate from the spinal cord and must pass between vertebrae
• Alignment of the spine is essential for the proper functioning of the entire body
• A misalignment (or subluxation) between two vertebrae can cause irritation to the surrounding tissues.
• The nerves then must pass through these inflamed tissues which can disrupt their signals.
• Chiropractic adjustments work to realign vertebrae, thus eliminating the underlying cause of a problem.
• The goal of Chiropractic care is not to merely eliminate disease, but to facilitate optimal physical and mental well-being

Saddle fit is critical to optimal performance. Dr. Meddleton routinely checks saddles for proper fit as part of a Chiropractic evaluation. He is also available for consultation when you are purchasing a new saddle for you horse.

Is your horse trying to tell you something?
Here are some clues to back soreness

• White hairs or hair loss on withers or under the saddle.
• Cold-backed, sinks when mounted.
• Cringes or guards when brushing the back.
• Shies often, rushes fences, refuses fences.
• Cinchy, fusses when saddle appears; won’t stand for mounting.
• Short strided. Stumbles or trips often.
• Always speeding up, won’t go calmly, uncomfortable down hills.
• Head tossing, travels with the head held high.
• Bucking, running away.
• Hollows back, not rounding or engaging the hind end.
• Not performing as well as usual.

The Veterinarians at Meddleton Equine are highly trained to detect and diagnose subtle Neurologic disease

• Diseases of the spinal cord are common in the horse
• Severe disease generally manifests as incoordination and weakness
• Mild disease can masquerade as lameness and/or decreased performance
• EPM and Wobbler syndrome are the most common spinal cord diseases of the horse

There are many factors that can affect how a horse moves and performs.

The most common cause of abnormal movement is pain originating from the feet, limbs, back, or muscles. However, it is not uncommon for abnormal performance or movement to be due to spinal chord abnormalities.

The spinal chord relays commands from the central nervous system (brain) to the peripheral nervous system (limbs) and sends back input from the limbs to the brain. The result is a system where the brain knows exactly where each limb is without requiring input from the eyes, and each limb seamlessly executes orders generated by the brain.

When there is a problem with the spinal chord, this breaks down. In severe cases, the horse is unable to walk or even rise and appears severely uncoordinated and weak. In mild cases, there can be subtle changes such as inconsistent foot placement, mild decrease in muscle mass (due to decreased use), and mild weakness. Some of these only manifest as decreased performance.

The first step in troubleshooting these cases is a thorough examination.

A veterinarian will determine if the problem is due to a spinal chord abnormality, musculoskeletal pain, or a combination of these.

As a complicating factor, horses with neurologic deficits are more prone to injury, so lameness and neurologic disease are often seen concurrently. The neurologic examination will establish a degree of severity that is based on how weak (paresis) and how uncoordinated (ataxia) a horse is. It also aims to determine if the abnormalities are symmetrical (is one side more affected than the other), and tries to determine the location of the problem (based on whether the forelimbs, hindlimbs, or both are affected). Once this has been established, adequate diagnostic tests can be recommended.

The two most common causes of neurologic abnormalities

The two most common causes of neurologic abnormalities are Equine Protozoal Myeloencephalopathy (EPM) and Wobbler syndrome/ Cervical Vertebral Compression.

Equine Protozoal Myeloencephalopathy (EPM) is a parasite that causes damage to the spinal chord as it migrates through it.

Wobbler syndrome/Cervical Vertebral Compression is a disease where vertebrae are either unstable (pinch chord when moving) or malformed (constantly exert pressure) and lead to excessive pressure on the spinal chord.

There are dozens of other causes of neurologic abnormalities, but they are uncommon. Screening for the two most common diseases is the first step and involves a blood test for EPM and radiographs of the vertebrae in the horse’s neck to evaluate the spinal canal.

EPM can be successfully treated with antiprotozoal medications.

Cervical Vertebral compression requires surgery for correction and not all horses are candidates for this.

To confirm that a horse has spinal chord compression and to determine if surgery would help it, a myelogram has to be performed. This is a test that is performed under general anesthesia. A dye that shows up brightly on radiographs is injected into the horse’s spinal canal, and multiple radiographs are taken with the neck relaxed, extended, and in flexion. This shows where and when compression is occurring. Horses that have 1 or 2 sites of compression in the cervical spine can be helped with surgery.

Meddleton Equine is equipped to diagnose and treat these and many other forms of Neurologic disease. As with most other diseases, rapid intervention to stop or slow down the injury to the spinal chord will result in improved outcomes. Chronic cases with long standing spinal chord damage are less likely to improve.

