New Information
By now all of you should be aware of the major changes at this practice. For anyone that didn't receive the letter explaining the new focus of the practice and structure I will include a copy here:
December 11, 2007
Dear Clients:
As we approach the new year I want to take this opportunity to inform you about some recent and future changes at Burlington Equine. By now many of you know that Dr. Kristin Haas and Dr. John Bergeson departed from the practice the first week of December. Kristin left to become the new State Veterinarian of Vermont and John left to pursue a career in small animal medicine. These departures happened in anticipation of some major modifications in the structure of this practice.
After 20 years of working as an equine veterinarian with 18 of those managing a very busy ambulatory practice I am ready for a change. While I still very much enjoy equine medicine, I want to continue, but in a different format and with a smaller staff. Many of the services that I will offer will be similar to what I currently do, but there will be more of a practice focus on sports medicine. Essentially that will mean that all of my time will be devoted not only to the alternative services, Chiropractic and Acupuncture, but also to lameness cases. I have long felt that we could improve our services in this area if we had more time and interest to pursue these cases. Over the past two years we have improved our diagnostic capabilities greatly with Digital X-rays, Digital Ultrasound, Thermography and Gastroscopy along with enhanced therapeutic options such as Shockwave Therapy. As my interests have moved more in this direction I would like to make this the focus of the practice where the work will primarily involve lameness type cases, including horses that not only have an overt lameness, but also those that are experiencing a decrease in performance or are in need of a diagnostic and treatment regimen to help identify and manage their specific problems.
The services that will be offered are as follows:
This will mean that I will not be able to provide service in a number of areas that Burlington Equine has in the past:
By limiting myself to just sports medicine cases it allows me to devote all of my time to focusing on problems related to these issues. Due to the fact that I will be working alone precludes me from being able to offer the full range of services listed above. In order to ensure that you will have emergency services when needed from other practices, it will be important that you establish a relationship with them for these types of services. There are a number of good quality equine ambulatory veterinarians in the area and a desire by many of them to expand. My hope is that they will be available to assist you as needed and that we will be able to all work together when problems arise. I have contacted a number of these practitioners and made them aware that they will be contacted by many of Burlington Equine’s clients. Listed below are the Veterinarians/Practices I have contacted:
Unfortunately for me Dr. Anne Finlayson and I will also be parting ways. I have worked with Anne since 1999 and will miss her expertise, professionalism and pragmatic approach to cases. She will be joining Vermont Large Animal as they will provide her more opportunities at this point than I am currently able to offer. For those of you in or near Chittenden County she will be available through their practice, and I would recommend contacting her for continuity of services. Again I hope to work with all of these practices and would like to make this transition as seamless as possible. If there are specific questions or recommendations please contact me and I will try to help.
In addition to the desire for a professional change in my life there are also some family-related reasons that have required that I be more available than I have been in the past. I hope that by downsizing and focusing on a particular aspect of equine medicine I will be able to make all of this work. I realize this change not only affects me, but also many of you that have depended on Burlington Equine over the years. While I have been considering this for some time I have been reluctant to take this rather major step as my time managing Burlington Equine has been fulfilling, and working with all of you along with the diversity of cases has provided interesting diagnostic and therapeutic challenges. My hope is that we can continue on a different level where this practice’s more focused approach to sports medicine type cases will be of benefit to you while you will still have all your other medical needs met from other larger practices. The transition date will be one month away - January 14. Susan and Linda will still be staying with me and they are available to help with medical records and to answer questions.
The other news as I look to the future is that we are exploring the feasibility of offering Nuclear Scans as a diagnostic procedure for those lameness cases where we are trying to gain more information. The licensing process is quite involved and it is difficult to say when this will go through. I feel this will complete the range of services that will be available through this practice and allow a much needed service for this area.
As always please feel free to contact me with any question.
Best regards,
Randy Frantz, D.V.M.
