UW Veterinary Care’s board-certified specialists in the Morrie Waud Large Animal Hospital provide comprehensive care to equine patients, from routine checkup to complex diagnosis
On a sunny winter day, Cougar, a 24-year-old Quarter Horse, gallops around the paddock behind the Morrie Waud Large Animal Hospital at UW Veterinary Care (UWVC), his sorrel coat glistening in the afternoon light as he strides about the familiar pasture.
“Cougar has three speeds: fast, faster, and fastest,” says his owner, Gail Bilmar.
She first brought Cougar to the teaching hospital in 2012 when he needed specialty care for respiratory issues and was treated by Sheila McGuirk, professor of large animal internal medicine and food animal production medicine. Since then, access to comprehensive, high-level equine care has kept Bilmar regularly returning.
Every five weeks, she loads Cougar and Beethoven, a 15-year-old Paint, into their trailer and makes the three-hour journey from Libertyville, Illinois, to UWVC to see Sabrina Brounts, clinical associate professor of large animal surgery and sports medicine. “She goes over them from head to toe,” Bilmar says. “I’d rather catch things early and get ahead of any problems.”
Although she relies on her local veterinarians for urgent care, Bilmar entrusts Brounts and the full UWVC team with her horses’ routine and preventive care, from vaccinations and nutritional support to dentistry and farrier services tailored to their individual needs.
“Dean (Johanningmeier), the farrier, creates special shoes for Cougar and Beethoven,” she says. “My boys are moving better than ever – good shoes make all the difference.” A difference that has Cougar running with the renewed energy of a colt again. “Cougar thinks he’s two, not 24. Why? Because of the university and the good care they give him,” Bilmar quips.
ROUTINE TO COMPLEX CARE
In 2016-17, the Morrie Waud Large Animal Hospital at UW Veterinary Care saw nearly 1,100 equine patient visits spanning its farrier, internal medicine, surgery, and sports medicine services.
While the clinic serves as a primary care provider for patients like Cougar and Beethoven, for others it serves as a last chance and a place where clients turn when their animals need advanced care and diagnostic technologies that aren’t available anywhere else in the region. Every day, UWVC’s specialists, residents and certified veterinary technicians tackle complex cases in equine patients large and small – from helping a Lusitano with severe laminitis (inflammation of the soft tissue structures that attach the pedal bone of the foot to the hoof wall) avoid euthanasia by providing months of around-the-clock care to repairing the limb deformity of a miniature donkey.
Brounts, the state’s only board-certified equine sports medicine and rehabilitation specialist, has helped a range of equine athletes return to their prime – from Wisconsin farm horses to a national dressage champion to international race horses. For her, collaboration is key to meeting the needs of each individual animal.
“If you look at human medicine, all the high-performance athletes have a full team behind them developing a plan that’s best for that individual to be successful,” Brounts says. “Many horses are athletes too – the same as an NFL player or NBA player – and it takes a team to keep that horse healthy.”“We try to identify the best diagnostics and research to tailor a treatment to the horse, one that will benefit it the most to get it back home, back to racing or jumping, back to dressage or eventing.”
UWVC is the first and only veterinary hospital in the Midwest to offer dynamic endoscopy, which allows veterinarians to evaluate airway movement and function while a horse is exercising. The tool, which uses a tiny camera to view inside the horse’s throat, attaches to the horse’s bridle and saddle pad and transmits readings to a remote tablet. It can be used without interference while a horse is moving or being ridden, which is useful for diagnosing laryngeal hemiplegia, a paralysis of the cartilage in the voice box (larynx) and vocal cords (vocal folds), and other ailments that interfere with a horse’s breathing.
“These conditions cause exercise intolerance or abnormal airway noises that can be limiting to an athletic horse’s career,” says Samantha Morello, clinical assistant professor of large animal surgery. “But the dynamic endoscope gives us a much more accurate diagnosis with which we can better plan treatment.”
The Morrie Waud Large Animal Hospital is also the only facility in the Midwest to offer flexible needle arthroscopy in the standing horse. This is especially useful for evaluating the stifle – basically the equivalent of the human knee and a common location of injuries in athletic horses – with improved accuracy and shortened procedure recovery time.
