Equine Hospital Services

When your horse needs extra care, we are here to help.

The Equine Clinic of Saratoga specializes in the diagnosis and treatment of horses with diseases that may require surgery or hospital care.

Did you know that the only surgeries routinely performed in general equine practice are minor lacerations and castrations? This is because horses are relatively difficult to anesthetize, and have a greater incidence of postoperative complications than other species. Therefore, advanced surgical expertise (with the accompanying expertise of anesthesiologists) are needed.

In addition, ECS has significant expertise in a range of high tech diagnostics such as, ultrasonography (musculoskeletal/tendon examination, chest/pneumonia), arthroscopy (chip removal, joint evaluation, fracture repair), laparoscopy (removal of undescended testicles/cryptorchids, removal of ovaries, part of a chronic colic workup), endoscopy and gastroscopy, incl. minimally invasive endoscopy (for throat and sinus problems), and digital, high resolution radiography.

We provide treatment, diagnosis, and expertise in a wide array of surgical and lameness issues.

Common examples of why patients visit our service:

Lameness - principally orthopedic disease in performance and companion horses, including arthritis and foot problems

Fractures - including small “chip” fractures that may impede optimal joint function, and short-bone fractures, which tend to respond well to bone plating and arthrodesis.
Colic - a catch-all term for abdominal pain, which may require surgery for diagnosis and treatment
Respiratory disease - primarily involving throat and sinus problems of performance horses
Reproductive problems - such as dystocia (difficult birth), and perineal lacerations acquired during foaling
Lacerations (cuts) - which may involve major orthopedic structures such as joints and tendon sheaths
Neoplasia (cancer) - which in the horse most commonly involves the skin (sarcoids, melanomas, and squamous cell carcinoma being by far the most common tumors) but may include internal organs (such as lymphosarcoma)

Orthopedic Surgery

Our orthopedic surgeons treat all forms of equine trauma, OCD, and lameness; with expertise in the field of arthroscopy, fracture repair and performance horse injury. We manage postoperative rehabilitation and work with referring veterinarians and licensed veterinary rehabilitation centers to optimize and expedite return to function.

Orthopedic surgical procedures include (but not limited to):

Fracture repair
Arthrodesis
Arthroscopy (any joint with chip fractures, OCD, articular fracture repair, sepsis or cartilage trauma)
Tenoscopy (any tendon sheath or bursa, soft tissue damage, sepsis, adhesion breakdown, annual ligament and check ligament desmotomy)
Stem cell cartilage resurfacing (cartilage damage, subchondral bone cyst)
Transcyst screw placement (buchondral bone cyst)

Foal-and Neonate Surgery

We have a particular focus on treating septic, infected joints in babies (“joint-ill”) using advanced antibiotic sustained release systems (controlled drug delivery systems) with -and without the use of Platelet-Rich Plasma Derived Biologics to prevent cartilage degeneration and joint inflammation, the two most common debilitating aspects of infected joints.

In addition, these treatments help increase antibiotic penetration to significantly reduce the number of bacteria organisms by clearing the biofilm shielding bacteria from antibiotics.

Sports Medicine and Rehabilitation

ECS Equine Sports Medicine and Rehabilitation service provides an interdisciplinary approach to diagnosing and treating the underperforming equine athlete. Whether you have a racehorse, hunter, show jumper, or other discipline, our team with expertise in musculoskeletal, respiratory, cardiovascular, neurologic, and hematological disorders can determine why your horse may be underperforming.

Upper Respiratory Evaluation

We have a high-speed treadmill and can tailor an exercise stress test to best challenge your horse and determine a cause of poor performance. Similarly, our over-ground endoscope system can be fitted to the horse during a breeze, work-out or while jumping to determine dynamic airway disorders under saddle.

Upper Respiratory Diagnostics:

High definition video endoscopy of the upper airway (laryngoscopy)
Over-ground dynamic endoscopy
Transcutaneous and transesophageal laryngeal ultrasound
Digital radiography

Accurate diagnosis can then be followed by open surgical or minimally invasive laser repair of many conditions.

