Wednesday 20 June 2012

Potentially VERY exciting...

Lots of you have followed the ups and downs as I've tried (with lots of help from others, especially vets Peter Clegg and Jeremy Hyde) to put together some solid research into the rehab we do here.

Of course, Project Dexter, which records the results from horses with navicular and DDFT-type diagnoses, is ongoing and I will continue to add to that (**we are at 50 horses, by the way - surely that's a milestone, and I reckon there will be a big Project Dexter blog before too long!!!**).

HOWEVER, this is something different - and it has great potential - though I won't know till next week if its really going to work...

To give you a bit of background, there are 2 ways of assessing damage to tendons and ligaments (ie the stuff which won't show up on x-ray) - either ultrasound or MRI.  
MRI is fantastic, incredibly detailed (images above courtesy of Hallmarq) and extremely expensive (it runs at £1000-1800 currently); it can also only be done at specific veterinary centres which have the right facilities.

Ultrasound is much cheaper and is portable - most veterinary practices have ultrasound machines which can be transported in the back of a car. Its often used to scan leg injuries but its much more difficult to get images of damage within the hoof capsule. Although I've heard eminent French vet Prof Jean-Marie Denoix describe obtaining ultround images of the DDFT within the hoof till now I've not come across a vet in England who thought it was do-able.

But step in Anna Ehrle, a fantastic German vet who joined our local practice last year. She's been to Rockley a couple of times and I've been extremely impressed with her but it was only in the last few weeks that I discovered she was a bit of an ultrasound specialist.
When she was last up here I asked her about scanning within the hoof and she was confident that we could get images of the DDFT and navicular bursa and that damage would show up provided it wasn't too deep. I mulled it over and realised that ultrasound would give me a way of looking at DDFT damage before and after rehab, and although it wouldn't be cheap, it would be a hell of a lot more practical than repeat MRIs.

It seemed mad not to give it a try so, after talking to M, Dali and Eva's owners, next week we are taking the plunge and Anna will come up here and scan all 3 horses. The advantage is that we already have MRI for Eva and Dali, which will give us a control for what we are looking for in the DDFT. Even better, Dali and M have been here only a short time, so if the scans are useful we can re-scan them at the end of their rehab.

I'll let you know next week what the scans are showing us, but I have high hopes - keep everything crossed...  :-)

11 comments:

Clare said...

Exciting prospect! Good luck, will watch with interest.

dreams579 said...

oooh! exciting exciting exciting!

still haven't heard back from the vet at my practice re control groups. am seeing my normal vet tomorrow (out for a rescan :( ) so i may be able to pick his brains a bit, and give amy a ring later this week.

july is also looking pretty quiet for me at the moment, so will try to work out a good weekend to come down for a visit :)

Nic Barker said...

Thanks both :-) Emma, that sounds like a plan - Catherine is also interested in getting involved so let me know when you are free!

Val said...

I will keep my fingers crossed for you and Rockley. Measurable data. Here we come!

jenj said...

Oooooh, data! Of the type that will make those peer reviewers sit up and take note! (Not that your other data somehow isn't good enough, but you know how the skeptics are...) Fingers crossed that it pans out!

What would be SUPER EXTRA awesome is if you could find horses with similar diagnoses who have been on a more "standard" rehab protocol (e.g. box rest) for the same amount of time that most horses are at Rockley. Those horses likely have images before and after 12 weeks... what a comparison that would make!

M's mum said...

I'm really excited that M gets to be a part of this - I hope he gives you good pictures!

Nic Barker said...

Jen, find me the funding and I will do just that ;-) As it is, I can only stretch the finances so far...!

jenj said...

Nic, I was thinking more of finding vets who have cases like this, who are ALREADY taking ultrasounds or MRIs at the beginning of treatment and then again after 12 or so weeks. Mooching off others' data, as it were, not doing it yourself! Perhaps there are some folks on Horse and Hound with images of their own horses? Or perhaps, in the US, on Chronicle of the Horse?

In all your spare time, of course! ;)

Nic Barker said...

The problem is, Jen, that horses with DDFT injuries within the foot aren't normally scanned with ultrasound simply because most UK vets aren't confident about getting good enough images.

As far as I know, the only vet who does is Denoix, and he is based in France but as he also has MRI at his disposal I doubt very much that he does before and after MRI.

Great idea, but I think as usual we are on our own on this one...

jenj said...

Ah well, my ideas often run away with me. It's still SUPER AWESOME COOL that you will be able to have some "before and after" data of horses at Rockley... I can't wait to see the results!

Kristen Eleni Shellenbarger said...

Oh this is just perfect! I have had a date set for new digitial xrays on Lazarus AND I was going to do Ultrasounds on his fetlock area, now wondering if it's possible to do for foot as well??? I don't have access or funds for MRI, but I'm SO looking forward to what you see, how you rehab b/c quite honestly, the possible results are SCARING me but having someone like you that takes the info and REHABS gives me such hope!!! :)