Magnetic Resonance Imaging in the Horse

Magnetic resonance imaging (MRI) uses a strong magnetic field and radio waves to produce detailed, various plane, cross-sectional images. It allows a simultaneous examination of both bone and soft-tissue structures and can identify injuries to tendons and ligaments as well as bones and joints. Generally, MRI is limited to the lower part of the limbs, meaning up to and including the carpus, or knee, and hock.

MRI was first performed on live horses in 1997 at Washington State University. As its availability has become more commonplace, MRI has increasingly become the gold standard for the diagnosis of musculoskeletal injuries of the distal limb. It has become especially helpful in the equine foot, a particularly common site of lameness where other imaging techniques are sometimes limited. 

MRI is indicated when a lameness problem has been localized to a specific anatomic area, generally through diagnostic nerve or joint blocks. Through limitations, other imaging modalities (X-rays, ultrasound, bone scan) may have failed to provide a specific diagnosis. MRI is also useful in interpreting the significance of findings that were previously identified, particularly those that have responded poorly to treatment. It is not a survey technique or a substitute for a thorough clinical investigation, including conventional imaging modalities. The interpretation of MRI findings is enhanced by the information obtained from these previous clinical examinations.

Front and/or rear shoes need to be removed prior to the exam depending on which limb/limbs are being imaged. Metal produces MRI image artifacts, significantly affecting image quality. If an examination of the feet is being performed, the feet are generally radiographed prior to the exam. This confirms that any metal from a nail has not been left behind in the hoof. If present, its removal is facilitated by this finding.

MRI examinations may be performed in a standing (low-field MRI) or recumbent (high-field MRI) position. Standard protocols result in the generation of hundreds of very detailed images that require time and specialized training for interpretation. Horses placed in lateral recumbency (down) require general anesthesia. Examinations take approximately an hour and a half. Those performed under general anesthesia generally image both the clinical and the opposite (“normal”) limb for comparison purposes. Time constraints with respect to sedation and keeping the horse still make this much more difficult in the standing individual. Younger or fractious individuals may not be able to be kept quiet enough to perform this procedure standing. Individuals undergoing general anesthesia are generally dropped off the day prior to the procedure for preanesthetic blood work and nail check radiographs, if required. Horses typically spend the night of the exam under observation before being discharged the following day. 

The main disadvantages of MRI involve cost, its somewhat limited availability, the limited accessibility to areas above the distal limbs (head, neck, stifle), and the need for general anesthesia in high-field magnets. The accurate evaluation of cartilage lesions using MRI in the distal limbs of horses remains difficult. 

MRI has greatly advanced our diagnostic capabilities and has enabled us to prescribe more focused treatments and more accurate prognosis. It is certainly not indicated in all situations, but may be considered in selected cases through consultation with your veterinarian.

Stay tuned: Dr. Haines is writing a follow-up post with MRI case study examples. 

Article written by Greg Haines, DVM, DACVS

Pilchuck Veterinary Hospital offers comprehensive diagnostic imaging options, including MRI, video endoscopy, high-resolution ultrasound and more. Please call 360.568.3111 for more information.

Dr. James Bryant Earns ACVSMR-Equine Certification

The time has come to add a few more letters after Dr. James Bryant’s name! Dr. Bryant recently traveled to Orlando to take his exams for certification by the American College of Veterinary Sports Medicine and Rehabilitation. And (surprise, surprise) ... he passed! So we’ll be updating Dr. Bryant’s business cards to: James Bryant, DVM, DACVS, DACVSMR.

We want to give BIG congratulations to Dr. Bryant for his new ACVSMR-Equine diplomate status. (There are separate specialties for equine and canine.) It is quite a lot of time and work to prepare for and take these exams and meet the other certifying requirements. Dr. Bryant is now “double-boarded,” adding this certification to his existing one from the American College of Veterinary Surgeons. [2.17.16 update: As of this update, Dr. Bryant is the only ACVSMR-Equine diplomate in the state of Washington.]

What exactly is the ACVSMR?