Cardiac and Lower Respiratory Evaluation

High definition video endoscopy of the lower airway (bronchoscopy)
ECD/EKG assessment of the heart rhythm at rest, during treadmill stress test and continuous telemetry after work.
Ultrasound of lungs (transthoracic), heart (echocardiography)
In-house laboratory to assess hematologic values, muscle enzymes, heart muscle markers, blood gas assessment

Lameness Evaluation

We routinely face challenging lameness conditions with the goal of diagnosing, treating, and establishing a clear rehabilitation plan to optimize return to function and performance. The entire history is analyzed with any previous pertinent imaging before starting a detailed musculoskeletal examination. Depending on the discipline, dynamic examination is performed utilizing full flexion tests and gait evaluation on a variety of surfaces. For more subtle lameness conditions in sport horses, riding examination is performed in our ring on site. Cutting edge diagnostic imaging is available to help define the exact injury or condition. We use the most current treatment modalities including a variety of regenerative therapies to best treat the injury or area of soreness. Ultrasound or radiographic guidance is routinely used during treatment of a variety of conditions to deliver the most accurate treatment possible.

Diagnostic Imaging available:

Ultrasound (Transcutaneous and rectal for sacroiliac/pelvic soreness)
Digital Radiography

Regenerative Therapies available:

Bone marrow derived mesenchymal stem cells (incl. BMACs)
Platelet-Rich Plasma “PRP” (Prostride or Arthrex)
Interleukin-1 Receptor Antagonist Protein “IRAP” (Arthrex)
Concentrated Platelet Poor Plasma (cPPP) as a unique source for biologically relevant concentrations of IGF-1. Often added to APS to enhance the anti-inflammatory benefits treating osteoarthritis

Additional Therapies available:

Extracorporeal Shockwave therapy (PulseVet)

Neurologic Gait Assessment

Neurological conditions affecting the spinal cord and peripheral nerves can cause gait abnormalities and affect performance. As part of a complete poor performance evaluation, an assessment of your horse’s gait, muscle symmetry, cranial nerves, reflexes and responses, and proprioception can be completed. When specific abnormalities are evident, additional diagnostics are available to diagnose and best treat your horse.

Diagnostics available:

Neurologic Examination including gait, cranial nerves, reflexes and responses
Cerebrospinal fluid aspiration and testing. At ECS, we preferentially collect CSF via ultrasound guidance from the C1-2 space in a standing sedated horse
Neurologic Imaging - neck radiography including oblique views and myelography
Electromyography (EMG) assessment for myotonia, denervation/peripheral nerve injury
Infectious disease testing - EPM and Lyme disease can affect the nervous system - we routinely perform and interpret specific testing for these conditions
Biopsy - muscle and/or nerve to diagnose specific conditions

Gastroscopy

Gastric ulcer disease is extremely common in performance horses of many disciplines and can cause poor performance, colic, and other secondary conditions such as palatal disease. We routinely perform gastroscopy with high definition video endoscopy of the entire upper gastrointestinal tract. Depending on the specific lesions observed (location, severity grade), we will tailor a medication, diet, and exercise plan to optimize healing and prevent recurrence.

Soft Tissue Surgery

Our board-certified equine surgeons perform a wide variety of elective and emergency procedures. We examine each patient in detail to accurately determine if surgery is necessary and if so, the best procedure based on the horse’s condition. After surgery, a thorough rehabilitation plan is developed to optimize healing and return to function. Emergency surgical patients such as those suffering colic or requiring caesarian section recover in our Intensive Care Unit where they receive around-the-clock monitoring, therapy, and pain management.

