Updated policies - Find out all the information about our updated policies at the bottom of the page.

Diagnostics

Find out more about our various Diagnostic options

  • Digital Radiography
  • Ultrasonography
  • vet-services-video-endoscopy Endoscopy
  • Gastroscopy
  • Laboratory
  • Overland Endoscopy

Digital Radiography

Radiography is the principle imaging modality for bone. When an x-ray beRadiographyam hits a patient, some of the x-rays are scattered, some are absorbed and some pass through unchanged. The appearance of the radiograph produced is dependent on the number of x-rays that pass through the patient and strike the x-ray plate. The more x-rays that strike the x-ray plate, the blacker the image appears.

We know that different tissues in the body absorb x-rays to differing degrees. Of all the tissues in the body, bone absorbs the most x-rays. This is the reason that bone appears white on a radiograph. Soft tissues absorb some but not all of the x-rays, so soft tissues appear on a radiograph in different shades of grey.

Oakham Veterinary Hospital uses a digital computer radiography system which produces radiographic images of excellent quality. The pictures are viewed on a computer screen and areas of particular interest can be enlarged to achieve more detail. The digital system also allows radiographs to be sent via email, for example to referring vets or farriers.

Oakham Veterinary Hospital also has a portable Eklin digital radiography system that affords our ambulatory vets the ability to obtain images of the highest diagnostic quality.

Ultrasonography

Ultrasonography is a versatile imaging modality for assessing soft tissue structures such as tendons and ligaments. Damage to tendons and ligaments can be seen on ultrasound as changes to the fibre pattern and cross sectional area of the structure.Ultrasound

The practice has six ultrasound scanners in total. Two large scanners are situated permanently in the hospital and an additional four scanners are portable and can be used on visits out of the hospital. The degree of portability and outstanding image quality afforded by these machines allows our veterinarians to effectively employ the use of ultrasound as a diagnostic imaging tool, anywhere, under any circumstances.

vet-services-video-endoscopy Endoscopy

Endoscopy facilitates the visualisation of otherwise inaccessible areasEndoscopy of the equine respiratory tract. The pharynx, larynx, guttural pouches and trachea can be visualised using a portable fibre optic endoscope. Using an endoscope, we can visualise these regions of the horse in great detail and take biopsy samples for on site laboratory diagnosis.

In the hospital we have two videoendoscopes that allow the image to be displayed on a TV screen, enabling the client and vet to observe and discuss the case at the same time. In addition, we have 3 portable endoscopes that allow horses to be examined by our ambulatory team without the need for a hospital visit.

Endoscopy is an essential part of the evaluation of horses with upper airway obstructions and abnormal respiratory noises, lung diseases, gastric (stomach) ulcers and many urinary tract diseases.

Gastroscopy

Gastroscopy is used to assess the stomach of horses to diagnose disorders such as equine gastric ulcer syndrome. At Oakham Veterinary Hospital, we have the latest mobile video endoscopes that are 3.5 metres in length meaning our vets can assess the oesophagus (gullet), the stomach and the first part of the small intestine (duodenum) to undertake a complete assessment of your horse.

Equine Gastric Ulcer Syndrome 

Equine Gastric Ulcer Syndrome (EGUS) is a complex condition, of which our medicine specialists are at the cutting edge of research. A list of some of their published work is shown at the bottom of this page. We now know that EGUS represents multiple different conditions causing different signs in different horse types. Broadly the disease is divided based on location to Equine Squamous Gastric Disease (ESGD), affecting the upper part of the stomach and Equine Glandular Gastric Disease (EGGD) affecting the lower part of the stomach where it empties into the small intestine. Some confuse EGGD with diseases of the ‘hind-gut’ or colon which are entirely different conditions. In fact, hind gut ulceration is usually associated with parasites or the use of painkiller medications (e.g Bute)

How do I know if my horse has gastric ulcers? 

A range of signs can be associated with diseases of different parts of the stomach or intestines as shown in the table below. None of these signs are specific to gastric disease and the only way to definitively diagnose gastric disease is to have your horse gastroscoped. Hind gut ‘ulcers’ can only be documented by ultrasound imaging of the colon. To undertake ultrasound assessment of the colon it is normally necessary to clip your horse.

Clinical Sign Equine Squamous Gastric Disease Equine Glandular Gastric Disease
Colic Mild to moderate usually after feeding
Possible link to recurrent colic
Mild and possibly recurrent, not related to feeding
Inappetence Often reported with ESGD Reduced appetite or altered feeding
Weight loss Related to reduced food intake Unexplained weight loss (i.e. with normal appetite)
Stereotypic behaviour Associated between oral sterotypies (e.g. crib biting) and ESGD.
Causal link not demonstrated
Not considered directly associated with EGGD
Changes in temperament Nervousness has been linked to ESGD Changes to temperamnent including nervousness and rideability
Poor performance Potential link, although causation has not been demonstrated Changes in rideability including reluctance to go forward
Other   Abnormal cutaneous sensitivity including self mutilation, resentment to girthing or leg aids

 

What does gastroscopy involve? 

In order to assess the entirety of the stomach your horse will have to be starved overnight (from 6pm) and water removed from the stable 2 hours before the examination. We will happily hospitalise your horse to do this, but you are also welcome to do this at home. Remember to be strict or the examination will have to be repeated! If you do bring your horse in the morning of the examination remember not to feed them en-route, it is very easy to slip into auto-pilot and hang a haynet in the horsebox.

