June 2015 - Hallmarq’s Standing MRI
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Thursday, 04 June 2015 19:31
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Availability of advanced diagnostic equipment grows in California.

Magnetic resonance imaging machines that scan a horse’s lower legs while the horse is standing have revolutionized the world of lameness diagnosis. “It is almost the standard of care,” says Dr. Carrie Schlachter, VMD and medical director at Circle Oak Equine Sports Medicine and Rehabilitation in Petaluma. Availability seems to be the technology’s only drawback, and, happily, that’s changing. Dr. Schlachter is “very excited” to be adding the standing MRI, or “sMRI,” to Circle Oak Equine, where it will debut along with a new surgery center on June 1. (With a formal unveiling of both on June 10, see sidebar below.)

Magnetic resonance imaging reveals all of the structures in a scanned area, including the soft tissue of ligaments and muscles, as well as bone. X-ray and ultrasound have a valuable place in the diagnostic process, but MRIs often reveal problems and their sources not identified by either. The problem with the sMRI’s predecessor, the so-called “down MRI,” is that the horse has to be put under general anesthesia and laid down. Anesthesia and the recovery from it pose many risks for horses.

Another plus of the sMRI is that it facilitates a progressive exploration during a diagnostic exam. It often happens that a nerve block indicates a problem is in the horse’s hoof, but the scan reveals no issues there. In those instances, the technician can easily continue scanning higher up the leg, typically to the fetlock joint. ”Because the horse is standing up and, if he’s being good, it’s OK to scan a little longer because he’s not at risk,” Dr. Schlachter relays.

The ease of use and low risk broadens the sMRI’s application beyond diagnostic to preventative care, because it can help monitor bone physiology for indicators of potential breakdown.

“It is a really important diagnostic modality,” Dr. Schlachter continues.  “It has and is still teaching us what goes on inside the foot, and it’s changed our views in many ways.” The sMRI has had an especially big impact on detecting and, in some cases, ruling out navicular disease. “When I was in veterinary school, we didn’t know what caused navicular. There was thinking that it was genetic, and there was a general sense that everything would go downhill from there.” With the sMRI’s help, veterinary thought has evolved to rule out genetic links and clarified cases where the problem had “everything to do with the soft tissue and nothing to do with the navicular bone. You couldn’t call it a ‘misdiagnosis’,” she clarifies. “It was just that we didn’t know what was going on.”

It’s also been a big help in “lamenesses of unknown origins,” thought to stem from issues in the hoof or fetlock joint. Past prescriptions for such cases involved putting the horse out to pasture for six months or so, at which point they would often return to soundness. Wear and tear was usually blamed, Dr. Schlachter explains. “And we would always be a little suspect of that horse’s soundness going forward. The sMRI has made it clear that horses often get ‘bone edema,’ which is like a bone bruise. With the proper treatment and rest, there is no long term impact.”

Coming To A Location Near You!

Made by Hallmarq Veterinary Imaging, Inc., standing MRIs were first introduced in 2002 and today there are 76 scanners located on five continents and the 50,000th scan was recently completed. The Circle Oak installation marks the fifth equine site for an sMRI in California. There are two in San Diego County’s San Marcos, at San Dieguito Equine Hospital and California Equine Orthopedics; one in Los Olivos at the Alamo Pintado Equine Medical Center and another at UC Davis.

Led by veterinarians, Hallmarq developed a business model in which the company is paid per scan. Compared to having to buy the sMRI outright, this model helps more facilities offer the service, thus helping more horses and their owners find answers that might have otherwise remained riddles.

The national average cost for a full MRI study is approximately $2200. This varies according to what each veterinarian charges, notes Hallmarq’s Dan Brown. That estimate is comprehensive, including a radiologist’s review of what can be 500 to 600 images, scanning both legs for comparison, light sedation, reports and other related services. Insurance companies often cover the procedure. “They are usually happy to pay for it because they realize they’re getting an early, specific diagnosis,” Dan explains. “In the long run, that saves money. In many difficult lamenesses, you might spend a long time guessing at the true cause of the issue and the most appropriate treatment. With MRI, even in those cases where it’s not a good answer, at least you know what you’re dealing with and can plan accordingly.” The reduced risk of an sMRI over a down MRI is appealing to insurers, too.

Dan predicts the sMRI’s availability will continue to grow. “We are getting inquiries from potential new sites all the time,” he says. “sMRI is rapidly becoming an imaging modality that no high-end referral hospital can afford to be without.”

For more information on Hallmarq Veterinary Imaging’s standing MRI, visit www.hallmarq.net or call 978-266-1219.


Having It All: Circle Oak Equine adds surgery and advanced imaging.

Circle Oak Equine, a specialty veterinary center focusing on equine sports medicine, lameness and rehabilitation, opens its long planned surgery center and welcomes a standing MRI on June 1.

In making these expansions, the facility in Sonoma County’s Petaluma will be one of few equine facilities worldwide to offer state-of-the -art, fully integrated, specialized sports medicine services under one roof and delivered by one team. “We offer cutting edge diagnostics, therapies and surgical techniques to ensure that horses receive swift, accurate diagnoses and the best opportunities for full recovery,” explains Carrie Schlachter, VMD, Circle Oak’s Medical Director.  “What we have lacked is surgery and advanced imaging capabilities, so we are thrilled to open our new surgery center, equipped with state of the art technology such as a standing MRI.

“Now that we have such accomplished veterinarians as Drs. Jack Snyder and Sarah Puchalski on our team, we can offer a full spectrum of equine sports medicine services.” Drs. Snyder and Puchalski joined the Circle Oak staff in 2014. Dr. Schlachter notes, “We share a common approach to equine health in that we strive to do more than simply treat a horse’s injuries; our goal is to enhance performance and extend a horse’s career.”

In addition to veterinary expertise, Circle Oak offers an extensive array of diagnostic and therapeutic modalities, including a HydroHorse underwater treadmill and an ECB cold saltwater spa, which are regularly incorporated into treatment plans.  The new surgery and imaging center will also include the Bay Area’s only standing MRI.

For more information about Circle Oak Equine call 707-738-2529 or visit www.circleoakequine.com.