No job too small
Rio, a miniature Shetland pony, was rushed to Edinburgh’s Equine Hospital for life-saving treatment as a newborn foal. His story is part of a vast range of work taking place at the Vet School, from teaching and research to veterinary services offered both locally and nationally, writes Tara Womersley.
It was a proud moment for Donna Riley when Rio, her two-year-old miniature Shetland pony, won a rosette at Edinburgh’s Royal Highland Show in June 2015. Fifth out of 13 in his class of coloured ponies placed Rio outside the best of the best that day, but the award represents a milestone for the pony who, after undergoing emergency surgery at the University of Edinburgh’s Equine Hospital, had to fight that little bit harder to reach “show quality” status than his fellow competitors.
Born near Carlisle, in the north-west of England, Rio developed a serious hind-leg infection almost immediately after his birth and, without treatment, would have been permanently lame and left with severe chronic arthritis. After an emergency referral from the local vet, Donna rushed the four-day-old foal and his mother Floss to the University’s Easter Bush campus, just outside Edinburgh, where experts at the Royal (Dick) School of Veterinary Studies (R(D)SVS) quickly assessed and prepped Rio for surgery.
The specialists confirmed that Rio’s infection was probably due to a lack of colostrum, the antibody-rich milk produced by mares after giving birth. Colostrum helps boost the immune system of new-born foals, but because Floss had been suffering from colic, Rio was unable to get enough colostrum to help fight off infections.
“It was all rather emotional,” Donna recalls of the two-hour journey north across the border. “My husband, who is a marine engineer, was away with work so my friend Emma came with me to take Rio and Floss up to Edinburgh.”
The mother-of-two endured a nervous but short wait while the vets went to work. First, they took ultrasound images and X-rays in the Equine Hospital’s diagnostic imaging suite, before analysing fluid samples from Rio’s joints in the onsite laboratory and preparing the equine theatre for surgery.
“We were able to use anaesthetic equipment that is generally used when operating on dogs.”
Dr Richard Reardon
The vets performed two operations on Rio – the first on the evening of his arrival to flush out his joints, and the second some days later to remove infected tissue from his umbilical area. By further examining culture samples, they were able to determine which specific infection Rio was suffering from, and which antibiotic would best fight it.
Edinburgh’s Equine Hospital is one of the few facilities in the UK that is equipped with the expertise and technology to deal with such a complicated and time-sensitive case as Rio’s. The close clustering of its imaging suite, laboratories and equine operating theatres enables staff to retrieve results quickly (lab results can be turned around in 15 minutes), and to collaborate on dealing with the challenge of unexpected factors, such as, in Rio’s case, his small stature.
“When we arrived, I don’t think they realised quite how small Rio was, as I was asked to bring the trailer around as close as possible to the diagnostic imaging suite to save him from having to walk very far,” Donna remembers. “He was only about 15 kilos – so about the size of a small dog – and he ended up just being carried in for imaging in someone’s arms.”
Rio’s tiny lungs would not have coped with the anaesthetics equipment generally used for ponies and horses, and Dick Vet staff had to bring over an anaesthetic machine from the School’s adjacent Small Animal Hospital.
Dr Richard Reardon, the equine surgeon who handled Rio’s care, says the breadth of experience within the R(D)SVS, and the quick thinking of School staff, ensured the Edinburgh team were able to provide their unique patient with the very best treatment.
“Although we do treat a number of Shetlands, as a miniature Shetland and at just four days old Rio is certainly the smallest foal I have treated,” he says. “Fortunately, our specialist anaesthetists have experience covering both the Equine Hospital and the Small Animal Hospital, so were able to use anaesthetic equipment that is generally used when operating on dogs”.
“There were also no blankets that would fit Rio’s small size, so we got a dog blanket and a dog rug to keep him warm. He certainly became a bit of a star with the students.”
Rio and Floss were monitored at the Dick Vet for nearly a month while the foal recovered and started to suckle again from his mother.
Dr Reardon says Floss also captured the hearts of Edinburgh staff. “Some mares can be incredibly protective of their foals, but Floss was exceptionally laid back and a joy to deal with,” he says.
Rio is one of around 1,500 referrals that Edinburgh’s Equine Hospital receives each year for specialist treatment. This is in addition to the 4,000 appointments made annually by the Dick Vet’s first opinion Equine Practice, which involves vets travelling to provide non-hospital treatment to horses in the area. The Vet School also has a Production Animal Service, which includes a farm animal general practice, a Hospital for Small Animals, which accepts referrals from first opinion vets, a small animal general practice and a Rabbit, Exotics and Wildlife Service.
Dr John Keen, Director of the School’s Equine Hospital and Practice, says: “As one of the very few large specialist equine referral hospitals, it is not unusual that Rio was referred to us from the north of England. We take in cases from all over Scotland, including the islands, and have also had cases referred to us from the south of England.”
Specialist treatment offered by the Equine Hospital includes orthopaedics, dentistry, and treatment for heart and lung conditions and, as with Rio, lameness. The Equine Hospital is also one of the few places in the world that has carried out operations to put pacemakers into horses.
As well as high-quality ultrasound that was used for Rio, the Equine Hospital offers every diagnostic imaging technique, including standing MRI and CT scanners, which reduce the risk of having to put horses under general anaesthetic for images to
“I was incredibly impressed with all that the Equine Hospital was able to do for Rio and the expertise of its staff,” Mrs Riley says. “He certainly had a tough start in life but you wouldn’t know it. We still call him our wonky donkey, although he’s now doing just fine.”
An ambitious £3.7 million redevelopment of the Equine Hospital starts in January 2016, for which a £1 million fundraising target has been set. The planned new Equine Diagnostic, Surgical and Critical Care Unit comes in light of a growth of emergency cases and an increased demand for advanced diagnostic and intensive management.
The unit will replace the Equine Hospital’s current surgery, radiography and intensive care block, which was last refurbished in 1993.
Teaching will benefit from an overhead viewing area in the theatre suite where students can watch and discuss operations as they are happening. The surgical area will consist of two state-of-the-art theatres with induction and recovery boxes, plus a new standing surgery suite. The suite, which can be used for standing fracture repair and laparoscopy, will reduce the risk of complications associated with general anaesthesia and enable faster recovery times.
The diagnostic and triage area will be located next to the surgical and critical care areas, reducing the need to move horses around the site.
Six stables will be dedicated to equine critical care, including a specialised stall for neonatal foals, which will enable them to remain with the mare.