An AVMA-recognized specialty organization, this group promotes “expertise in the structural, physiological, medical and surgical needs of athletic animals and the restoration of normal form and function after injury or illness.” You can read more at

At Pilchuck Veterinary Hospital, our veterinarians and staff are passionate about providing the best possible care to our patients. Certifications such as this, along with continuing education, strong working relationships with our clients, and collaboration among colleagues, allow us to do just that. Thank you for entrusting us with your animal friends’ veterinary care needs!

Congratulations, Dr. Bryant!

Happy National Hedgehog Day!

Today we celebrate ... National Hedgehog Day! (Yep, the hedgehog shares a special day with the groundhog.)

In honor of these endearing animals, Lynnae G., a licensed veterinary technician from our large-animal department, kindly shared some photos and information about her two hedgehogs, Dexter and Hiro. 

From Lynnae:


I have had Dexter for about four years. Dexter loves to snuggle and get belly rubs.

Dexter: so photogenic! 

Dexter: so photogenic! 

He loves to run on his wheel and eat mealworms. While I was in vet tech classes, I would take Dexter with me every night. He made friends with everyone and even charmed an instructor into being his godmother. He would usually sleep in my shirt during class and sometimes he would cruise around the table looking for worms. 

Dexter loves to cuddle ...

Dexter loves to cuddle ...


I have had Hiro for almost four months. Hiro is a grumpy little boy but we are working on it. He is 3 years old, very curious and an explorer.

Hiro wants a beard of his own!

Hiro wants a beard of his own!

His absolute favorite thing in the world is running on his wheel! He will run for hours and hours. It's how he keeps his handsome figure.

Hiro stays hydrated after all that wheel-running

Hiro stays hydrated after all that wheel-running

He is a picky eater, and he leaves the pieces of food he doesn't like in his bowl for me to throw away.  

Thanks to Lynnae for putting this post together for us on Hedgehog Day! Want more hedgehog pictures? Read 12 things we can learn from hedgehogs.

Smile for ... Dental Specials!

February is National Pet Dental Health Month. To recognize this and promote the importance of dental health for our animal friends, we are pleased to offer dental specials for both our small-animal and equine patients. Details are below – let us know if you have any questions!

Dental Special for Dogs and Cats
February and March

PVH is offering FREE* full-mouth X-rays for our canine and feline patients during February and March.

Approximately 80 percent of dogs and cats over 2 years of age have significant oral health issues, which can result in pain, suffering and other problems. Many times, a tooth may appear healthy on the surface but can be fractured or infected below the gumline. X-rays allow us to see the tooth root and supportive structures to determine if there are any problems.

*PLEASE NOTE: A $120 to $200 value. Promotion is available only with a full dental cleaning and oral exam.

For details and appointments, please call 360.568.3113 to talk with a PVH small-animal receptionist.

Equine Dental Special
February Only

PVH is offering FREE* oral exams for equine patients during the month of February. 

With regular dental exams, we can identify and address dental issues as early as possible in our horses, including abscesses, ulcers, loose teeth, infected teeth or gums, periodontal disease, and misalignment of teeth. These days, many horses are maintaining functional dentition into their third – and even fourth! – decades of life. And that’s something horse owners and their horses can both smile about.

*PLEASE NOTE: Promotion is only available with vaccine appointments and/or dentals – charges apply if sedation is required.

For details and appointments, please call 360.568.3111 to talk with a PVH large-animal receptionist.

January Is National Train Your Dog Month (Part Two)

This is the second part of John Sparks’ guest post on an “Obedience First Approach for Behavior Issues” for January’s National Train Your Dog Month. Read Part One here.

Teaching a dog to choose “right action” in situations where he is tempted to do otherwise should be our objective with training. The dog will learn important skills like impulse control and having regard for other members of his social group. A dog that lacks impulse control and that has an overinflated sense of “self” tends to do as HE pleases, which can be a dangerous thing.

Building a Solid Foundation That Can Handle Pressure

When I train dogs and students, I do my very best to make the training motivational, enjoyable and fair, which includes making it easy for the dog to “get it right.” While we have to use some stressors and pressure during training, I make a solid effort to avoid intense pressures. The “real world” is full of surprises and realities that can’t be avoided, and that can be dangerous or deadly to our dogs if they are not properly prepared to deal with these pressures. Corrections and punishers, as part of a well-thought-out and -executed training plan, can be essential to the success of many dogs.

