On the case
An alpaca is not what you would normally expect to find at a
specialist equine referral centre. However, one of these South
American camelid’s is exactly what arrived one glorious sunny
Monday morning at the Animal Health Trust. Esther Skelly
MRCVS takes up the story.
H
e had been referred to us
for radiographs (x-rays) of
his neck as his vet suspected
he might have a neck
problem or trauma. When
he arrived we noticed clinical signs such
as a subtle head tremor that indicated
he may have cerebellar disease (area of
the brain) which may have caused him to
have walking difficulties. Unlike most of
our equine patients he didn’t require any
sedation, promptly lay down and stayed
absolutely still for his radiographs, before
being unceremoniously loaded back into
the transit van for his return home. Being
a referral centre we do regularly see the
more unusual cases, which is one of the
things I find most exciting about the AHT.
Learning Curve
Albert Einstein famously said “The only
source of knowledge is experience”, this
is certainly true in veterinary medicine.
Like driving a car, you only start to truly
learn to drive when you pass your test. I
may have passed my veterinary degrees
however, the longer I work here at the
Animal Health Trust, I realise there is so
much more to know about veterinary
medicine and science. There are still so
many questions that need answers, so
many challenges never encountered
before and this is such a wonderful part
of my career. Often here at the Equine
Centre we see very difficult cases to
diagnose, which have been referred to
us by other vets for a more experienced
The Dyson Hop
In the months I have been here I have
seen a number of forelimb lameness
cases which we have colloquially
nicknamed “The Dyson Hop”. These
are horses which have a hopping type
of lameness only seen when ridden
and they look like they continuously
want to break into canter from trot. We
begin by using nerve blocks (injection
of local anaesthetic solution around a
nerve) to identify the source of pain,
and gradually work up the lame limb to
include joint blocks of the elbow and
shoulder. None of these sites ‘block out’,
and even after a raft of radiographs
(x-rays) and ultrasound images these
cases remain undiagnosed and, so far,
incurable . There is no way to definitely
say that these cases are what we call
the “Dyson Hop” until you have done
a thorough investigation, because the
source of lameness may be identifiable
either after nerve blocks or x-ray. Dr
Dyson does have some theories on the
cause of this type of lameness, however
until more advanced diagnostic tools
EQ Life September 2013 www.eqlife.co.uk
become available, we cannot definitively
say. This month we saw another one of
these cases and they really frustrate me
as at the moment there is no real hope
for these horses to return to full athletic
function as they are in a lot of pain
from an unknown source. At the Animal
Health Trust we are continually compiling
data and information on these horses
and one day hope to have an answer to
this particular ‘question’.
A fascinating case which presented to
us recently was an event horse which
displayed a similar type of hopping
opinion. These opinions come from Dr
Dyson and Dr Murray, our two senior
orthopaedic specialists, who would be
very open and say that even with all their
experience they are still learning too.
lameness to the “Dyson Hop”, however
we did discover an amazing cause of this
lameness. After taking some radiographs of
the horse’s shoulder we discovered what
looked like a piece of bone sitting in the
shoulder muscles. This turned out to be
Heterotopic ossification (where bone tissue
forms outside of the skeleton) and has not
previously been described in the horse.
One of the real advantages of working here
at the AHT is our vast range of resources
which are available to us not only in terms
of diagnostics but also literature. This
allows us to make better clinical decisions
and make every case a valuable learning
experience for the future.
As the months roll on I can reflect
back and see how much I have learnt in a
short period of time. I am grateful for the
learning environment I am in, where I am
encouraged to think more critically and
to make better judgements rather than
rushing to find a quick fix. I hope in next
month’s article to tell you a little about the
vast amount of research that is performed
at the AHT and how this has helped
advance veterinary medicine as we know it
today. EQ
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