UWVC clinicians are utilizing a new tool to streamline lameness exams, as well. Gathering measurements from three sensors affixed to the horse – one on top of the head, one on the ankle and one on the pelvis or rear – the Lameness Locator program makes pinpointing the affected limb much easier and calculates an objective numeric score.
“You still have to watch the animal and figure out the cause of the lameness, but it gives you a baseline number for comparison,” says Amelia Munsterman, clinical assistant professor of large animal surgery. “It’s a great way to monitor progress. Having a numeric value in the chart to compare to is a key measure – especially in cases where the patient sees a different doctor on a follow-up visit.”
TREATING THE BIG PICTURE
Munsterman, who joined the School of Veterinary Medicine faculty in 2016, is board certified in both surgery and large animal emergency and critical care.
While her primary research focuses on monitoring for complications after surgery and developing methods for measuring abdominal pressure, she is also interested in traditional Chinese veterinary medicine. Munsterman is certified in acupuncture, a therapy she’s found to be an effective addition to conventional diagnostic and treatment plans for equine patients.
“Horses are great because you can actually scan them, by running your finger or a pen cap over their acupuncture points. They actually ‘tell’ you what’s wrong with them,” she says. “With other species like dogs, you can sometimes see it, but horses are the best in terms of their response.”
“If a point is sensitive, they will look at you or move away from you,” she adds. “So then if I set that collection of points, I can bring them together to look at the big picture to say ‘OK, he’s telling me that his hock hurts today.’”
When they’re not treating patients, UWVC’s specialists dedicate a significant portion of their time to research in areas including tendon healing, joint therapies, neonatology, and post-operative care. Their findings inform new, advanced treatments delivered in the clinic.
For example, Brounts can now offer patients a novel method for monitoring tendon injuries that is only available at UW–Madison. Her dissertation research uses Acoustoelastography (AEG) – a technique developed in the Department of Biomedical Engineering to monitor human Achilles tendon injuries – to evaluate similar injuries in horses. Using ultrasound technology, she creates dynamic videos that show the stiffness of tendons and help measure with an objective rating how well they have healed.
“Performance horses commonly suffer injuries to their superficial digital flexor tendons, and they often re-injure them after a premature return to competition,” says Brounts. “AEG provides a simple, objective, non-invasive method for monitoring healing progress and helps take the guesswork out of deciding when a horse can safely return to competition.”
To date, she has followed the tendon injuries of more than 50 horses ranging from 5 to 30 years of age – each for a span of six month to a year – and hopes to further evaluate the average healing rates based on age groups.
GROWING TO MEET FUTURE NEEDS
Given all of this specialized technology, the space available for clinical care, along with education and research space, is reaching a critical limit. The UW School of Veterinary Medicine is in the middle of a $115 million building expansion campaign, Animals Need Heroes Too, which requires private and public support.
A top priority for UW–Madison’s 2019-21 building window, the project will enhance the Morrie Waud Large Animal Hospital, double the size of the small animal hospital, provide additional learning spaces, and triple the school’s research space.
Planned improvements to the large animal hospital include the addition of a covered arena that provides year-round access to lameness and neurological exams, regardless of the weather, as well as a larger and even safer isolation facility, which will be the only one of its kind in the state.
During the campaign, the hospital continues to make improvements. The large animal hospital’s reception space has recently undergone a transformation to boost staff and client comfort and an equine bay inside the clinic is being reconfigured to create a dedicated space where clinicians and students can review patient cases.
“We’ve creatively repurposed storage spaces and retrofitted rooms to squeeze the most productivity out of our current space,” says Ruthanne Chun DVM’91, associate dean for clinical affairs and UWVC director. “Despite these challenges, we’ve delivered high-quality care because of our team’s focus on serving our patients.”“It’s clear that our patients and clients will benefit greatly from the completion of this expansion, but so will our students, who are the future of the veterinary medical profession, and so will animal lovers, veterinarians, and people across Wisconsin.”
Learn more about the school’s future plans at AnimalsNeedHeroesToo.com.