Featured Article (June 2004)

10 Questions for Nathaniel A. White II,DVM, MS. Diplomate ACVS - Director of Marion duPont Scott Equine Medical Center

Dr. White is the Theodora Ayer Randolph Professor of Surgery and is the Director of Marion duPont Scott Equine Medical Center. He is an internationally recognized expert in equine colic and musculoskeletal disorders.

The Marion duPont Scott Equine Medical Center at Morven Park in Leesburg, VA is one of three campuses comprising the Virginia-Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University. Opened in 1984, the Equine Medical Center is a referral hospital for equine patients. The Center’s staff of healthcare professionals includes board certified veterinarians in anesthesia, internal medicine, and surgery, veterinarians in residency and internship training programs and certified veterinary technicians. Veterinary services are provided for out patients and hospitalized patients by appointment. Critical care and emergency services are available 24 hours a day, every day of the year.

What are the most common equine health issues treated at Marion duPont Scott Equine Medical Center (EMC)?

Doctors at the Equine Medical Center are specialist in medicine and surgery. The surgery services see mostly lameness and orthopedic problems. Arthroscopic surgery is one of the most common procedures. Colic is a common emergency with a majority of those seen requiring emergency surgery. Upper airway problems are also common. The internal medicine service commonly examines horses for neurologic disease such as wobblers and EPM, pulmonary disease, and gastrointestinal disease such as ulcers, colic and enteritis. The medicine service also cares for the neonatal foals that make up a large part of the work in the spring months. Emergencies make approximately 1/3 of the cases admitted annually.

Over the past several years EMC has acquired state of the art equipment and facilities to better to serve our equine community. How is EMC funded?

The EMC is funded from three sources. Some of the faculty are supported by state funds as part of the Virginia-Maryland Regional College of Veterinary Medicine. The second source, which predominates, comes from hospital fees for service. The third funding source, which has allowed the EMC to maintain its state of the art facilities and equipment, is private donations. In the past four years donations have supported construction of a treadmill facility and isolation unit, renovation of the MRI room, construction of a video laboratory and molecular research laboratory, setup for a farrier’s shop, and planning and construction for a research barn. Acquisition of new arthroscopic equipment, x-ray machine, fluoroscope, image capture systems, blood pressure units, and fluid pumps have all been possible as a result of private donations.

EMC is the first equine hospital in the eastern United Sates to offer Magnetic Resonance Imaging (MRI) for horses using a new MRI unit. What are the benefits of the MRI to horse owners?

Magnetic Resonance (MR) creates images by detecting the alignment of protons in all tissues within the magnetic field. A large magnet is used to align the protons in the horse’s leg while a radio frequency is pulsed into the limb. The resulting radio frequency emitted from the tissue is used to create an image on a computer. MRI is unlike radiographs or ultrasound as it detects changes in the chemical characteristics in tissues and not just structural change. Inflammation, infection and changes in the make up of both soft tissues and bone can be detected with MRI. MRI also allows visualization of multiple slices through the leg in 3 dimensions. Because MRI detects fluid and chemical changes it can help diagnose changes in structure as wells as tissue inflammation which can’t be detected any other way. Disease can be localized as well as providing a specific diagnosis, which wouldn’t otherwise be available.

EMC’s High-speed Treadmill is another invaluable diagnostic tool. What kinds of problems can the Treadmill identify?

The treadmill allows horses to move at any rate of speed including race speed in a controlled environment. Because the horse remains in one location, examining the upper airway, drawing blood samples and examining the heart can all be done while the horse is exercising? The treadmill is used commonly to detect upper airway problems only seen during exercise. An endoscope is placed in the nasal passage during the exercise to look for paralysis, abnormal movement, and redundant tissue all of which can obstruct the airway. Several of these problems can only be diagnosed when the horse is moving at high speed. Muscle and lung problems can also be studied on the treadmill. Using video cameras, gait and lameness can also be evaluated at different speeds.

What is the success rate of your Comprehensive Neonatal Care Unit and how many foals do you treat on an annual basis?

The neonatal unit treats from 40-50 critically ill foals annually with a 78% success rate. The work requires round the clock dedication of nurses, doctors, residents, interns, students, and volunteers. Frequently all the hospital services including surgery, radiology, laboratory are involved with the care. Drs. Martin Furr and Harold McKenzie organize and run the foal critical care unit combining more than 25 years of experience in foal care. It is rewarding to learn that these foals go on to lead normal lives in numerous types of performance.

As a horse owner can I call the EMC directly or do I need a referral from my family veterinarian?

The EMC is predominately a referral center and clinicians prefer to work with clients and their veterinarians for optimal patient care. Referring veterinarians are an essential part of a team approach before, during and after the care at the EMC. Horses and owners are not turned away if they call directly for service, however, if previous diagnosis and treatment of a condition by a veterinarian has been completed, EMC doctors will attempt to establish a referral for the benefit of the horse and for any treatment that may be needed after a visit to the Center.

MC has expanded its scope to include bio-medical research. What types of research does this include?

Faculty at the Equine Medical Center have completed research in many areas, all of which relate directly to clinical problems seen in the hospital. Currently research on colic, EPM, wobblers, upper air way surgery, suspensory desmitis, antibiotic efficacy, gastric ulcers, endotoxic shock, laser surgery on joints, analgesics, and joint disease is being completed at the Center by faculty and graduates students. Creation of a molecular laboratory this year will allow the faculty to take advantage of new techniques to detect a horse’s response to diseases and the benefit of treatment.

Dr. Ken Sullins has pioneered laser surgery at EMC. What kinds of procedures are offered for horses?

Laser surgery has developed into an essential part of the surgical armamentarium for horses. The EMC is fortunate to have multiple types of lasers including a diode laser, a Yag laser and CO2 laser. All have different uses. The diode and Yag lasers are used for upper airway surgery both for cutting and vaporization of tissue. Both can be effective for tumor removal or tissue ablation. The CO2 works like a scalpel and can be used for surgical dissection, tumor removal, uterine surgery, eye surgery and hemostasis. Lasers have changed the way that upper airway problems in horses are treated.

EMC has an active Volunteer Program. 208 volunteers have contributed over 24,000 hours. What opportunities are available for someone who would like to volunteer?

Volunteers make a great difference to our patient care and hospital operations. Volunteers help with patient care by grooming, cleaning stalls and aisle ways, stocking supplies, walking horses, foal sitting, monitoring IV lines and vital signs, feeding and helping foals. Volunteers also help with library assistance, video services, ambulance operations, and gardening.

How do you envision EMC ‘s role in the equine community in ten years?

The EMC will continue to be a resource for the commonwealth’s horse industry. While serving as a teaching hospital for veterinary students and graduate students, the EMC will constantly strive to be at the cutting edge of equine medical science. Now and in the future this will require partnering with all facets of the equine industry as well as veterinary practitioners to support the needed facilities and expertise. The hospital will utilize the expertise of specialist both locally and regionally to provide the best health care for horses. Additionally the EMC will become repository for equine health and performance information making it available to the horse owner and horse industry. Our goal is to be nothing less than the best.