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Horse MRI— A Positive Experience by Lynne Pernsteiner

It started with lameness

When our young Quarter horse “Fancy” came up lame, we consulted with our equine veterinarian  She performed an extensive lameness exam, including a physical work-up, a radiograph and an ultra-sound imaging of Fancy’s front leg. Unfortunately, nothing was found so we decided to try “resting” our horse—which is not as easy as it sounds!

Several months passed without a sign of improvement so we called our vet back for more testing. This time she tried blocking nerves to pinpoint the troubled area and discovered that the injury was low in the fetlock. During this time we consulted with other veterinarians and tried several treatment options— from new shoes to steroid injections. Each thing we tried seemed to work for a short time, and then the lameness returned.

A MRI referral  

After a year and a half of “guessing” how to help Fancy become sound, we decided we needed better answers. My daughter, Julia, and her horse had missed two show seasons and we had some big decisions to make. It’s expensive to keep a lame horse; the vet calls and various treatment plans were adding-up financially. Our vet suggested we take Fancy to the University of Minnesota for an MRI (Magnetic Resonance Imaging).

When I called the University of Minnesota’s Large Animal Hospital to schedule the procedure, I was completely shocked to discover that it required a 3-day horse hospital stay. Immediately after scheduling the MRI, I searched the Internet looking for information. Instead of calming me, the information I gathered about MRI’s caused me great stress. What I thought was going to be a simple procedure became an emotional ordeal. The expense, the risk and the potential outcomes became very overwhelming. After a week of inner turmoil, I called the Large Animal Hospital with a list of questions and was ready to pull the plug on the MRI if the answers weren’t to my satisfaction. The receptionist must have sensed my anxiety as my call was immediately transferred to the surgeon performing Fancy’s MRI, Nicolas Ernst, DMV.

Talking to Dr. Ernst not only erased my fears of an MRI, but he helped me understand how lucky horse owners are to have the Large Animal Hospital, the Leatherdale Equine Center and the Piper Performance Clinic right here in the Twin Cities. I had no idea we had the equine equivalent to the Mayo Clinic right in our backyard. The call was also good as it reminded me that getting information from the Internet—while it may be good—is like taking a drink from a fire hydrant.

The Large Animal Hospital

A member of the veterinary staff met us at the equine entrance. After helping us get Fancy settled into her hospital stall, we were given a tour. Many of the medical staff members also owned horses and empathized with us. On the tour we learned that the University of Minnesota Large Animal Hospital performs several MRI’s a week, and that they are ranked as one of the top three equine veterinary schools in the country. We also learned that the MRI machine used there is the best in the Midwest, as it has twice the imaging of other machines. They explained it as having double the number of pixels, which creates twice the picture, and that is huge because highly detailed images are easier to read.

The MRI

An MRI is a non-invasive procedure that creates detailed pictures of soft body tissue, bone and organs without the ionizing radiation that x-rays and CT scans have. MRI machines use a strong magnetic field, radio waves and complex computer equipment to give 2 and 3 dimensional images and cross sections of body parts. Several hundred images are taken during the procedure. A big advantage of the MRI is its ability to change the contrast of an image, as different contrast settings will highlight different tissues and allow pathology to stand out. An MRI makes the changes in the chemical makeup of tissues more visible. MRI’s performed on live horses have been around for only the last 15 years. This relatively new tool in veterinary medicine has allowed for improved medical diagnostics.

At the University of Minnesota you are able to view your horse’s surgery through a surgical window, but due to the nature of the MRI, we weren’t allowed to watch. The veterinary technician working with us, Sheryl Ferguson, explained the following process horses go through during an MRI.

After your horse arrives at the hospital they make sure their shoes are pulled, and then basic radiographs are taken to detect metal. The MRI machine contains a huge magnet and metal can be hazardous to the patient and staff. If metal is detected, for example, from nail shards in the hoof from horseshoes, then a technician must remove each metal piece prior to the MRI. After checking for metal, the horse is weighed, given a thorough bath and put to bed in a comfortable stall for the night.

