Penn Veterinary Medicine | University of Pennsylvania

Imaging Services at New Bolton Center

Services include Nuclear Scintigraphy, Ultrasound. Digital Radiography, MRI, CAT Scan and High Speed Treadmill Evaluation.

Nuclear Medicine

Nuclear scintigraphy at New Bolton Center dates from 1993 and makes Penn Vet among the earliest facilities to offer this form of imaging for large animals.

Imaging well over 400 horses each year, the nuclear medicine program at New Bolton Center is one of the busiest in the world.

Dr. Michael Ross assumed primary responsibility for developing the facility at New Bolton Center and continues to interpret the studies. Three-phase bone scans can be obtained (vascular, soft tissue and bone phases). However because of the rapidity with which the radiopharmaceutical is eliminated from the circulatory system, the anatomic areas must be carefully selected for the vascular or soft tissue studies.

A scan of the entire skeletal system is possible; however care should be taken to precede the scan with a complete clinical evaluation so that areas of increased radiopharmaceutical uptake (IRU) can be evaluated in light of the animal’s clinical findings. It is also important to acknowledge that areas of clinical importance may not cause IRU and so may not produce a positive scan. Proximal suspensory desmitis, for instance, persists as one of the clinical conditions with a highly unpredictable response and therefore the bone scan is not always a reliable means of evaluation of this condition without a preceding lameness examination. Specialized scans can provide information on white blood cell accumulation in some areas of infection and have been utilized with good success in the evaluation of persistent orthopedic infections difficult to diagnose by other tests.

This modality is available to all of the large animal species admitted to the hospital, although the horse comprises the vast majority of the patient population. High level athletes, subjected to the rigors of training, are admitted for the diagnosis of stress fractures of the upper limbs and pelvis which are not easily localized with the use of diagnostic anesthesia (nerve blocks). Degenerative changes in the spine are also an example of a condition in which activity on the bone scan can support clinical evaluation.

Animals admitted for scintigraphy must remain in the hospital for a minimum of 24 hours after radiopharmaceutical administration to allow the radioactivity to subside. Nuclear scintigraphy remains one of the most useful ways to provide answers to difficult lameness questions but results must be combined with careful clinical examination.

Ultrasonography

 New Bolton Center is one of the leaders in large animal ultrasonography, particularly as it applies to the horse. Diagnostic ultrasound was established at the large animal hospital of the University of Pennsylvania in the early 1980s when a tradition of clinical excellence in large animal ultrasonography was established.

Diagnostic ultrasound has expanded to include the evaluation of tendons, ligaments, joints, muscles and bones of all parts of the body; puncture wounds and draining tracts; peripheral vasculature; masses and swellings; eyes; the high-risk pregnant mare; the neonatal foal and the entire thorax and abdomen. Ultrasound-guided biopsies, aspirates and injections are routinely performed.

Diagnostic ultrasound has revolutionized the ability to obtain definitive diagnoses in a wide variety of large animal diseases. Ultrasound-guided intra-lesional treatments are part of our therapeutic armamentarium, as is the use of focused high-energy extracorporeal shock wave therapy.

The diagnostic ultrasound group within the Section of Sports Medicine and Imaging has outstanding faculty and staff with state-of-the-art equipment, including 2 dimensional ultrasound, 3 dimensional ultrasound reconstruction, extended field of view imaging, power Doppler, pulsed wave and color Doppler. A complete ultrasound evaluation can be performed on all large animal patients. Large animal ultrasonography has an average yearly cardiac case-load of 1900 patients.

Radiology

Radiology at the George D. Widener Hospital encompasses a number of services including support for the imaging capabilities of the Field Service, diagnostic imaging in the radiology suite as well as stall-side throughout the hospital and in the operating rooms.

Digital radiography capabilities have been in place since 2003, the earliest veterinary school hospital to provide them, and these images are transmitted to a view system (PACS) which permits temporary modification of the images to facilitate evaluation. Multiple mobile x-ray machines with digital radiography units enable us to obtain digital images in all of the areas of the Hospital.

A 1000 mA x-ray generator in the radiology suite provides excellent imaging in standing adult large animals, including head, neck, chests, shoulders and stifles. Standing radiographs of the abdomen as well in the small ruminants and camelids assist in diagnosis of gastrointestinal and urinary bladder abnormalities.

Under general anesthesia, on a table modified to accommodate digital radiography, a myelogram of the cervical spine (neck) and radiographs of the pelvis and lower spine are easily accomplished. Support of both the clinical case load, as well as research projects so important to the progress of veterinary medicine, keeps Radiology a busy hub of the hospital.
 

High Speed Treadmill Evaluation

Description of Service and Procedures

Determination of the cause of an abnormal upper respiratory noise associated with poor performance may be difficult to diagnosis during routine examination. Comprehensive evaluation of the horse while exercising on the high speed treadmill facilitates dynamic analysis of multiple body systems. Types of testing available include:

• Resting and exercising upper airway endoscopy.
• Resting and exercising electrocardiogram (ECG).
• Resting and immediate post-exercising echocardiogram.
• Serial exercising arterial blood gas analysis including acid-base. analysis, blood oxygen and carbon dioxide levels.
• Post-exercising lower airway endoscopy and cytology. (bronchoalveolar lavage - BAL).
• Pre- and post-exercising muscle enzyme analysis.

Estimated time for completion of service

High-speed treadmill evaluation can be completed on an outpatient basis and the typical hospital stay is 5-8 hours. Laboratory data may require several days for completion.

Requirements

Horses should be sound and fit, preferably training at the level during which the performance problem occurs. Horses must be shod with four flat shoes (no toe grabs, heel caulks, borium, etc.) to exercise on the treadmill. Where appropriate, please bring your horse’s harness or other tack.

Appointment / Referral information

Referral by your veterinarian is recommended but not required. For more information contact Mary Croteau: 610.925.6407 or 6128