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Dr. Nora Grenager |
Steinbeck Equine is the only
private practice equine hospital to offer a residency
program sanctioned by the American College of Veterinary
Internal Medicine.
Dr. Nora Grenager is well
on her way to becoming board certified through this
program under the direction of Dr. Eric Davis.
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SCEC now provides Game Ready
to treat injured horses in the hospital and for preventative
therapy on site at horse shows. Game Ready Equine
is an Accelerated Recovery System for horses utilizing
the same physical therapy used by professional human
athletes. It includes ergonomic, flexible wraps that
are secured around the areas to be treated and a
microprocessor-regulated Control Unit that is filled
with ice and water.
To reduce swelling, ice is
only half of the solution. Active Compression Units
force tissue debris out of the affected area and
allow fresh blood flow into that part of the body—unlike
static compression wraps. Dry cold therapy offers
deeper, more consistent cooling without the danger
of cracked heels or other damage caused by excessive
moisture from wet cold therapies like ice boots.
This dry cold and active compression therapy accelerates
recovery of strained tendons, muscle tears, soft
tissue swelling and other injuries that plague performance.
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Dr.
Matern is now certified in veterinary acupuncture
through Colorado State University. Acupuncture
is the insertion of small needles into specific
points on the body to cause a desired healing effect.
This technique has been used in veterinary practice
for at least 3000 years to treat many ailments.
Acupuncture is also used as preventative treatment
against various acute and chronic conditions in
animals. The American Veterinary Medical Association
considers veterinary acupuncture a valid modality
within the practice of veterinary medicine and
surgery. Used either by itself or in conjunction
with Western medicine, veterinary acupuncture can
assist the body to heal itself by affecting certain
physiological changes.
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IRAP therapy is not a music
group, it is a somewhat new treatment for arthritis
in horses and in humans. A chemical that is largely
responsible for the pain associated with arthritis
is called Interleukin 1. IRAP decreases joint pain
by interfering with the activity of Interleukin 1
and similar compounds.
For the procedure, you obtain
a large syringe of blood. The syringe you pull the
blood into has hundreds of glass balls that have
been exposed to a certain gas that favors the “IRAP” and
helps amplify it. Once the blood is obtained, it
is incubated overnight and then spun in a centrifuge
to separate the serum from the other components.
This serum is rich in IRAP and once passed through
a filter, is injected directly into the desired joint.
Extra serum is frozen for subsequent treatments.
Typically, a series
of 3 injections are performed 1 week apart to treat
1 affected joint. Coffin joints and stifles that
don’t respond well to steroid injections
seem to be the most popular condition to treat.
Reactions are uncommon largely due to the fact
that it is the patient’s own serum.
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Tildren® is a drug that
has been available in Europe for many years to treat
navicular disease and has recently become available
in the United States to veterinarians who go through
special licensure. It is similar to drugs used to
treat osteoporosis in people. The activity of the
cells that cause the destructive changes we see on
X-rays with navicular disease is suppressed. Apparently
the activity of these cells is very painful and by
reducing their activity, many horses become much
more comfortable.
There are many different treatment
protocols being utilized with Tildren but most involve
placement of an iv catheter and administration of
a large amount of the drug as an iv drip for about
an hour. Generally in 2-4 weeks the benefits are
beginning to be realized and the effect lasts for
approximately six months. Horses may remain sound
longer by giving monthly boosters.
In addition to navicular disease,
many veterinarians use Tildren to treat horses with
hock pain. Many lameness diagnosticians feel that
Tildren has been the first major breakthrough in
the treatment of navicular disease in horses.
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Stem cells have been injected
into injured ligaments for many years now and are
becoming increasingly popular as a treatment for
joint disease as well. The idea is that by providing
a large population of cells at the site of injury
that are not yet committed to becoming any one tissue,
you encourage them to become what is needed for repair.
There are different ways to
obtain stem cells for use in horses. One is to take
bone marrow from the horse and inject it directly
into the damaged tissue straight or after some modification.
Another is a commercially available product called “A-cell” in
which the source of stem cells is fetal pig bladder.
A-cell comes in an injectable form used for tendon
injuries and as a sheet used for treatment of wounds
(A-cell is currently off the market but reports say
it will soon be back). We have been using a 3rd source
for the past several years with very promising success,
a company called Vet-Stem. The stem cells used are
not of embryonic origin but come from the patient’s
own adipose tissue. By using the patients own fat,
rejection becomes almost a non-issue.
Apparently fat is a storage
reservoir for stem cells which is handy because it
is readily accessible. The fat is typically harvested
through a surgical incision made above and to the
side of the base of the tail. This fat is stored
in a special container and sent overnight to a lab
in southern California where the stem cells are separated
out, suspended in saline, and sent back to the veterinarian
again by overnight mail. Ultrasound guidance is then
used to inject the stem cells directly into a torn
ligament or tendon. Alternatively, the stem cells
may be directly injected into a badly damaged joint.
