Kissing Spine Case Study by Sophie Gent – part 3 of the Thermology series

by guest blogger Sophie Gent

 

This 8yr old Eventer was referred for a scan by his treating vet. The horse had been observed as being lame behind and the treating vet suggested that the left hock was jarred.  Both TMTS were medicated.  Over the subsequent months his owner noticed some swelling in both forelimbs, but this dissipated over 24hrs, in training the horse was reluctant to push from behind, was showing signs of discomfort after fast work and generally lacking his normal elastic movement.

 

Thermographic Findings From Full Body Scan:

Focal inflammation of the caudal thoracic spinal region is observed on dorsal views of the back.

There is mild multifocal intertarsal inflammation on dorsal views of the hocks, plantar views are normal.

 

Discussion:

Thermal findings in the dorsal hocks correlate with a history of tarsal joint pathology.

Further clinical correlation of the thermal findings in the caudal thoracic and lumbar back is advised. Thermal findings may simply indicate muscular tightness, but spinal ligamentous sprain and dorsal overriding of the spinous processes can produce similar thermal patterns and these should be ruled out.

LH pre exercise hyperthermic asymmetry may be secondary to increased weight bearing on this limb if there is RH lameness.

 

Further Veterinary Investigation:

A lameness work up by the treating vet found the horse to be sound.

X-rays of the thoracolumbar spine and left and right hocks identified mild osteoarthritis in the left tarso-metatarsal and distal intertarsal joints

X-rays of the spine identified 3 close interspinous processes  T14-T17 correlating well with thermography. These were medicated with Methylprednisolone.

 

 

How To Book An Appointment

 

If you are interested in having a physiological assessment of your horse, you can find contact details for your local SyncThermology technician by visiting their website www.syncthermology.com where they will be happy to provide you with a free telephone consultation to determine if thermography could assist you and explain the screening process.  They also work closely with many veterinary practices around the country and their service can be accessed on a referral basis through your treating vet.

To learn more about thermology, SyncThermology run free CPD’s and workshops around the UK.  Go to www.syncthermology.com for more information.

Thermology uncovered…continued

How Thermology Is Influencing The Veterinary Industry And The Horse Owner’s Approach To Lameness Investigation – part 2

by guest blogger Sophie Gent, continuing on from our previous blog…

 Benefits                                                                                                                                                           

There are many benefits to using Thermology to assist diagnosis, treatment and rehabilitation. As the technology identifies inflammatory and neurological processes one of its main clinical benefits is when it is used to non-invasively locate the potential source of lameness. Horses can be imaged in a short space of time without the need for sedation. Numerous injuries, diseases and conditions can be identified and monitored. Services are now available through many veterinary practices and if referred, costs can be covered by insurance. The technology is also cost effective, a full body assessment with dynamic testing and veterinary interpretation is available for as little as £395.

Physiological imaging is a powerful tool when used correctly in specialist areas of medicine or as an adjunctive imaging modality. If owners source the service from their local vet then it is likely that the technology will have a positive influence on the investigation and ultimately diagnosis.

Joint Related Conditions – How Can Thermography Assist?

Thermology detects the inflammatory processes that are produced when physiological changes start to occur in a joint, the technology can assist veterinary surgeons in the identification of both early stage and chronic joint disease. Degenerative changes are often the cause of lameness but structural imaging may not contribute to the investigation in the early stages, it can be challenging for vets to encourage further or more expensive diagnostics particularly when x-ray and ultrasound have been performed to no avail.  As Thermology is non-invasive, sedation free and offers affordable function testing it can support the use of further diagnostics and earlier treatment. Using the technology to review joints which are difficult to image with x-ray or ultrasound has proven beneficial to many vets and has helped warrant targeted investigations.  Assisting in isolating stifle pathology has been a reason many practices have utilised our service.

To learn more about thermology, SyncThermology run free CPD’s and workshops around the UK.  Go to www.syncthermology.com for more information.

How Thermology Is Influencing The Veterinary Industry And The Horse Owner’s Approach To Lameness Investigation – part 1

Thermology Uncovered – a three part series by Sophie Gent

 by guest blogger Sophie Gent MD SyncThermology

Thermography has become a popular imaging option that is easily accessible to horse owners without the need for a veterinary referral, however it has fast become a problem for many veterinary practices as the technology is unregulated and therefore difficult to control. Often thermal screening services are carried out by technicians who use a wide range of imaging technology, making it increasingly difficult for horse owners to select which service they should use.  Equipment can now vary from thermal cameras that fit onto the back of a smart phone to clinical grade imaging equipment which is used in human medicine.  Image interpretation by veterinary surgeons generally does not come as standard and horses are often imaged in less than perfect screening environments, however clients are still proactively sourcing “thermographers” to investigate lameness before calling their vet.  As a general rule, many horse owners do not understand what the technology is detecting and more importantly its limitations before outsourcing services. Raising awareness, expanding research and educating the industry is a challenge many veterinary professionals are now working to improve.

The biggest misconception for horse owners is that thermography is a standalone test which will provide a diagnosis whilst avoiding expensive vet bills… but in reality, thermography can only provide an indication rather than a diagnosis and will normally warrant further targeted investigation. To use this technology correctly there first needs to be an understanding of its benefits and limitations before deciding if it should be used as part of a clinical evaluation or treatment plan.

Thermology measures the autonomic nervous system and detects physiological (functional) abnormalities and can graphically record inflammatory and neurological processes, all helpful information when data is collected and interpreted accurately. “Hot spots” are irrelevant to a point, the interpretation of this technology it is all about pattern (pathology) recognition, temperature differential and comparative studies, coupled with extensive veterinary experience.

Many aspects must come together to achieve accurate and reliable results, just like all other diagnostic tests, results should be interpreted and reported on by trained veterinary surgeons who can reliably factor previous and current clinical signs into their analysis of images. Thermography is a test of physiology, so without an in depth knowledge of the autonomic system the correct analysis can be difficult; owners wouldn’t expect their horses’ x-ray or MRI scan to be reported on by anyone other than a vet and thermography should be no different.

To achieve the most accurate results the technology used for testing should be of the highest clinical specificity designed for physiological imaging and data collection should be done by experienced technicians under veterinary referral. If clients do not want to investigate results further or work with their vet then this will become the biggest limitation. Thermography cannot see structure (anatomy) so without the use of additional diagnostics or veterinary examination, the ability to correlate findings and confirm a diagnosis is limited.

In most cases dynamic testing (a work-up or lunging) should be carried out.  One of the main benefits of imaging physiology is that things change and dysfunction can be well highlighted when the body is put under physiological stress. Imaging horses without exercise can limit the reliability of results but is unfortunately commonly seen in the industry. Exercising patients (dependent on veterinary advice) induces reactions; these reactions very often help to confirm or rule out primary pathology and provide a better understanding of whether exercise induced or exacerbated a condition.  Images should be collected pre and post exercise and in controlled environments.

To learn more about thermology, SyncThermology run free CPD’s and workshops around the UK.  Go to www.syncthermology.com for more information.

 

Keep an eye out for the next blog which will explain the benefits of thermology…