As all devotees of the many equestrian disciplines know, the horse is a versatile and gifted athlete. Athletes often encounter performance limiting problems during their training and career, and horses are no exception.

Meddleton Equine is equipped and staffed to provide state of the art lameness and poor performance diagnosis and treatment.

What is the problem?

• Lameness is the most common
• Problems of the foot, ligaments, tendons, muscles, and joints.
• Chiropractic
• Neurologic
• Cardiovascular
• Respiratory

Diagnostic imaging

• Digital Radiographs to look at bones and joints
• Digital Ultrasound to look at soft tissue
• MRI for the foot or if radiographs and ultrasound have not identified a problem in an area that has been blocked out

Treatment options

Dr. Mark Meddleton administers Adequan IM injection

• Shockwave
• Intralesional therapy – IRAP, PRP, Stem cell, A-Cell
• Joint injections (HA, Adequan IA)
• NSAIDs
• Disease modifying agents – Legend, Adequan
• Surgical Arthroscopy – OCD lesions, joint chips, check ligament desmitis

What if it is not pain?

• Cardiac evaluation including ECG and echocardiography
• TTW/BAL and thoracic ultrasound to evaluate the lungs
• Gastroscopy to rule out Gastric ulcer disease
• Upper airway endoscopy to evaluate laryngeal function
• Uterine/Ovarian evaluation in mares
• Behavior modification – Progesterone implants, Regumate, Vitamin B-1

It is generally recommended that all horses be examined by a Veterinarian prior to purchase. The pre-purchase examination is of utmost importance for all horses being considered for use in athletic endeavors.

What is the pre-purchase examination?

• A thorough pre-purchase examination takes between 2 and 3 hours
• All the major systems of the horse are examined
  • Eyes, ears, heart, lungs, skin, external reproductive organs, GI, musculoskeletal, neurologic
• Horses are evaluated in motion
  • Plan on riding the horse for the observing Veterinarian
  • Ideally, the horse should perform its intended discipline
• Flexion tests are performed
  • These tests put pressure on specific sets of joints to try to determine if mild joint abnormalities are beginning to develop
• Radiographs and possibly ultrasound
  • Due to the high incidence of joint disease in athletic horses, a full series of radiographs is generally recommended
  • This can help identify early joint abnormalities that may be performance limiting in the future

What will I get out of it?

• Determine if there are any health problems (heart, lungs, eyes, tumors, etc) that are likely to be detrimental to the horse’s athletic potential or lifespan
• Determine if there are orthopedic problems (lameness)
  • Moderate and severe problems generally warrant a recommendation against purchase
  • Mild problems generally result in a frank discussion as to the prognosis for performing in the intended discipline
    • This discussion should include: estimated costs of managing these potentially limiting problems, possible effects on resale, estimated timeframe for worsening of progressive conditions
• Discussion of conformation and current trimming/shoeing

Lameness, severe conformational faults, heart disease, respiratory abnormalities, and behavioral problems are the most common abnormal findings that lead to a horse not being recommended for purchase. Other tests such as laboratory analysis of blood, drug screens, ECG, endoscopy (part of basic exam for all racehorses), and breeding soundness examination may be recommended in addition to the basic pre-purchase examination in specific cases

The pre-purchase examination does not constitute a guarantee that a horse will be able to perform its intended function. It is a certificate at a specific point in time detailing any existing abnormalities or concerns.

Performance Equine Dentistry with full mouth balancing and alignment

Equine Dentistry is a critical part of the comprehensive plan for the health and maximal performance of your horse. The Veterinarians at Meddleton Equine, Inc. are all trained in Performance Horse Dentistry with full mouth balancing and alignment

What is Performance dentistry at Meddleton Equine?

• Removal of sharp oral points
• Correction of any dental malocclusions (wavemouth, stepmouth, ramps, hooks)
  • Correction of severe problems is only feasible with power tools
• Extraction of any diseased teeth
• Composite restorations and filling of spaces (diastemas) left by missing or moving teeth

Why the Powerfloat?

• The Powerfloat allows the Veterinarian to rapidly correct dental abnormalities:
  • Resulting in less sedation time
  • Less time with the horse’s mouth held open
  • Less trauma to the surrounding tissues (gums, cheeks, tongue)

Why does my horse need dental care?

• Most horses develop sharp points on their cheek teeth 10-14 months after a float
• Sharp points result in painful oral lacerations and ulcers
  • Pain results in decreased chewing
    • Possible chokes and impactions colics
    • Less efficient use of feed
    • General discomfort
  • Oral pain often affects performance and acceptance of the bit

When should my horse have its teeth floated?