If we have done a good job at peeling back layers of stress, building a proper relationship, and teaching alternatives, then our dogs will be prepared for a fair correction or punishment for failing to take right action when the situation dictates. 

“Obedience is like insurance. It must be acquired before the moment of need.”– William Koehler, The Koehler Method of Dog Training

There are plenty of dogs out there that don’t really require an obedience first approach; these are the kind of dogs that will listen up and straighten out with one leash pop or stern “NO.” Even with this type of dog, I would rather reduce his stress, build a relationship with him, and teach “right action” through obedience training first. 

To me, there is a difference between teaching a dog to be “under control” and teaching a dog to be “in control.” The difference in my opinion is TRAINING, as opposed to FORCING. 

When a dog is forced to be under control, his choices have been made for him. When a dog has learned to be in control, he is making decisions for himself, decisions based on experiences that he has had through proper and consistent training. When a dog has learned to be in control, he needs very little input from his handler, and has very little to worry about in his day-to-day life. 

Earning your dog’s trust, respect and loyalty through an obedience first approach can make the struggle of dealing with your “difficult” dog a thing of the past. It isn’t easy work; it takes time and effort; there will be times of frustration and times of elation. But in the end, it can get you what you have always wanted: a dog that will listen to you! 

In order to be heard, you must first prove that you are WORTHY of being heard. You must show your dog that there is value to be gained from listening to you.

Thanks again to John Sparks of Sparks K9 for this informative guest post! You can learn more about Sparks K9’s dog training and socialization services at For more information on the Sparks’ pit bull rescue, Balanced Bullies Rescue & Rehabilitation, visit

Note: Photos provided by John Sparks; please do not use without permission.

January Is National Train Your Dog Month (Part One)

January is National Train Your Dog Month, and we are pleased to have our very first guest blogger to help us with this important topic! Many thanks to John Sparks of Sparks K9 Services for penning (OK, typing) this helpful information for us. He and his wife, Kim, also run Balanced Bullies Rescue & Rehabilitation, a nonprofit dedicated to the welfare of pit bulls.

These two do wonderful, wide-ranging work with and for our animal companions, and we at PVH are proud to call them friends. With that, let’s turn to John’s article on:

Obedience First Approach for Behavior Issues

How most behavioral issues can be resolved through obedience training
By John Sparks, Sparks K9 Services

As a dog trainer specializing in aggression (toward both dogs and humans), I know firsthand that the majority of behavioral issues can be greatly improved, or “cured” altogether, through an obedience first approach. Many highly successful trainers, old and new, including the late William Koehler, have employed this approach with great success.

In this post and a follow-up post, we’ll look at the main reasons the obedience first approach works so well in my practice and for my clients.

Stress Reduction

Most dogs with behavioral issues have “triggers” – things that set them off. The triggers themselves are usually not the root cause of the behavioral issues, though. Most behaviorally challenged dogs are suffering from stress, and the triggers just push them over the edge of their stress threshold (kind of like the old saying “the straw that broke the camel’s back”). 

Stress layering (multiple layers of stress that stack on top of each other) is a common problem, and happens with humans and dogs alike. 

Things that can cause a dog stress include, but are not limited to:

  • being on a leash
  • new people
  • new surroundings
  • noise
  • inconsistent or unclear communication from their handler
  • lack of training
  • other dogs
  • barrier frustration
  • unusual events
  • inconsistent schedule
  • lack of clearly stated behavioral boundaries
  • lack of impulse control
  • pain 

Behaviors that result from stress can include but are not limited to:

  • leash aggression
  • poor manners with guests
  • hyperactive behavior
  • house soiling
  • unwarranted aggression (toward dogs/humans/other animals)
  • fearfulness

Proper obedience can significantly reduce stress for dogs; it can peel back the layers of stress by giving the dog tasks to focus on, establishing clear and consistent communication between the human and dog, and teaching the dog how to be in control of his own emotions and actions. Specific triggers rarely have to be dealt with individually, as the training lowers stress overall, so any one trigger is rarely enough to send your dog over threshold.

Proper Relationship Building

Do you ever wonder why people act differently around strangers than they do around friends or family? Have you ever noticed that your dog acts differently around different people, or around different dogs? Have you ever wondered why? 