Your horse will need to be sedated to have the gastroscope passed up your horse’s nostril, to the back of its throat and down the oesophagus into the stomach. The scope is then steered around the stomach to assess it within its entirety. Horses may also need to be twitched to prevent them moving their head during the procedure, which can result in a nose-bleed. If this happens it always stops, and looks worse than it is.

How do I treat my horse with gastric ulcers? 

True gastric ulceration occurs in the squamous (upper) portion of the stomach (ESGD) and can be effectively managed in almost all cases with oral omeprazole paste (Peptizole, Gastroguard, Ulcer Gold), which reduces the production of acid in the stomach. The drug is most effective if administered on an empty stomach in the morning, one hour before feeding. Horses will typically improve clinically within a week of treatment, although stopping medication early can result in a return of signs. Once healed, it is possible to prevent recurrence by removing risk factors and changing the diet. A range of supplements can be purchased, but please discuss these with your vet as some will have no effect on the health of your horse’s stomach. Ocassionally horses may require ongoing low dose ‘maintenance therapy’ using omeprazole.

Disease of the glandular stomach (EGGD) are not, in fact, ulcers. Research carried out by our team has shown that these are an inflammatory condition that are rarely associated with gastric ulceration. Although omeprazole can be helpful to lower the acidity of the stomach to encourage healing, we no longer believe that acid injury is the cause of this condition. Indeed, EGGD rarely heals with the use of oral omeprazole alone. Other medicines, that are not authorised for use in horses, are frequently used and we have extensive experience in using these medicines. If you have any questions about this you can discuss them with anyone in the medicine team. EGGD often takes longer for complete healing but stopping treatment early often results in an immediate return of signs and disease. Specific supplements can be useful, but the choice of active ingredient is very important.

Can I treat my horse without it having a gastroscope? 

Although treatment without the results of gastroscopy used to be the norm, this is no longer recommended since different diseases require different medicines and treatment periods. Although horses will improve clinically with untargeted treatment while receiving medication, the underlying disease is not changed if the wrong treatment is selected. As such, signs usually recur and attempts to ‘save-money’ can often be counter-productive. We offer a discounted ‘all-in’ gastroscopy fee to ensure this procedure remains cost effective.

Does my horse need rescoping at the end of treatment? 

We strongly recommend that all horses are re-scoped at the end of treatment to ensure complete healing. This is particularly important for EGGD where disease will recur if complete healing is not achieved. We offer a discounted re-scoping fee in recognition of the benefit this has to your horse’s health.

Where can I find out more? 

Our medicine specialists are actively working to improve the profession's understanding of gastric disease in horses. The following scientific studies are freely available, others can be found in the waiting room.

David Rendle, Mark Bowen, Tim Brazil et al (2018) Recommendations for the management of equine glandular gastric disease. UK-Vet Equine 2018 2:Sup1, 2-11 https://www.magonlinelibrary.com/doi/pdf/10.12968/ukve.2018.2.S1.3

Varley G, Bowen IM, Nicholls V et al (2016) Misoprostol is Superior to Combined Omeprazole and Sucralfate for Healing Glandular Gastric Lesions. Equine Veterinary Journal 48, 11–12 https://onlinelibrary.wiley.com/doi/full/10.1111/evj.15_12612

Sykes, B. W., Bowen, M., Habershon-Butcher, J. L. et al. (2018). Management factors and clinical implications of glandular and squamous gastric disease in horses. Journal of veterinary internal medicine, 33(1), 233-240.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335573/pdf/JVIM-33-233.pdf

Laboratory

Oakham Veterinary Hospital has a well equipped in-house laboratory that is run by a full-time technician toLaboratory provide reliable and prompt results. A full range of haematology, clinical chemistry, microbiology, cytology and parasitology services are available. The vast majority of routine bloods are processed same day and results are available with veterinary interpretation. More complex samples including histology are sent to external labs for processing. The lab is also responsible for on-site processing of PRP, I-RAP and bone marrow concentrate.

The laboratory is one of only a limited number in the country to be approved by the Horserace Betting Levy Board (HBLB) for the isolation of veneral pathogens associated with Contagious Equine Metritis (CEM). The lab works closely with the stud team and is responsible for semen freezing and storage and processing chilled semen for dispatch throughout the UK and Europe.

Services available include:

  • Cytology, culture and sensitivity on bacterial samples
  • Performance horse profile
  • Tracheal wash analysis
  • Urinalysis
  • Contagious Equine Metritis (CEM) culture
  • Endometrial swab culture
  • Semen evaluation
  • Faecal worm egg counts as part of Oakham's Strategic Worming Package

Overland Endoscopy

Overland endoscopy is used for the diagnosis of upper respiratory tract disorders in exercising horses. ThisEndoscopy complex equipment works by allowing us to see inside a horse's throat during ridden exercise. The horse is ridden with a small endoscope threaded up the nose, and real time images of the throat function are transmitted to a computer via blue tooth technology. Horses can be exercised in our arena or taken to gallops elsewhere, where a faster competitive exercise test can be performed. This equipment has already greatly increased our ability to diagnose the cause of respiratory noises and poor performance in equine athletes.

  • The gold standard for diagnosing equine upper airway disease causing poor performance.
  • Allows accurate diagnosis of conditions such as dorsal displacement of soft palate, aryepiglottic fold collapse along with many other problems, previously elusive with static endoscopic exam.
  • Quickly and easily fitted to any horse at clients’ premises or gallops.
  • Allows horse to exercise under normal conditions enabling analysis of high quality images.

 

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