I am looking forward to the new format and a chance to specialize in this aspect of equine practice. We have offered some new services in the past 2 years - Shockwave Therapy, Digital Radiography, Mesotherapy and Video Endoscopy and these will be integral in this new practice.
As of April 2007 we are introduced our newest service. For those of you not familiar with the impact of stomach ulcers on the equine industry I would recommend that you review the following article: Equine Gastric Ulcers.
Video Endoscopy
This is a procedure previously offered at referral institutions that allowed for the visualization of the lower respiratory tract and portions of the digestive tract in the horse. We have been able to use a shorter endoscope for years that permitted us to examine the upper airway from the pharynx through the mid neck area, however we were not able to get beyond this point nor to pass the scope into the stomach so we could evaluate the horse for the presence of ulcers. Now we can do that and more. In addition the equipment is ambulatory which allows us to transport it to the barns and there is a color monitor for easy visualization by clients as well as methods to capture and store the images. As you can read in the Equine Gastric Ulcer article on this website, ulcers are a significant issue for horses and can negatively impact them in terms of performance and general well-being. Ulcers are undoubtedly one of the most frequently under diagnosed conditions. Probably this is true because the signs can be vague thus leading owners and Veterinarians into different directions when trying to sort out why there has been a drop in the horse's performance or why their behavior has changed. Of course the classically described horse with ongoing mild to moderate colicky signs would not be hard to associate with ulcers, but many of our patients do not always exhibit these signs. As our diagnostics have improved so have our medications and methods to manage these conditions. We look forward to discussing this with you if there are any questions.
Shockwave Therapy
Shockwaves are high-pressure, low frequency sound waves, generated by a device outside the body and applied to the affected tissue in a site-specific manner. When the shockwaves meet tissue interfaces of different densities, the energy contained in the shockwaves is released and interacts with the tissue. The shockwaves appear to relieve pain and accelerate healing within the injured tissue. Primarily the sound waves provide a mechanism to stimulate the healing process by interacting with the affected structures. In addition, it blocks pain conduction in the nerves for a period of time. This type of therapy was originally used to treat human beings with kidney stones, it allowed for the breaking up of the stones without the need for invasive surgery. More recently, shockwaves have been used to treat a range of orthopedic conditions in both human beings and animals. Besides its use for kidney stones in people, the other common applications which are similar to its use in equine medicine involve treatments for "tennis elbow", heel spurs, tendon issues involving the shoulder and selected non-union fractures. There are multiple equine orthopedic conditions that are similar to these human conditions and involve joint disease, soft tissue injuries and injuries to the interface of ligaments with bone. Specifically conditions that can improve with shockwave therapy are as follows:
In the past 18 months we have started to employ these treatments and have already seen benefits in both acute and chronic conditions. Previously for horses that needed this type of therapy we referred them to Tufts Veterinary School or Rochester Equine. Now we are able to offer the same service with focused shockwave. Therapy will generally consist of 2-3 treatments 1-2 weeks apart. If patients are insured this type of therapy is generally covered as this uses focused shockwaves versus radial ones, thus allowing more precision and deeper penetration.
Shockwave Therapy being applied to a horse with a proximal suspensory ligament
injury.
Link to more information on Shockwave Therapy:
Digital Radiography
In addition to our regular portable x-ray machines we now offer the ability to take digital radiographs. For those of you not familiar with this technology, simply think about the benefits of digital photographs or sound. Digital x-rays allow us to take an image in the field and have it displayed on a computer screen within seconds. Images can then be expanded, altered to enhance different aspects of the tissue and analyzed quickly to provide a diagnosis or to complete a purchase exam. Although traditional x-rays are still beneficial, the digital x-rays offer unsurpassed image quality and the ability to diagnose conditions that could remain elusive even with our best techniques.
Once images are taken they can be saved onto a disk for second opinions with purchase exams or to allow a surgeon to evaluate prior to referral. In addition images can be saved as JPEG files for clients to show farriers to aid with a shoeing plan. Since we have a strong interest in working with farriers we expect to be able to supply high quality images that will permit measurements and an ability to effectively monitor various foot conditions.