Time and experience create connection. It takes time and effort to build mutual trust and respect, as well as clear communication and cooperation.  Most people who have dogs displaying behavioral issues have a fragile relationship built on “love” and hope, not a healthily developed relationship built on trust, respect, communication and cooperation. A lack of proper relationship seems fine when things are calm, but when pressure or stress is introduced, things fall apart quickly. 

I spend a great amount of time teaching my students how to build proper relationships with their dogs. A lot of this time focuses on teaching them to properly train their dogs around distractions, so that their dogs can learn to be responsible for their own actions and mindset, even when pressure and stress build. Our relationships with our dogs is not built on moments of calm, but instead should be defined by how well we handle the moments of stress together.

In the next post, we’ll discuss teaching the “right action” as the preferred alternative, as well as building a strong foundation that can handle pressure. Stay tuned!

Note: Photos provided by John Sparks; please do not use without permission.

Kick Off the New Year in Good Health

Resolution time is here once again. Just as you may be setting health-related goals for yourself, consider doing the same for your pets! What can you do to start being proactive about Fluffy’s or Fido’s health today?

Diet Time?

A healthy weight is as important to pets as it is to people. Obesity predisposes animals to arthritis and can cause cats to develop diabetes among other problems. If you think your pet is overweight, contact your veterinarian to discuss a safe, effective diet and exercise plan as well as a healthy target weight.

Pet Oral Health

An often overlooked area in preventive health care for pets is dental care. Consider brushing your pet’s teeth three times a week. Are you likely to be defeated by your pet’s cunning toothbrush avoidance tactics? If so, integrate appropriate dental care treats and chews into your pet’s diet to promote good dental health.

Microchip Musts

Although microchips are a great way to reunite you with a lost pet, they must be maintained properly to be effective. When your pet is found and his or her microchip is scanned, the microchip company will contact you ... but if your contact information is out of date, the microchip is useless! Check with your microchip company to make sure your contact information is current.

Disaster Preparedness

Just as you might put together a disaster preparedness or emergency kit for your family, do the same for your pet. Make sure you have fresh water and pet food on hand in the event of an emergency. It’s also a good idea to have some pet first aid items available in case your pet sustains an injury.

Stay Active

January is Walk Your Pet Month, but you may be less inclined to spend time outdoors depending on the prevailing weather conditions. Regardless, walks are very important because they provide enrichment for dogs, and the exercise is good for maintaining their weight and joint health. Keep older pets mobile by taking shorter walks more frequently – mild to moderate low-impact activity is beneficial for arthritic joints.

These are some useful tips to help guide you and your pets to your healthiest year yet. Regardless of what you do, being proactive with your pet’s health is key! From all of us at Pilchuck Veterinary Hospital, we wish you and your pets good health.  

Article written by Andrew Rocco, DVM

Located in Snohomish, Pilchuck Veterinary Hospital offers comprehensive and 24/7 emergency care: 360.568.3113

Happy National Bird Day!

It's National Bird Day! To celebrate, we're featuring Horatio & Tandy, two birds who live with small-animal veterinary technician Lindan Spromberg. Below, Lindan shares a little more about these two guys. Here's to all our feathered friends out there!

From Lindan:

I have two Macaws currently. I have a Blue and Gold Macaw named Horatio.
Lindan and a smiling Horatio!

Lindan and a smiling Horatio!

I rescued him 20 years ago from a pet store where he sat in a wrought iron cage with only one branch and no toys. I had never owned a bird before and was just in the store to buy food for the cat when I saw him and said hello. He just looked at me and stared, never said hello back. I moved on and started looking at the other cages and he began to SCREAM! Not just a little noise, an ear piercing scream. So I went back to the cage and started chatting with him. I turned around to leave the room and he screamed and screamed, clearly he was trying to get my attention. So I bought him, on the spot and have had him ever since. He is 36 years old, they can live to well over 80 years of age. He speaks, he says: Hello, hi, whatever (and sometimes he puts a little attitude in there and says what…..ever…. ). He says bye bye, apple, wow, and of course all the things you don’t want him to say. He says “no!” “knock it off” “stop that” “shutup” and unfortunately a certain four-letter word. No, I didn’t teach him that, but I can't get him to stop saying it. Luckily he only says it once in awhile. He also has a hilarious laugh (click here to listen).
I also have Tandy, he is a Military Macaw.


