Equine Track

Month	Primary Rotation	Concurrent/Elective
July	Equine Medicine (ambulatory)	Lameness & orthopedics (concurrent)
August	Equine Surgery	Anesthesia & perioperative management
September	Equine Emergency	Rotation blocks
October-December	Elective Rotations	Reproduction, sports medicine, ophthalmology, dentistry
January-February	Advanced Cases & Research	Clinical projects or additional specialty exposure

Clinical Pearls & Rounds Preparation

🐴 Lameness Evaluation

Systematic Approach: Master the five-point lameness evaluation: observation at walk/trot, localization, diagnostics (flexion, intra-articular anesthesia, imaging).
Diagnostic Anesthesia: Understand how to perform and interpret intra-articular injections (hyaluronic acid + corticosteroid) for regional anesthesia.
Imaging Interpretation: Develop skill in radiographic interpretation of common orthopedic lesions; recognize when advanced imaging (ultrasound, CT, MRI) is indicated.
Prognosis & Management: Communicate realistic prognosis based on lesion type, severity, and horse use; discuss treatment options (conservative, interventional, surgical).

🐴 Colic Management

Rapid Assessment: Triage colic patients based on pain level, vital signs, and physical findings; determine urgency for surgical exploration.
Diagnostic Algorithm: Apply systematic approach: history, physical exam, nasogastric intubation, rectal exam, abdominal ultrasound, blood work.
Medical Management: Manage pain, fluid/electrolyte deficits, and gastric reflux; monitor for peritonitis or septic shock.
Surgical Indications: Recognize when medical management is failing and surgical exploration is necessary; understand common surgical procedures.

🫁 Respiratory Health

Airway Assessment: Evaluate upper and lower airway disease; perform endoscopic examination when indicated.
Performance Limitations: Understand how respiratory disease impacts athletic performance; discuss conditioning and environmental management.
Infection Management: Diagnose and treat equine influenza, herpes virus, strangles, and other respiratory infections.
Environmental Controls: Counsel on dust control, ventilation, and management strategies for horses with respiratory disease.

💊 Medical Management Essentials

Drug Dosing & Routes: Master equine-specific drug dosing (based on weight); understand IV, IM, oral, and topical administration routes.
Antibiotic Selection: Choose appropriate antibiotics for bacterial infections; understand equine pharmacokinetics and resistance patterns.
Anti-Inflammatory Therapy: Use NSAIDs, corticosteroids, and joint injections appropriately; balance efficacy with complications.
Client Communication: Discuss treatment options, costs, and realistic outcomes with horse owners; manage expectations.

🏥 Equine Emergency Medicine

Shock Recognition: Identify and manage hypovolemic, cardiogenic, and septic shock in horses; initiate appropriate fluid therapy.
Wound Management: Assess and manage traumatic wounds; understand when surgical exploration is needed for penetrating injuries.
Toxicology: Recognize poisoning (plants, medications, chemicals); manage decontamination and supportive care.
Anesthesia Considerations: Understand equine anesthesia protocols, complications, and recovery management.

🔬 Diagnostic Approach

Physical Examination: Develop skilled equine exam; master auscultation, percussion, and palpation techniques.
Lab Interpretation: Understand equine-specific reference ranges; interpret hemograms, biochemistry, and other diagnostics.
Imaging Selection: Choose appropriate diagnostic imaging (radiography, ultrasound, endoscopy) based on clinical presentation.
Sampling Techniques: Perform nasogastric intubation, rectal examination, synovial fluid collection, and other diagnostic sampling.

NAVLE-Style Quiz Questions

1. A 10-year-old warmblood gelding is presented with acute, severe abdominal pain (8/10), elevated heart rate (88 bpm), and prolonged nasogastric tube reflux (2 liters). What is the most likely diagnosis and initial management?

A. Strangulated small intestinal colic — Surgical emergency — Severe pain, elevated HR, and significant gastric reflux suggest strangulation. Immediate referral for surgical evaluation, aggressive fluid resuscitation, and likely surgical exploration.

2. During a lameness exam, the horse is lame at trot on the left forelimb. After intra-articular injection of the left shoulder joint with local anesthetic, the lameness persists. What is your interpretation?

A. The lesion is NOT in the shoulder joint — pursue other diagnostic sites — Improvement after intra-articular anesthesia localizes the lesion; no improvement means the problem lies elsewhere (elbow, carpus, lower limb, or soft tissue).

3. A 15-year-old draft mare presents with chronic lameness, significant bilateral carpal thickening, and radiographic evidence of severe osteoarthritis. She is used for light riding. What is the most appropriate recommendation?

A. Conservative management with intra-articular joint injections (hyaluronic acid + corticosteroid), NSAIDs, and modified work — limit to walk/trot activities — Chronic OA is not surgically correctable; management focuses on pain control and limiting high-impact activities.

4. A broodmare at 8 months gestation is presented with fever (102.8°F), cough, and serosanguineous nasal discharge. What is your primary concern?

