SPECIALIST EVALUATION
A Comprehensive Clinical Perspective
Equine internal medicine addresses medical conditions affecting one or multiple body systems, as well as cases in which clinical findings warrant further investigation or interpretation. Each evaluation begins with a detailed medical history and physical examination; additional assessment is guided by the individual horse and clinical presentation. Movement evaluation may also be incorporated when appropriate to help distinguish medical, musculoskeletal, and performance-related factors.
Diagnostic testing is selected according to the clinical question and may include laboratory testing, high-resolution ultrasonography and video endoscopy, echocardiography, electrocardiography (ECG), dynamic respiratory endoscopy, bronchoalveolar lavage (BAL), muscle biopsy, cerebrospinal fluid analysis, endocrine or infectious disease testing, and other specialized diagnostics.
WHEN TO SEE AN INTERNAL MEDICINE SPECIALIST
Is an Internal Medicine Evaluation Right for Your Horse?
Specialist evaluation can provide additional perspective when clinical signs are complex or recurring, diagnostic findings require further interpretation, multiple concerns are present, or the response to treatment is not as expected.
Unexplained Weight Loss
Changes in weight or body condition without a clear cause.
Recurring Digestive Problems
Recurrent colic, chronic diarrhea, or fecal water syndrome.
Respiratory Concerns
Chronic coughing, abnormal respiratory noise, or labored breathing.
Cardiac Concerns
Heart murmurs, abnormal rhythms, or unexplained exercise intolerance.
Abnormal Bloodwork
Persistent or unexplained abnormalities in laboratory results.
Neurologic Changes
Weakness, ataxia, seizures, or other neurologic abnormalities.
Endocrine & Metabolic Concerns
Signs or laboratory findings associated with hormonal or metabolic disease.
Persistent or Complex Conditions
Multiple clinical signs or conditions that haven’t responded as expected.
AREAS OF EXPERTISE
Respiratory
Evaluation of coughing, abnormal breathing, exercise intolerance, nasal discharge, poor recovery, and other respiratory concerns. Diagnostic evaluation may include respiratory examination, exercise testing, cardiopulmonary ultrasound, endoscopy, tracheal wash, bronchoalveolar lavage, and dynamic/overground endoscopy.
Gastrointestinal
Evaluation of recurrent colic, chronic diarrhea, weight loss, poor appetite, abdominal discomfort, changes in manure, and other gastrointestinal concerns. Diagnostic evaluation may include bloodwork, abdominal ultrasound, gastroscopy, fecal testing, nutritional assessment, and other targeted diagnostics.
Cardiac
Evaluation of heart murmurs, irregular heart rhythms, exercise intolerance, poor performance, weakness, collapse, and other signs of cardiovascular disease. Testing may include electrocardiography (ECG), echocardiography, and exercising or 24-hour ECG monitoring when appropriate.
Neurology
Comprehensive neurologic evaluation for weakness, stumbling, abnormal gait, ataxia, behavioral changes, difficulty swallowing, seizures, and other signs of neurologic disease. Testing may include infectious disease testing, cerebrospinal fluid analysis, advanced imaging, radiographic myelography, muscle biopsy, and other specialized diagnostics.
Endocrine & Metabolic
Specialized evaluation of PPID (Equine Cushing’s Disease), equine metabolic syndrome, insulin dysregulation, hyperinsulinemia, insulin resistance, thyroid function, and other endocrine or metabolic disorders. Testing and management are individualized based on medical history, diet, body condition, laboratory findings, and the needs of the individual horse.
Neuromuscular
Evaluation of weakness, muscle pain, stiffness, exercise intolerance, abnormal movement, muscle tremors, collapse, and suspected disorders affecting muscle or nerve function. Diagnostic testing may include bloodwork, post-exercise muscle enzyme evaluation, genetic testing, muscle biopsy, and selected exercise or metabolic testing.
Hematology
Specialist interpretation and evaluation of anemia, abnormal blood cell counts, platelet abnormalities, unexplained bleeding or bruising, and persistent changes in bloodwork. The goal is to determine whether an abnormal laboratory result is clinically significant and whether additional investigation is warranted.
Infectious Disease
Diagnosis and management of horses experiencing fever, respiratory disease, diarrhea, neurologic signs, weight loss, enlarged lymph nodes, and other signs associated with infectious disease. Consultation regarding diagnostic testing, quarantine, and biosecurity when contagious disease is suspected or confirmed.
Dermatology
Evaluation of persistent hives, itching, hair loss, skin lesions, recurrent infections, nodules, scaling, crusting, photosensitivity, and other unexplained skin conditions. Diagnostic investigation may include cytology, skin scraping, culture, biopsy, allergy evaluation, and other targeted testing when indicated.
Neonatal Medicine
Evaluation and management of newborn foals with weakness, prematurity, infection, respiratory disease, gastrointestinal disorders, angular and flexural limb disease and other neonatal medical conditions. Diagnostic evaluation and treatment are tailored to the unique needs of the neonatal foal.
