Clinical
Clinical Diagnosis and Treatment
Svend’s specific field of expertise and interest is that of equine orthopaedics.
Consequently, his clinical work in recent years has almost exclusively concerned orthopaedics and pre-purchase examinations.
His experience is not limited to the thousands of lame and under-performing horses examined throughout a long career in equine orthopaedics but also from observing thousands of competition horses in movement. This has not happened overnight; Svend’s European background among top dressage riders has given him this basis from before he even entered veterinary studies in 1972.
Svend has a life-long interest in imaging, radiology and ultrasonography, tools he uses daily. An increasing number of practices use the latest diagnostic technology, but these are only as effective as the veterinary surgeon interpreting the results.
Svend is co-author of the Internationally renowned textbook:
Clinical Radiology of the Horse, which is now in its 4th edition and which is considered the standard radiology textbook.
There are no shortcuts. Patience, tenacity and experience are key.
If treatment is not instigated early and effectively, a traumatised joint unfortunately often remains inflamed and the inflammatory cascade soon spirals like a snowball down a mountain (many people would have heard me talk about the “slippery slope” of joint degeneration) towards osteoarthritis, where we still have no options of treatment and certainly have lost the horse from competitive sports.
Svend accordingly believes that this vicious cycle must be broken before being firmly established and that the joint can often help itself regenerate if treated aggressively early enough and managed correctly.
Various medications are available for joint treatment, varying from corticosteroids to hyaluronate, polysulphated glycosaminoglycans as well as IRAP and PRP which belong to the group of treatments referred to as “regenerative medicine.” So named because they use the body’s own reparative abilities to improve the healing of injured structures such as joints and tendons and ligaments. Both preparations are produced from a sterile blood sample obtained from the horse. Therefore, these preparations are natural substances and do not infringe on doping regulations.
Svend has equally strong views on rehabilitation of joints following either surgery or joint injections.
He strongly believes that training of athletes should never be stopped but altered and targeted to the rehabilitation needs of the injured structure(s). Turn-out in paddocks does not figure in this regime, because it is non-controllable and non-quantifiable.
Alternatively, controlled exercise (hand walking, horse walker, water treadmill etc.) are used to “tease” the injured structure(s) back to work as soon as possible and under the same loading pattern as will be required when in full training.
Svend has been in the fore front of diagnosing and treating “kissing spines” for more than 30 years, having done more than 400 surgeries of this problem.
The diagnosis is rarely simple and is often confused by the discrepancy between the radiographic picture and the (perceived) clinical signs. The key to successful treatment therefore remains a precise diagnosis which requires extensive clinical experience in sports horses with reduced performance. A change in training pattern with or without injections of the back might reduce the need for surgery.
An accomplished pre-purchase examination is a pre-requisite for future performance. It requires broad experience from the veterinary surgeon and an ability to use this experience to decide what is acceptable or not for future performance.
Vetting horses is, to some degree, a “numbers game” and Svend has certainly “clocked up numbers” vetting performance horses in most European countries with an industry of sports horses. Through this, Svend has established colleagues and clinics around Europe where he finds excellent facilities for vetting’s and top-class radiographs.