• Most horses require yearly floats and all horses should receive dental examinations every 6-12 months
• Yearlings and 2 year olds should be checked for developmental abnormalities
• The first float is generally recommended between 2 and 3 years of age
• A float should precede the first bitting
  • A painful first experience with the bit can have long lasting adverse effects on the horse’s training

A word of caution concerning lay "equine dentists"

• These people have no professional training and do not have a medical/dental degree
• A short course or apprenticeship with another "equine dentist" is their only education
• They practice their vocation illegally
• They have no training in the use of tranquilizers and are not allowed to use them
• They are unlicensed: there is no accountability for the safety and welfare of your horse

Adult (mesenchymal as opposed to embryonic) stem cells are primitive, non-differentiated cells that are located in the bone marrow, adipose (fat) tissue, and the circulatory system. They are part of the bodies repair system, and are able to transform into nearly any type of cell in the body.

When normal tissue is diseased or injured, these stem cells are signaled to migrate to the area of damage. There, under the influence of the local growth factors and signals, these stem cells will differentiate into whatever cell type is needed to help regenerate the normal architecture of the tissue. With this in mind, stem cells have been used to treat tendon and ligament tears, muscle injuries, bone cysts, bone fractures, OCD, arthritis, and even heart muscle damage. Its primary use in the horse has been with tendon and ligament injuries.

Using Stem Cell Therapy in torn tendons or ligaments significantly improves the outcome. The stem cells differentiate into tendon or ligament cells, thus healing the injury with tendon cells in tendons or ligament cells in ligaments thus delivering site appropriate regeneration without scarring.

When these areas heal with scar tissue, they never heal as strong or as elastic as the original structure, are more prone to re-injury, and heal very slowly. In some cases they may never heal completely. Using stem cell therapy can dramatically improve the quality and rate of healing, reduce the time off and the likelihood of re-injury, and help get your horse back to your previous level of work.

A shock wave is an acoustic wave with very high amplitude and rapid rise time. The VersaTron system focuses these high-energy pulsed sound waves on clearly defined sites of injury in your horse, leaving surrounding tissues unaffected. Shock Wave Therapy was initially used in human medicine to break up kidney stones, but has been used for human musculoskeletal conditions since the early 1990’s. It is an FDA approved treatment for tennis elbow and heel spurs.

While the exact mechanisms by which shock waves produce healing are still being researched, there are many healing effects that are known. It has been shown to increase the presence of stem cells and local growth factors, increase cell divisions due to cytokine release, increase bone formation, and increase new blood vessel formation, thus improving blood supply.

Several peer-reviewed scientific reports in horses have demonstrated that shockwave is beneficial in proximal suspensory desmitis (suspensory ligament injuries) and distal tarsal arthritis (bone spavin). Additionally, Shockwave has been used extensively for a number of other conditions with favorable results. These include sore back muscles, kissing spines, sacroiliac pain, lumbosacral pain, neck pain, tendonitis (especially when avulsion fractures are present), bucked shins, splint bone fractures, ringbone, navicular disease, certain bone cysts, and, more recently, non-healing wounds.

We are pleased to offer Shock Wave Therapy using the only shock wave machine specifically developed for orthopedic applications in the horse. The VersaTron is portable and your horse can be treated on the farm, and can usually be performed with light sedation in less than one hour per treatment. A typical protocol is to treat the affected area 3 times, with 3 weeks between treatments.

IRAP stands for Interleukin-1 Receptor Antagonist Protein. Interlukin-1 (IL-1) is the major inflammatory cytokine responsible for inflammation in the joint, cartilage degradation and resulting osteoarthritis. IL-1 has a counterpart, Interlukin-1 Receptor Antagonist (IL-1Ra) which blocks IL-1 and prevents the inflammatory cascade from proceeding. These two cytokines are in a balance in a healthy joint, but with arthritis, the balance shifts towards IL-1which accelerates cartilage damage and leads to osteoarthritis.

IRAP Joint Serum Therapy uses the patient’s own white blood cells (macrophages) to mass produce IL-1Ra with the goal of injecting a high concentration of IL-1Ra back into the inflamed joint. This results in a potent anti-inflammatory and anti-degradative effect. The process requires 50ml of the patient’s blood drawn with a special syringe containing acid-etched glass beads to activate the patient’s macrophages. The blood-bead mix is then incubated for 24 hours to increase IL-1Ra levels, centrifuged, and filtered and frozen for future use. The resulting fluid is a sterile preparation with a high concentration of IL-1Ra that your Veterinarian can inject into your horse’s arthritic joints to decrease pain and inflammation and help heal the cartilage.

