Scanner time!

16.02.2012

Only saw one appointment today once I got back from the GP. Disappointing!

Big blue roan chunky boy with bilateral swelling behind the ears. Spongy and seems to communicate. Scanned with ultrasound and the texture looked spongy/soft tissue with no large pockets of fluid. This was the second scan, revisiting because they have flared up again and seem to cause ridden discomfort (head shaking/dropping). Going to go away and increase work to see what occurs and work from there. Diagnosis subnuchal synovial bursitis.

17.02.2012

1. Vaccinations for a grey event pony. Late for appointment due to ridiculous road closure and non-existent diversion. In, out, shake it all about.

2. Bandage change for a lovely bay mare with an injury to her left metatarsus. Wound looks good and has a lovely pink granulation bed. No sign of infection and the wound beginning to contract nicely. Re-bandaged under pressure with an Allevyn dressing and Intrasite gel. Re-bandage on Monday. Also dropped off some Regumate for extremely hormonal little companion pony. She was kyoot.

3. 'Swollen bottom' on an old grey show pony with a very lovely elderly owner. Wasn't sure what to expect from a presentation of 'swollen bottom'; it actually seemed to have oedema around the tail base and anus which was a little pink and warm. It didn't seem to be itchy and wasn't very sore. No obvious puncture wounds. Dispensed steroid cream and bute. Advise to keep a close eye on the old fella.

4. Xrays on a very, very sore 20y/o grey showjumping pony. Was sore in front and now sore all around; constantly shifting his weight. Took lateral xrays on all four feet, but no apparent signs of laminitis upon development. [Must remember to look up basic xray settings...58kV and ?mAs] Advised to soak all hay fed for at least 24hrs and minimise feed to just enough to disguise bute (BID).

5. Back in the clinic xray and scan on the back of a big dark bay welsh x tb following an acutely painful back and poor muscling of the longissimus dorsi muscles. Medicated the facet joints under ultrasound guidance with depomedrone and used needle therapy with saline. Sedated with dom & torb + a little ACP.

6. Last, but not least, an ultrasound scan the left metacarpophalangeal joint of an ex-showjumper which was swollen and painful. Sedated with dom & torb. At the level of the proximal sesamoids (landmark for annular ligament) the annular ligament was absent (possible previous surgery) and there were pockets of fluid and a mesotenon stalk-like attachment between the sheath and the tendon. There were also islands of calcification in the DDFT & SDFT which were showing up with comet trails on the scanner. These can be better visualised with an off incidence (slight tilt) to the scanner. The tendon goes from black to white on the screen and the little patches stand out more clearly - allows you to see more clearly where they are. Following a sterile scrub we drained the fluid and injected hyaluronic acid (anti-inflammatory properties) into the space. We wrapped all this up in a pressure bandage and advised box rest for at least a week to let him recover.

Cleaned up and headed home for the day. Back here in mid-May and I can't wait.