Initial research with fat
derived stem cells in horses has been encouraging.
Clinically, the ultrasound scans of tendon or ligament
injuries is amazingly improved 60 days after injection
and we feel like more horses are going back to their
previous level of work with less recurrences.
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The 2006 year is already underway,
with RAVS teams working in Northern Guatemala and
on Easter Island. Our Native nations and Appalachian
season of providing free Veterinary care to remote
Western reservation communities and mountain hollows.
It seems like 2005, the year of the disaster, was
eons ago instead of just a few months. It is easy
to quote the extraordinary statistics and list the
achievements: 1,160 RAVS volunteers treated 42,018
animals in 2005. The free services rendered are conservatively
valued at $1,475,583.00. Teams including 873 veterinary
students from 25 different schools in the USA, Europe
and Latin America worked in communities from North
Dakota to Easter Island, and from Sri Lanka to Maine.
This does not even include RAVS Katrina and Wilma
Hurricane relief efforts in which RAVS normally deployed
131 Veterinarians, 258 Veterinary Technicians, 28
students, and 40 other personnel. Hundreds of others,
who wanted to work in Mississippi, Louisiana, or
Mexico, were referred by RAVS to other organizations
not included in these figures. RAVS personnel operated
shelters, rescued animals, treated injuries, reunited
owners and pets, and were recognized by everyone
from government officials to thankful guardians for
their effectiveness and dedication. Then there are
all the people, like the dog owners in Sneedville,
Tennessee, or the Mayan farmers in Uaxactun, Guatemala,
or the children at Fort Apache, Arizona who listened,
and heard the message of humane and responsible animal
care. All the while our volunteers learned from our
clients in the rural communities about their lives
and the lives of their animals, and how they can
help in the future.
For more information on the
most up to date news, RAVS is always available at www.ruralareavet.org.
The website also includes information on volunteering
and the 2006 RAVS schedule.
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The traveling veterinary clinic
opens at 8 a.m. on the Hoopa Valley Indian Reservation
northeast of Eureka. By then customers have been
in line since 6:30 on the cold banks of the Trinity
River, and are eager to get inside with their dogs
and cats.
The pets are not as eager.
Many have never been indoors, and a fire station
that has been converted to a surgical ward is not
a gentle introduction to the sheltered life.
"It only takes one dog
to start the riot," says Jennifer Scarlett of
San Francisco, who is familiar with an 8 a.m. cacophony
in her position as field veterinarian for Remote
Area Veterinary Services (RAVS) a program of the
Humane Society of the United States and the Fund
for Animals.
For six years, RAVS has been
taking veterinary students onto reservations across
the country to put them through a MASH-style trial.
For the annual Hoopa outing in March, 35 students,
including 20 from UC Davis, met the 27-foot horse
trailer that hauled supplies up from RAVS headquarters
in Salinas. It takes a day to set up the station
with exam and anesthesia stations, six surgical tables,
each staffed by a licensed vet plus one or two students,
all of whom could probably think of easier ways to
spend spring break.
The free clinic runs six days
of 12 to 14 hours each. The vets finish up at 9 or
10 p.m., walk down the street to camp at the teen
center, then commute back to the clinic in the morning.
They will treat any animal, from on the reservation
and off, and will go into the field to treat horses
and donkeys. In March, they treated 393 patients,
the majority for spaying and neutering. The estimated
value was $69,000.
"The RAVS animal clinic
changes our world," says Robin Roberts, a member
of the Hoopa Valley Tribe, who has lived on the reservation
since 2001. "When I first moved here, there
were roving packs of dogs and feral cats and lots
of runover animals. Now people's consciousness level
has been raised. They've actually learned correct
pet care."
More>>>
Also visit: www.sfgate.com/slideshows
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Approximately
200 people attended our 2006 Horseman’s Day.
Topics included lectures on Strangles, West Nile
Virus, and Epm by Dr. William Saville, Hoof Nutrition
by Dr. Scott Gravlee, Stem Cell Use in Equine Injuries
by Dr. Bobby Cowles. Dr. Matthew Durham did a presentation
on Silicosis in Horses. Paula Wittler spoke about
the Rotating Wormer Program.
The late Roy Forzani, renowned
horse trainer, was commemorated with a touching speech
by Dr. Tim Eastman and a beautiful placard made by
Dr. Gary Deter.
We hope to educate our clients
so they can help us catch problems as early as possible
through careful observation of medical symptoms.
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Ten animals tested
positive for rabies in Monterey County within the
year, 6 skunks and 4 bats. These are the more common
species we tend to see positive for the disease
in this County.
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