Tandy came from a pet store that was phasing out selling birds. I knew him when I worked at the pet store and a few years later I bought him. He was born in 1990 and is 25 years old. He says: Hello, hi, Habitat (which is the name of the pet store), Rock and roll, Tandybird, Meow (he tries to meow), and he has learned how to sound like Horatio’s scream -__-.

Many thanks to Lindan for sharing these pictures and background on her birds!

Five New Year’s Resolutions for Your Horse

(From a Veterinarian’s Point of View)

Each year, you make a New Year’s resolution for yourself, but what about what you could be doing for your horse? Your trainer wants you to work on half passes, sliding stops, higher jumps or whatever your discipline may be ... but what does your veterinarian want you to focus on?

  1. Weight: Maintaining your horse’s weight, whether you have an easy-keeper or thin horse, should be high on this year’s priority list. Overweight horses are predisposed to conditions such as equine metabolic syndrome and laminitis. Laminitis can be very difficult to manage and can be career-ending and potentially even life-threatening. For thin horses, the root cause of the problem can be even trickier to diagnose. Is it nutritional, dental or due to another serious disease such as pituitary pars intermedia dysfunction (equine Cushing’s) or cancer?
  2. Dental care: On average, it is recommended that you have your horse’s mouth examined and floated once yearly. Skipping years of oral balancing, performed during the dental float, can potentially lead to serious misalignments such as creating jaw-locking steps, painful hooks and significant periodontal disease.
  3. Preventive care: The importance of vaccines cannot be stressed enough. Did you know that the best time of year to vaccinate for Eastern/Western encephalitis and West Nile is in the spring and early summer? These neurologic diseases are carried by mosquitoes, so it is best to boost your horse’s immunity to these prior to bug season. Another component of preventive care is parasite control. A vast majority of equine parasites are actually carried by a small percentage of horses. Fecal floats quantify how much an individual horse is affected by parasites and have completely changed deworming protocols. Now, deworming is tailored to the individual horse to prevent parasite resistance through unnecessary deworming.
  4. Senior care: Horses are frequently living longer, and our retirees start to require more medical care as they age. Common issues that need to be addressed include deteriorating ligaments and arthritis pain, loose teeth, weight/dietary management, and diseases such as Cushing’s and equine metabolic syndrome.
  5. Regular exercise: Busy schedules create horses that are “weekend warriors” – horses that are ridden hard on the weekends and do minimal work during the week. This makes it hard for horses to build up cardiovascular and muscle strength, and can also predispose them to injury in joints, ligaments and muscles. Could you get out to the barn for a longeing session in the middle of the week?

This year, make it your New Year’s resolution to improve your horse’s health. Buckle down on getting your fat horse trimmed down or your thin horse beefed up. Make it your mission to address dental and preventive care. Start a conversation with your veterinarian on how you can help your older horse’s arthritis or if you need to begin testing for diseases such as Cushing’s. Go the extra mile and put another workout in on your horse. Your equine friend will be sure to thank you later!

Article written by Liana Wiegel, DVM

Located in Snohomish, Pilchuck Veterinary Hospital offers equine ambulatory care, referral hospital services and 24/7 emergency. Call 360.568.3111 to schedule a consultation with one of our equine practitioners.

Basic First Aid Client Seminar Set for January 21!

Are you interested in learning about basic first aid and wound care for horses, along with barn fire prevention?

Please join us for the PVH large-animal department's next client education seminar on Thursday, January 21. All the details are below; give us a call at 360.568.3111 with any questions. Hope to see you!

Basic First Aid and Wound Care, and Barn Fire Prevention
Client Education Seminar

With Travis McKinzie, DVM, PVH Large-Animal Ambulatory Veterinarian
Guest Speaker Adam Farnham, Senior Forensic Engineer, Unified Investigations and Sciences

Thursday, January 21, 2016
6:30 p.m.
At Pilchuck Veterinary Hospital, 11308 92nd Street SE, Snohomish

Light snacks and beverages will be provided.

There's no fee to attend, but please register by January 14: 360.568.3111