PVH equine ambulatory veterinarian Dr. Travis McKinzie recently wrote an article about equine first aid for the Washington State Quarter Horse Association newsletter. We've shared his article below and hope you find this informative!

Here are a few pointers on when to call a veterinarian and what to do until he or she gets there. Colic, lacerations and choke are just a few hot topics. We will cover more in another issue.


Colic simply means abdominal pain, but for horses, this is an emergency because of their very long intestinal tract. Signs include pawing, kicking or biting at side, going down, rolling (without shaking off), not eating, etc. Call your vet and try to keep your horse from rolling until your horse can be seen. You may have to walk your horse or trailer him or her to keep the horse from rolling. Banamine is a useful drug, but your vet should be consulted before giving it because it can mask some of the signs for the exam and the IV form is better if your vet can see your horse quickly. If the vet visit will be delayed, then he or she will often have you give it. A general rule of thumb is that if a colic requires banamine, it should also be seen and stomach tubed.


Lacerations are inevitable with horses. If the cut is suturable, it is generally best if this occurs within four hours. Do not put powders, creams, etc. into a wound that you want sutured. Cleaning the wound with saline and applying K-Y Jelly to keep the wound from getting recontaminated is good as the K-Y is water-soluble and will allow for any dirt or hair to be more easily flushed out. Also remember that “proud flesh” is nothing more than a good healing mechanism (granulation tissue) gone to excess. Anything that kills proud flesh stops healing tissue that is needed in the early stages of wound healing. These products should be used only after granulation has filled in the wound defects. Granulation can be handled by trimming if need be. Tetanus needs to be up to date and antibiotics will likely be needed. If you see white in the wound (bone, tendon or ligament), this wound is more urgent.


Choke sometimes resembles colic as your horse may become very distressed. This is a plug of feedstuff in the esophagus that the horse cannot swallow. The difficulty breathing is that saliva (or water the horse drinks) will build up and the horse cannot swallow it. Pronounced coughing and nasal discharge with feed mixed in are the major signs. It is OK to delay veterinary treatment a couple of hours for choke. You will need to walk the horse some to relieve the distress and massage the lower neck and throat area to help your horse resolve this on its own. However, if not clearing within two hours, it is important to get treatment. Injury to the esophagus and aspiration pneumonia are complications that are possible if you wait too long. Also, treating these is a messy process, so be prepared to get coughed on.

In any case, having a good relationship with your veterinarian ahead of emergencies is very important. Have contact/emergency numbers accessible.


Dr. McKinzie's Equine First Aid Presentation (PDF)
From a Recent Horse Owner Education Seminar

By Travis McKinzie, DVM, Equine Ambulatory Department

Located in Snohomish, Pilchuck Veterinary Hospital offers ambulatory, referral and 24/7 emergency care. Call 360.568.3111 or visit pilchuckvet.com for more information.  

When MRI May Be Helpful in Equine Lameness: Three Case Examples

This is the second part of Dr. Greg Haines' article on MRI for horses. Read part one of the article.

Magnetic resonance imaging (MRI) may be indicated when a lameness has been localized to a specific region, generally through diagnostic nerve or joint blocks. Through limitations, other imaging modalities (X-rays, ultrasound, bone scan) may have failed to determine a specific diagnosis.

MRI has greatly advanced our diagnostic capabilities particularly within the equine foot. Common injuries within the foot that have been diagnosed with MRI include deep digital flexor tendon (DDFT) injuries and navicular bone degeneration. Below are specific examples when MRI was helpful diagnostically. The first two deal with the foot, the third with the proximal metatarsus (Mt3) – cannon bone/hock.

Case #1

A mare presented with a seven-week history of forelimb lameness that failed to improve. There were no obvious clinical findings and no response to solar hoof tester placement. The lameness was worsened when the mare trotted in a circle. She showed minimal improvement to a palmar digital nerve block (blocks the heel area and sole of the foot) and was essentially sound after an abaxial sesamoid nerve block (blocks from the fetlock to the foot). X-rays failed to identify any specific abnormalities. Given the chronicity and lack of improvement, an MRI was undertaken. A marked DDFT lesion was diagnosed by MRI.