The second day is a busy one, as the staff prepares and performs the MRI. A catheter for the IV is placed early, and then the horse’s mouth is flushed to cleanse for intubation (the breathing tube). When all 10 to 12 members of the veterinary team are in place, the horse is sedated. Because horses generally weigh over a thousand pounds, the sedation is done in a small, padded stall so the horse doesn’t injure itself. Once the horse is sedated, a special electrical hoist is used to position the horse on a padded MRI table. The anesthesia team then goes to work to connect the oxygen and anesthesia machines to the horse. It is their job during the MRI to monitor the horse’s breathing and fluids, and also to keep the horse comfortably asleep.

When the horse is ready to go into the MRI imaging room, medical technicians work together to ensure the horse is in the correct position. Precise placement of the horse for an MRI can be crucial for taking exact images. It is also important for the medical staff to monitor how long a horse is in a certain position to ensure that there isn’t too much pressure on any given area for extended time, as this can cause myopathies. (Muscle soreness) The horse is then wheeled into a soft-lit room where a large, doughnut shaped MRI machine stands. The MRI process takes between 30 and 90 minutes, depending on what needs imaging. During the MRI medical staff members work together as an orchestra, each with a specific job conducted by a surgeon, in our case, Dr. Nicolas Ernst.

During the MRI the technologist operates the MRI machine from a computer located in another room. She works in tandem with Natasha Werpy, DVM, an Equine Diagnostic Imaging Specialist located at the University of Florida Gainesville. MRI images are digitally sent to Werpy, who reads and interprets the MRI images from over a thousand miles away.

Once the MRI is complete the horse is moved via the electrical hoist from the imaging table and placed in a padded recovery room. Many horses’ first response to their unknown situation and surroundings is “fight or flight.” The medical staff carefully observes the horse as it comes out of anesthesia to ensure it doesn’t stand up too quickly, possibly injuring itself. An air mattress like floor keeps the horse from standing right away and staff members monitor the inflation level of the mattress to keep the horse comfortably resting until its able to get up. Once the horse is up and moving it is brought back to its hospital stall. At this point we received a call from the hospital, telling us that Fancy was doing well and that they were able to get good MRI images.

The University of Minnesota’s Large Animal Hospital likes to keep horses under observation for approximately twenty-four hours after an MRI. When we picked up our horse the following day she looked great. She had a few patches of hair that were matted down and the vet technician explained they were from the surgical taping needed to position the oxygen and anesthesia tubes. Fancy also had a shine to her coat from the Show Sheen they used to more easily position her on the MRI table. Our horse was happy to see us on the third day and we were happy to be bringing her home.

The MRI report

The day after we brought Fancy home I received a call from the Large Animal Hospital checking up on her. I also received an email report from DVM Werpy, the Equine Diagnostic Imaging Specialist at the University of Florida Gainesville. The MRI showed that Fancy had significant tendonitis of the deep digital flexor tendon and a depression of the navicular bone—indicating the degenerative navicular disease. Our vet recommended a new type of shoe with pads and a rounding of the toe to take the pressure off. She also advised using a newly approved medication, Osphos, which slows bone degradation.

We all have to make decisions on to how to best care for our animals based on our own circumstances. There isn’t one answer to fit all situations. For us, having an MRI was a good decision. We needed answers so we could make informed decisions. Looking back, I wish we had done the MRI sooner. A lot of time and money were spent not knowing what was wrong. We may have even allowed the disease to worsen, as we didn’t know what we were dealing with. Through this process we’ve come to realize how lucky we are to have such knowledgeable medical staff and incredible equine medical resources available to help us when things go wrong.

Thanks

I would like to thank the University of Minnesota Large Animal Hospital staff for making our MRI experience such a good one. I especially thank DVM & Equine Surgeon, Nicolas Ernst, Veterinary Technician, Sheryl Ferguson; MRI Imaging Associate, Susan Steward; and Chief Development Officer, Bill Venne, for their time, knowledge and dedication to horses.

Postscript

It has been one month since the Osphos injection and Fancy seems to be improving. While barrel racing may no longer be in her future, we are looking to introduce her to a new job as a lesson horse.

*For more information on the University of Minnesota Equine Center & Hospital you can check out:

The U of M Equine Center website at— http://www.cvm.umn.edu/umec/

Facebook— University of Minnesota Equine Center

Cowgirl Logic:

“SOMETIMES you will never know the true value of A MOMENT until it becomes A MEMORY.” Unknown

 

 

 

 

 

 

 

 

 

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