Digital radiography has rapidly developed in equine medicine, yet it is not offered in all practices. Certainly this is a mainstay in referral centers and we are excited to offer this service either in the field or at our clinic.
Mesotherapy
Mesotherapy is a technique that has been used for over 30
years in France and consists of shallow (4-6 mm) injection of medications
into tissue of the neck or back to block pain. Today, it is commonly practiced
in France, where more than 15,000 practitioners utilize mesotherapy for the care
of their human patients. Mesotherapy is also practiced in many other countries
around the world, including: Belgium, Columbia, Argentina, and throughout
Europe. This technique was introduced into the United States by a French
veterinarian, Dr. Jean Marie Denoix.
Mesotherapy is a treatment that stimulates the mesoderm, the middle layer of the
skin, which will, in turn relieve a wide variety of symptoms and ailments. The
treatment is used to stimulate the Giant Fibers. The technique involves the
injection of substances to stimulate the mesoderm for various purposes. The
mesotherapy injections involve extremely small needles that penetrate the
interdermal layer of the skin only to only a shallow depth. The number of
treatments needed depends on many variables including the condition, the
abnormal physiology causing the condition, as well as the chronicity of the
problem. A minimum of one to two sessions of mesotherapy is performed generally
to assess the horse’s response. Mesotherapy is effective for a multitude of
conditions because it helps reverse the physiology of that condition, and stop
the pain spasm cycle.
Since much of our focus with lameness conditions involves the back, this may allow another method to help alleviate back pain in addition to chiropractic adjustments, acupuncture, shockwave therapy and deeper anti-inflammatory injections. In addition for horses with limited neck flexibility, we expect it to have a role in these conditions.
Horse receiving mesotherapy treatment for neck inflammation.
As seen in the above picture there are small skin bumps that appear as the medication is deposited just below the skin surface. Theses swellings will quickly dissipate and the benefits should be realized in 3-7 days. Patients will be out of work for the first few days, then depending on the condition they can begin ground work or light work under saddle.
Link To Vetri-Science
I am including an easy link on this site to Vetri-Science as many of you have expressed interest in their products following the Nutrition Seminar we hosted in March 2006. This will allow you to order directly from the company. If you have specific questions on which supplements may be most suitable please feel free to contact us.
You will need to use the following for orders: Username = horse Password = twister47
General Information
There will be several new submissions in this on-line newsletter: some are articles written by us, I have also included some from previous Burlington Equine Newsletters, and others will be articles and links from the internet. We are frequently faced with questions about treatments and diagnoses clients find through internet searches. Granted there are reliable sources available, but the vast majority are anecdotal and far removed from the type of peer-reviewed material that we rely on to treat our cases. However, one of the exciting aspects of Veterinary Medicine is that we have more freedom to delve into some of these less well accepted treatments when necessary and when based on appropriate medical principles. We are always willing to respond to any questions you have about your horses and hope you will always be willing to call our office or submit them via e-mail.
We will use this site as a forum to post recently written articles, provide access to previous ones, announce current information and respond to your questions. E-mails will be sent to notify clients of web site updates. If you know of someone that has not been notified and would like to be in the future, send in the e-mail address.
Our e-mail address is : bevet@gmavt.net .
Any ideas or questions that would improve this site would be appreciated.
LYME DISEASE
In the past few years we have been testing more horses for Lyme Disease and finding that quite a few carry a titer (antibody level) indicating exposure and some are truly infected by the organism. Treatment is fairly straightforward, but response to therapy is affected by the duration of infection. Behavioral changes, multiple lamenesses and /or generalized stiffness may be the initial signs that raise the index of suspicion.
In endemic areas such as Connecticut and lower New York state, Veterinarians have used the dog vaccine to try and protect their equine patients. No one is sure how effective this strategy is, but because of the large number of cases they are hoping it will provide some benefit. At this point we are not recommending using this vaccine. See Lyme Disease article.
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