In most cases 4-5 syringes are produced and frozen. The treatment protocol is to inject the affected joint once weekly for 3 weeks. If there is a fourth syringe, it is saved to be used if needed in the future.

Dr. Mark Meddleton administers mesotherapy treatment

Mesotherapy is a treatment generally used to treat a horse's painful, spasmodic back. Depending on the horse and condition, a variety of medications may be injected into the middle layer of the skin, the mesoderm, using a specialized port and very small needles. This will affect pain receptors in the mesoderm, inhibiting the pain cycle thus relieving pain, muscle spasm, tension, and inflammation.

PRP, or Platelet Rich Plasma, is plasma with concentrated platelets obtained from a horse’s own whole blood sample with an anti-coagulant. The blood sample is put in a centrifuge and processed to concentrate the platelets to at least 4 times that found in whole blood. The plasma, then rich in platelets, is injected back into the same horse’s lesion. This has been used very effectively in tendon and ligament lesions.

Once injected into a lesion, the platelets are activated and release anabolic growth factors such as platelet-derived growth factor, transforming growth factor-B, and vascular endothial growth factor. These growth factors not only stimulate healing, but also stimulate circulating adult stem cells to migrate to the lesion as well.

Breeding

When it's time to breed your mare, we provide the following services:

• Live Cover
• Artificial Insemination (AI)
• Stallion Collection
• Cooled semen shipping
• Embryo Transfer
• Problem mares:
  • Reproductive Ultrasound
  • Uterine Culture, Cytology, Biopsy, Lavage, etc.
• Fetal sexing and advanced pregnancy evaluations available on request.

Foaling

What to expect with your foaling mare

Below is a timetable of what to expect when your mare foals. If anything does not occur in the time frame below CALL OUR OFFICE IMMEDIATELY!

1. The mare will break water first - she is now in labor. The foal should be on the ground within ½ hour.
2. The foal should stand within 1 hr of being born.
3. The foal should nurse within 2 hours of being born.
4. The mare should pass the placenta in one piece within 4 hours.

Once the foal is born, if everything has gone according to the above plan, call our office to arrange an appointment to check the mare and foal.

They will need to be checked approximately 24 hours after foaling to check that the foal got the proper immunities from the colostrum and that the placenta was passed whole and without tears. Save the placenta in a cool area (away from dogs and coyotes) for the examination by a Veterinarian.

Neonatal Care

Meddleton Equine is staffed and equipped to treat all sick foals.

The hospital has large stalls to accommodate a mare and its foal comfortably. The ICU unit is equipped with oxygen and IV fluid setup allowing for 24 hour a day respiratory support and cardiovascular resuscitation of the sickest foals.

There is an on site laboratory which makes it possible to accurately monitor these rapidly changing cases. Access to immediate surgery enables rapid correction of conditions such as ruptured bladders or strangulating hernias.

• ICU unit equipped with oxygen and IV fluid setup allowing for 24 hour a day respiratory support and cardiovascular resuscitation of the sickest foals
  • On site laboratory for 24 hour monitoring and intervention
  • Access to surgery for immediate correction of surgical problems
• Hours count when it comes to the treatment of sick foals
• Foals are born with no immunity to disease
  • They must ingest colostrum during their first 12 hours of life
  • Vaccination of the mare 1 month prior to foaling helps with production of high quality colostrum
• Foals should be examined at 18-24 hours of age to determine if they are healthy, developmentally normal, and have absorbed sufficient levels of antibodies from the colostrum
• Foals that are not nursing or appear weak should be examined immediately
• Foals should have a strong suckle reflex immediately after birth
• Foals should stand within 1 hour of birth
• Foals should nurse within 2 hours of birth
• The placenta should be passed within 4 hours of birth
• Any delay for these important events should prompt a call to your Veterinarian
• There are many problems that can occur in the early post-partum period that should be evaluated by a Veterinarian
  • Dummy foal/Neonatal asphyxia
  • Meconium impaction
  • Blood/Joint infection (septicemia)
  • Ruptured bladder
  • Orthopedic abnormalities
  • Hernias
  • Neonatal isoerythrolysis
• Foals can deteriorate very rapidly and should be evaluated as soon as a problem is detected. Timely intervention is generally required for a good outcome.