A. Equine herpes virus (EHV-1) — risk of abortion and neonatal death — EHV-1 causes abortion, particularly in late pregnancy. Isolate immediately, monitor for further complications, and treat supportively. Notify other horse contacts.

5. A 5-year-old competition horse returns from a 2-week layoff and now exhibits exercise-induced respiratory distress at canter. Endoscopy reveals abnormal pharyngeal collapse and waveform abnormalities on the left. What surgical procedure is most likely indicated?

A. Laryngeal platypharyngoplasty (tie-back surgery) — Laryngeal hemiplegia (left-sided based on imaging) causes airway collapse during strenuous exercise. Tie-back surgery stabilizes the arytenoid cartilage to restore airway patency.

6. A stallion bred to a mare last month returns for a follow-up fertility check. Semen analysis shows 40% motility and 60% normal morphology. What is your assessment?

A. Below-normal semen quality — investigate for subfertility or systemic disease — Stallions should have >70% motility and >70% normal morphology. Investigate thermal injury (fever, overheating), testicular disease, or other causes.

7. A 4-year-old eventers horse presents with stiffness that improves with warm-up, then worsens with extended exercise. Radiographs show subtle lucencies in the tarsal bones. What is the likely diagnosis?

A. Equine osteoarthritis/bone spavin (hock) — degenerative joint disease — Subtle radiographic changes in tarsi with worsening lameness during exercise is classic for low-grade hock OA. Joint injections and conservative management are indicated.

8. During routine rectal examination of a horse with colic, you palpate a firm, rope-like structure in the abdomen and severe peritoneal pain on ballottement. What diagnosis is suggested?

A. Large colon impaction with possible rupture or severe peritonitis — Rope-like colon with severe peritoneal pain suggests impaction with rupture/necrotizing enteritis. Surgical consultation is urgent. Assess for septic shock.

9. A mare receives her annual influenza/rhino vaccine and develops severe cellulitis at the injection site 2 days later. What is the likely cause?

A. Vaccine reaction/local inflammatory response OR injection into subcutaneous tissue rather than muscle — Improper injection technique (too shallow) can cause localized inflammation. Treat with NSAIDs, ice/heat therapy, and consider antibiotics if signs of infection.

10. A performance horse exhibits weight loss, poor coat quality, and decreased performance over 3 months. Bloodwork shows mild anemia (PCV 28%), low albumin, and elevated liver enzymes. What diagnostic approach is most appropriate?

A. Investigate for parasitism, nutritional deficiency, or chronic disease (ulcers, liver disease) — The constellation of poor condition, anemia, hypoproteinemia, and elevated enzymes suggests parasitic burden, nutritional imbalance, or systemic disease. Fecal exam, diet assessment, and further diagnostics indicated.

11. A foal (2 weeks old) presents with fever, suppurative exudate from the navel, and swollen, painful joints. What is the suspected diagnosis and treatment priority?

A. Septic arthritis/navel ill — antibiotic therapy and possible joint lavage — Omphalitis (navel infection) can seed bacteria to joints causing septic arthritis. Treat with aggressive IV antibiotics and consider joint drainage/lavage. Manage secondary shock.

12. An Thoroughbred racehorse trained on a dirt track develops chronic cough and exercise intolerance attributed to "heaves" (RAO). What is the primary management recommendation?

A. Environmental modification (hay dust control, good ventilation) + NSAIDs + possible inhaled bronchodilators — Recurrent airway obstruction is managed with dust control measures first; medications (albuterol inhalers, dexamethasone) are adjunctive.

13. A 20-year-old horse is found standing with extreme difficulty and marked abdominal pain. Ultrasound shows echogenic fluid in the peritoneal cavity. Abdominocentesis yields turbid fluid with elevated WBC. What is your assessment?

A. Peritonitis (likely bacterial/septic) — grave prognosis in horses — Septic peritonitis in an aged horse is a very poor prognostic indicator. Treatment includes aggressive IV fluids, high-dose broad-spectrum antibiotics, and aggressive supportive care, but prognosis remains guarded.

14. A horse is presented with acute lameness on the right forelimb. Flexion of the distal interphalangeal joint markedly worsens the lameness, but flexion of other joints produces minimal effect. Where is the lesion localized?

A. Distal interphalangeal (coffin) joint or surrounding soft tissues — Worsening with DIP flexion localizes to that joint; pursue intra-articular anesthesia of DIP and perform diagnostic imaging (radiography, ultrasound) of the region.

15. A broodmare has a history of early pregnancy loss (95+ days). Current ultrasound at 60 days gestation appears normal. What preventive management is most appropriate?

A. Consider progesterone supplementation (altrenogest or compounded progesterone) through first trimester — Recurrent late pregnancy loss suggests early embryonic development issues. Progesterone support may reduce loss risk. Ultrasound monitoring throughout pregnancy is also recommended.

Core Rotations

Equine Medicine

Equine Surgery

Lameness & Orthopedics

Equine Emergency

Elective Rotations

Reproduction

Sports Medicine

Ophthalmology

Dentistry

Suggested Rotation Timeline