Regional Limb Perfusion
Regional Limb Perfusion (RLP)
Regional limb perfusion (RLP) is a technique which provides a high concentration of an antibiotic to the soft tissues, joints, and bones of the limbs. The antibiotic used would be very expensive if given at a dose appropriate for the entire horse but the cost of the drug is more affordable since it is delivered into a superficial leg vein below the level of a tourniquet, and the benefits great. Drug concentrations achieved generally exceed that required to kill many types of bacteria and persist locally in the tissues for an extended period of time. This makes RLP a practical adjunctive treatment for septic conditions affecting the extremities (the knee and hock and below). Continue reading
Techniques of non-invasive Lung Function Testing
In the clinical setting, three main non-invasive methods are currently used at Tufts to test lung function in awake large animals: Forced Oscillation Techniques (FOT), plethysmography and measurement of functional residual capacity (FRC), which is an estimate of lung elasticity.
Forced oscillation techniques (FOT) are non-invasive tests to measure the resistance of the breathing system and thus evaluate airway narrowing. Different frequencies (1-7 Hz) of small air-pulses are directed into the patient’s airways via a face mask, while a computer captures changes in pressure and flow of these waves during spontaneous breathing. This calculates respiratory system resistance (Rrs).
A horse with airway inflammation undergoing FOT lung function testing at Tufts' Hospital for Large Animals.
A high Rrs often indicates airway narrowing due to thickening of bronchial walls and / or mucous accumulation in the lower lung. In horses with lower airway inflammation (e.g. IAD), we commonly observe a frequency dependence of resistance. This means that higher values for resistance are recorded at the lower oscillatory frequencies (1-2 Hz), a finding that is indicative of bronchoconstriction. Higher oscillation frequencies (> 2 Hz) provide information concerning central airway resistance. Baseline respiratory resistance measurements using Forced Oscillation Techniques can also be combined with bronchoprovocation tests to determine airway hyperreactivity or “twitchiness.” Continue reading
Achieving Excellence in Equine Podiatry
Equine podiatry requires collaboration between farriers and veterinarians, says Tufts' Dr. Carl Kirker-Head
If there’s ever a disease that requires the veterinarian’s medical and surgical expertise and the farrier’s anatomical and functional knowledge of the hoof for a successful outcome, it is laminitis. In years past, the two professions often worked in a vacuum, neither one fully engaging the other in the interest of the patient. That situation is now very different, in no small way due to the sustained efforts of a few dedicated educators and practitioners from both professions, along with the gentle encouragement of academic institutions like Tufts University‘s Cummings School of Veterinary Medicine.
Since the early 1990’s Dr. Kirker-Head and the Hospital for Large Animals have hosted annual continuing education podiatry forums, frequently in conjunction with the Southern New England Farriers Association. The subject matter is always interesting. Tufts can lay claim to the only comprehensive forum addressing the farriery needs of the draft horse (2004). Most recently (2010), Dr. Ric Redden – a recognized leader in evolving podiatry techniques for managing laminitis – presented a day seminar on shoeing modalities for problem cases. And like any entity exploring the boundaries of knowledge, one should expect topics to sometimes be controversial Continue reading