We offer a complete range of diagnostic services to investigate internal medicine problems, following initial examination further diagnostic tests are used to investigate your horses complaint. From time to time visiting internal medicine specialist Rachael Conwell BVetMed Cert EM (IntMed) DECEIM MRCVS is available for appointments to assist with cases that require more in investigation. We have four intensive care boxes that have 24 hour CCTV, which allows continual monitoring of critically ill patients.

Upper Respiratory Tract (URT) Disease

For exercise-related complaints dynamic overground videoendoscopy examination is the new gold-standard, replacing the traditional dynamic treadmill videoendoscopy and standing videoendoscopy. The test involves fixing a special endoscope and monitoring equipment to the horse and rider to visualise the URT on a distance located lap-top in real-time whilst the horse is exercised. This is the most accurate test to diagnose exercise related abnormalities of the URT and ensure the most appropriate treatment is performed.

We have a full range of videoendoscopes available for imaging the upper respiratory tract. The hospital also houses the world first CT scanner allowing examination of the head in a standing sedated patient. The system was developed by Alastair Nelson and has since been installed in several hospitals across the UK.

Lower Respiratory Tract (LRT) Disease

Complaints of the LRT may be similar to those of the URT. Coughing may be more likely and resting respiration rate subtly increased and laboured. Standing videoendoscopy allows examination of the trachea down to the major bronchi. Collection of respiratory secretions for cytology and bacteriology analysis allows investigation of certain conditions. In smaller patients radiography of the lungs is also possible. Ultrasonography is used to examine the chest, and help collect pleural fluid samples and to biopsy lung tissue.

Cardiac Disease

Determining the true clinical significance of cardiac abnormalities (murmurs and arrhythmias) is a challenge, especially when such condition are often incidental findings during routine clinical examinations. When associated with a clinical problem however, complaints may include poor growth, poor performance, weight loss, prolonged recovery from exercise and laboured breathing. Auscultated abnormalities can be further investigated using a blood test, echocardiography, colour-flow doppler examination and resting and exercise electrocardiography.

Weight Loss

Many medical conditions can be responsible for weight loss and be accompanied by an array of other complaints. Investigation begins with a thorough oral and dental clinical examination and a review of the worming management of the horse. Initial auxiliary tests commonly include worm faecal egg counts and survey blood tests. Where necessary cases are further investigated tailored to the patient’s history and clinical signs. Other tests may include hormonal blood tests, dynamic sugar absorption tests, abdominal ultrasonography, liver biopsy, rectal biopsy or even abdominal exploration with intestinal biopsy collection under general anaesthesia.

Liver Disease

Complaints suggestive of liver disease include dullness and lethargy, inappetance, weight loss, colic, skin lesions, and filling of the limbs. Due to the functional reserve of the liver and insidious disease onset clinical signs may be variably present. Blood tests are used to definitively to confirm the presence of liver disease. The causes of liver disease range from the well-known toxic causes of ragwort poisoning to bacterial, inflammatory, metabolic and obstructive disease processes. Use of ultrasonography aids evaluation of liver disease alongside a liver biopsy to histologically describe the disease state present, establish the most likely cause, help tailor best medical care and to help establish a prognosis.

Urinary Tract Disease

Disorders of the urinary tract are uncommon in horses. Complaints of increased drinking and urinating, frequent attempts to urinate, straining to urinate especially alongside colic, discoloured urine and non specific signs of dullness and weight loss may suggest an underlying urinary tract disorder. Catheterisation of the urinary bladder, urinalysis and blood tests compliment initial clinical examination. Further diagnostics used according to clinical features include videoendoscopy of the lower urinary tract (urethra, bladder and the ureters as they enter the bladder), ultrasonography of the kidneys and bladder, kidney biopsy, water deprivation tests and plain and/or contrast radiography in foals.

Neurological Disease

Clinical signs of neurological disease are varied, ranging from the rare seizure to more subtle and highly ambiguous clinical signs that maybe overlooked by owners. For example, complaints of a head tilt, head shaking or compulsive walking may be reported as a change in behaviour. Or complaints of stumbling or a jerky, exaggerated limb action may be reported as a musculoskeletal lameness. A thorough systematic, neurological examination is required to localise and ensure a neurological lesion is not overlooked. Further diagnostics are invariably required to definitively diagnose different neurological lesions. These may include blood tests, head and neck radiography, guttural pouch videoendoscopy, a myelogram to identify spinal cord compression in the neck, analysis of fluid bathing the spinal cord, muscle biopsies and advanced imaging techniques such as a standing computed topography (CT) scan of a horse’s head – just to name a few.

In October 2010 Dr Barrie Grant DVM MS DACVS MRCVS from Canada flew to the UK to perform cervical spinal surgery at Rainbow Equine Hospital on a horse that we diagnosed, following a myelogram, with Wobbler syndrome. The operation involved fusing two adjacent unstable vertebrae in the neck using a metal implant to fix the vertebrae in place and prevent them compressing the overlying spinal cord.

Ophthalmological Disease

Common ocular complaints include watery eyes, cloudy ‘blue’ eyes or a closed, painful eye. Not all clinical signs however are as strongly indicative of ocular disease. A wide variation in the normal appearance of horse eyes exists. It is therefore advisable for any ambiguities in the health of a horse’s eye to be examined to determine their clinical significance and avoid putting yourself at risk by riding a horse with a possible visual impairment. Initial examination may often be adequate for diagnosing common corneal ulcers and cases of uveitis. For more complex cases where a more thorough examination of the globe is required use of radiography, ultrasonography and tonometric evaluation may be necessary. Medical management of ocular diseases can require hospitalisation and the placement of an indwelling catheter in the eye lid to facilitate frequent, non-intrusive delivery of medicines.

Endocrine Disease

Complaints of increased drinking and urinating, changes in coat quality, obesity and unexplained, recurrent laminitis may all be suggestive of an underlying endocrinopathy. Various special but simple to perform blood tests offer a quick diagnosis of the common hormone imbalances diseases of Equine Cushings Disease and Equine Metabolic Syndrome (EMS). Following diagnosis, through simple management chances and alongside medical treatment, the quality of these horses’ lives can be dramatically improved.

Equine Gastric Ulcer Syndrome (EGUS)

Clinical signs of EGUS are vague and often non-specific. Complaints include poor performance, recurrent colic, poor appetite and weight loss. Diagnosis is made following gastroscopy (videoendoscopic examination of an empty stomach): involving passage of a long endoscope along the nasal passageway, down the oesophagus and into the stomach to examine the mucosal lining. EGUS may be a primary or secondary disease syndrome. Therefore prior to gastroscopy other diagnostic tests may be used during initial investigation to rule out or investigate possible concomitant diseases. Greater awareness of this condition is leading to its increased investigation and subsequent diagnosis in foals and across all types of performance horses.

Laboratory services

We have the back up of a full in house laboratory which allows us to analyse blood samples for our inpatients 24 hours a day.