Case #2

This horse had only a two-week history of forelimb lameness that was also worsened by trotting in a circle. Again, specific abnormalities on initial examination were not noted. The lameness essentially resolved after a palmar digital nerve block and radiographs failed to provide a specific diagnosis. MRI evaluation revealed marked navicular degeneration characterized by a flexor cortex erosion.

Case #3

This horse had a two-month history of right rear lameness that was localized to the area of the proximal metatarsus (Mt3) – cannon bone/hock. The horse displayed a mild improvement to a lateral plantar nerve block (blocked the area of the proximal cannon bone – suspensory ligament), but a significant improvement was noted after a tibial peroneal nerve block (blocked the area of the hock). Radiographs failed to identify any significant abnormalities. An ultrasound evaluation of proximal Mt3 demonstrated proximal suspensory ligament enlargement. A bone scan of the rear limbs was considered normal. The horse was rested and had extracorporeal shock wave therapy performed to the area of the proximal suspensory ligament without any clinical improvement. An MRI evaluation revealed enlargement of the origin of the suspensory ligament with disruption of the medial bundle. The area of the hock was ruled out as a potential source of lameness.

In each instance, a specific treatment plan was initiated and a more accurate long-term prognosis for soundness was provided. It is important to remember that MRI is not a survey technique or a substitute for a thorough clinical investigation, including conventional imaging modalities. The interpretation of MRI findings is greatly enhanced by the information obtained from these evaluations. It is clearly not indicated in all situations, but may be considered in selected cases through consultation with your veterinarian.


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.

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 vsmr.org.

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!

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.

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

PVHer Profile: Stacey Sikorski

Introducing our PVHer Profiles series! This series of posts allows clients and friends to learn a little more about the veterinarians and staff at Pilchuck Veterinary Hospital. If you have any suggestions or questions, just let us know!  To kick us off, we turn to ... Stacey!

Name: Stacey Sikorski

Position: Referral coordinator for the equine hospital, equine sponsorship and events coordinator

When did you join PVH? September 2002

Favorite part(s) of your job? Job is never the same day after day.

Hometown: Moodus, Connecticut

Education: B.S., genetics and cell biology, WSU

Tell us a little about your work background: I’ve been working with horses since the age of 14. I started working with Arabians at age 16, thought I wanted to be a veterinarian but really what I wanted was to be a trainer. I finished college and got the opportunity to work for Meadow Wood Farms as a show groom. Eventually I was promoted to head show groom, barn manager where I learned most of my skills. When the farm closed down, I found my way to PVH and "retired" from the horse show industry but still dabbled a little on the side working for Jeff Lee and Company, who eventually lured me back to the show world on a part-time basis.

What does your work day entail (no pun intended!)? At PVH, my day can include reviewing equine billing, scheduling for the surgical team, sponsorships, and just about anything else thrown my way.

A favorite patient success story? Magic’s. Magic had a compound fracture of a hind leg, went to surgery twice and has since healed and returned to active competition.

Your work-related super power? The ability to keep calm no matter what ER walks in the door

Any animal companions of your own?

  • High Spirrits, 23-year-old Arabian Gelding
  • OKW Annika, 8-year-old half-Arabian mare
  • MacKenzie, 8-year-old female Scottie
  • Angus, 8-year-old male Scottie 
Stacey and High Spirrits

Stacey and High Spirrits

Showing OKW Annika at Donida Farm

Showing OKW Annika at Donida Farm

MacKenzie (L) and Angus (R)

MacKenzie (L) and Angus (R)

What do you enjoy doing outside work? Watching baseball (huge Seattle Mariners fan), horseback riding, car shows, running my businesses 

I not only work at PVH and for Jeff Lee and Company, but I also run two other businesses on the side. I have a small boarding facility at home, and I run Equine Clipping Services, which is a mobile body clipping and show clipping service. I don't sit still well to say the least. 

Clipping a client's horse

Clipping a client's horse

Favorite animal-related activity in the Snohomish area/PNW? Horse shows of course!

What book is on your nightstand? No time to read – last book was by Stephen King, Doctor Sleep.

What’s in your music rotation right now? Aerosmith, Hinder, Volbeat, Five Finger Death Punch – I lean toward the harder side of rock.