Soft Tissue Surgical Procedures include (not limited to):

Respiratory tract surgery (arytenoidectomy, laryngeal reinnervation, nasal septum removal, alar fold resection, sinus flap or trephination)
Laparoscopy (cryptorchidectomy, ovariectomy, nephrosplenic space ablation, epiploic foramen ablation)
Simple and complex wound repair
Reconstructive surgery (wound grafting)
Mass removal, biopsy
Suspensory fasciotomy (+- neurectomy)
Gastrointestinal surgery
Urinary tract surgery (nephrectomy, standing cystolith removal, urethral extension)

Emergency Services

Our Emergency and Critical Care service is available 24 hours a day, 7 days a week. At our state-of-the-art hospital, we are equipped to handle urgent and critical cases.

Upon arrival, you will be greeted by a doctor or licensed veterinary technician who will quickly assess the patient’s vital signs and triage the case. We understand these are often stressful times for an owner and horse and commit to providing information as quickly and accurately as possible.

Our Emergency and Critical Care service has a dedicated ICU facility and can handle a variety of emergency problems, including those related to:

Colic - medical and surgical
Wounds and lacerations
Orthopedic emergencies such as fractures, cellulitis, tying up and septic joints
Respiratory emergencies such as pneumonia or airway obstruction
Ophthalmic emergencies such as ulcers and globe trauma
Cardiac emergencies such as dysrhythmia or congestive heart failure
Traumatic injuries such as head and neck trauma
Transfusion therapy
Shock and endotoxemia
Pain and pain management

Our patients are hospitalized in a well-equipped hospital setting, and their care is supported by our access to lab work quickly to best direct patient treatment.

Equine Dentistry at Hospital

Horses presenting for routine oral health checks and advanced dental conditions have complete oral examinations performed utilizing dental diagnostic tools and a rigid endoscope. Identified pathology is thoroughly discussed with the owner, and an appropriate treatment plan is devised. Power and hand instrumentation is used to reduce sharp enamel points and contour abnormal dental surfaces. Detailed dental radiographic imaging and computed tomography is available for horses with more advanced oral, dental, and sinus pathology.

When necessary, both intraoral and extraoral extraction techniques are available to remove diseased teeth. The majority of dental procedures are performed with horses under standing sedation with regional and local nerve blocks; only a very small number of procedures require general anesthesia.

Diagnostics and solutions for complex dental-oral-sinus related illnesses, oral masses, severe dental fractures and malformations, and oronasal fistulas are constructed and treatments performed as a team with the equine soft-tissue service, and jaw fractures are handled in coordination with the equine orthopedic service.

We also frequently partner and consult with other services in the hospital including anesthesiology, internal medicine, cardiology, dermatology, and ophthalmology, to provide the most comprehensive care for your horse.

Services offered:

Complete oral examination with rigid endoscope
Sinoscopy and rhinoscopy
Occlusal adjustment (“float”)
Regional nerve blocks
Intraoral extraction
Extraoral or surgical extraction via buccotomy
Incisor and canine tooth extraction for tooth resorption and hypercementosis
Sinusotomy for dental extraction and treatment of sinus disease secondary to dental pathology
Oronasal fistula repair
Conventional and surgical root canal treatment where appropriate
Crown reduction with vital pulp therapy
Crown restoration
Periodontal therapy and surgery
Management of traumatic occlusion
Interceptive orthodontics
Surgical biopsy and oral tumor staging
Oral tumor/cyst removal
Maxillofacial and mandibular repair post-trauma

Equine Podiatry at Hospital

Offering a unique service combining the experiences our expertise with a partnering expert farrier.

We work with farriers to help horses with foot problems including laminitis, poor angles, poor conformation, lameness, and performance issues.

Services include:

Consultations with farriers and veterinarians
Acute care (founder, tendon issues, foot lacerations, etc)
Specialty shoeing for chronic and ongoing lameness and performance problems

We work together with your farrier and provide advice and follow-up consults. This can be done at our hospital (next to the Skidmore riding stable) or stall site.

Call for more information and details about how this service may benefit your horse.