Monthly Archives: November 2015

The Basics of the Coaching Program

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How to Create a Superb Dissertation

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Meet Dr. Janet Greenfield-Davis

Janet head shot

Dr. Janet Greenfield-Davis knew she wanted to be a veterinarian since elementary school. She grew up riding and competing on the hunter/jumper circuit in California before attending California Polytechnic State University and graduating from the University of Glasgow School of Veterinary Medicine in Glasgow, Scotland. Working alongside her husband Tyler Davis, Janet joined the Palm Beach Equine team as an intern before accepting a full-time position in 2010.

What inspired you to be a veterinarian?

I started riding at eight years old in a little field at the end of my street. As I started to grow up, my dad got me taking lessons and competing. He asked me one day when I was 11, ‘What do you want to be when you grow up’? I told him that I wanted to be a veterinarian and work on horses. He never let me forget that, so I grew up and became a veterinarian.

What is it like to work with your husband everyday?

It’s wonderful. How many people can say that they get to see their significant other throughout the day, work on cases together, and bounce ideas off each other? We have worked together since the day we met. We went to school together, sat together in class and now we work together. I absolutely love it.

Have your children inherited the animal-lover gene?

Oh yes! We have two girls – Zella is two and Maisie is five months. Zella comes on calls with me regularly. She has her own toy stethoscope in my truck.

What is your specialty?
I specialize in acupuncture and herbal medicine. Both piqued my interest in vet school, and when I came to Palm Beach Equine, there was an opening for an acupuncturist. I really love having a way to treat animals without using drugs or steroids. It’s one more method to help equine athletes reach peak performance and is gaining more and more popularity. When I first started, people didn’t embrace it as much, but now even more doctors are starting to turn to it for cases they are not sure how to diagnose. With all the strict rules in FEI, it is a way to make a horse feel better without using drugs.

acu 1

When you are not working, where can we find you?

Hanging out with my kids and my husband. We try to do family things as often as we can.

What advice would you give to someone considering vet school?

It’s a long, hard road but if you love it, it is so worth it.

What do you like about being on the Palm Beach Equine team?

We have all the diagnostic equipment we could ever need, and I love the quality of practitioners that we have at our practice. We always work as a team – everyone’s number-one goal is the best care for horses and animals in general.

Name one thing most people don’t know about you?
I used to swing dance. I taught lessons and performed for a long time.

 

Blazer Back to Winning Ways after Sinus Cyst Surgery

Blazer by Cynthia Skaar with Accurate Depiction

Jo Ann Hopkins and her 12-year-old Appendix-bred gelding, Blazer, are currently placed third in points in the local 1D barrel racing circuit in Florida. However, just three months ago, Blazer underwent surgery at Palm Beach Equine Clinic for a growing cyst in his sinus. On August 1, 2015, Dr. Weston Davis, DACVS, performed the surgical procedure on Blazer for an expansile paranasal sinus cyst of the left paranasal sinuses, extending to the right concho-frontal sinus.

Hopkins noticed that Blazer, who she calls “George” for his laid-back attitude, had a raised knot on his head this spring and consulted with her local vet, Dr. Kelly Alderman. The area was monitored closely and remained the same until June, when Hopkins noticed Blazer wheezing while running barrels and the knot increasing in size.

Dr. Alderman performed radiographs on the site and aspirated the swelling where a substantial amount of fluid was removed. She confirmed that the bump was a suspected paranasal sinus cyst. At that point, Blazer was referred to Dr. Weston Davis of Palm Beach Equine Clinic, who advised Hopkins that the cyst was likely growing slowly within the sinus for a considerable amount of time with no clinical signs. The diagnosis was an expansile paranasal sinus cyst of the left paranasal sinuses, extending to the right frontal sinus.

Blazer cyst xrazy

For surgery, Blazer was placed under standing sedation and local analgesia (painkiller) and his head was aseptically prepared before Dr. Davis performed a frontonasal sinusotomy (incision into the sinus). He made an opening from the middle of Blazer’s head to the corner of his eye. Once the skin flap was elevated and the bone fractured, a large amount of fluid was evacuated, which is consistent with the contents of a paranasal sinus cyst. Dr. Davis also observed that the sinus cavity was extremely distorted and expanded. The cyst lining was debrided and removed, then the sinus was lavaged and a tube was advanced into the sinus cavity to facilitate drainage. The sinus was packed with gauze tied together and soaked in a dilute betadine. Finally, the bone flap was replaced and the skin was closed and covered with a sterile bandage.

The gauze packing was removed 48 hours after surgery and upon release from Palm Beach Equine Clinic, Hopkins was instructed to monitor the incision for heat, swelling and discharge. Bute, in the amount of 2g, was administered orally once a day for five days and Dr. Alderman removed the sutures after 10 days.

Hopkins characterizes Blazer as a sweet gelding with heart to spare, and is happy to report that his recovery has been fantastic. After six weeks of stall rest and rehab time to get back in shape, Blazer recently won his first barrel race after surgery. According to Hopkins, Blazer is running better than ever thanks to Dr. Davis and the staff at Palm Beach Equine Clinic.

OTTB Gets a Second Chance at New Career Thanks to PBEC

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Palm Beach Equine Clinic is renowned for its exceptional care of performance sport horses of all disciplines around the world. Sometimes, the veterinarians and surgeons have the opportunity to treat the horses owned by their colleagues. This summer, PBEC veterinary technician Megan O’Neal experienced the clinic’s surgical expertise firsthand when her rescued off the track Thoroughbred was diagnosed with severe spinal impingement.

O’Neal adopted Blessing, a ten-year-old mare, almost three years ago. After Blessing’s career on the track ended, she was given to Pure Thoughts Horse Rescue in Wellington, FL. Blessing had moved through a few foster homes before O’Neal gave her a forever home. Blessing had been successfully jumping three-foot courses with one of her previous foster homes. After adopting Blessing, O’Neal was jumping the mare as well, but only about two-feet high. She had plans to compete, but Blessing’s behavior changed under saddle. The mare began rearing and bolting, endangering both herself and her rider. Her attitude on ground handling turned sour as well, no longer enjoying to be groomed and pinning her ears in agitation.

With the help of staff surgeon Dr. Weston Davis and the excellent imaging technology available at PBEC, O’Neal was able to pinpoint the cause of Blessing’s troubling change in behavior. The diagnosis was severe chronic back pain with dorsal spinous process impingement (kissing spine lesions). The vertebrae in her back from T16 – L1 were affected, which is the mid-section of the horse’s back, in the general region of where the back of the saddle sits.

The first course of action was to try several non-surgical techniques to treat Blessing’s pain. Dr. Davis tried treatments of intramuscular injections for arthritic pain and corticosteroid injections in between the spinal vertebras. A veterinary chiropractor adjusted the mare every few weeks. For almost eight months, several additional methods were tried to avoid surgery including acupuncture, back stretches and oral muscle relaxants. In July, when the pain continued after all their efforts, O’Neal finally decided that surgery was the only option for recovery.
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In the state-of-the-art hospital at PBEC, Blessing was sedated to obtain pre-operative radiographs that map the exact site of the lesions. She was placed under general anesthesia and the surgical site was sterilely prepared. Dr. Davis made a single 20cm incision on the dorsal midline over the palpable dorsal spinous processes. Eighteen-gauge needles were inserted at regular intervals and used as radiographic markers to identify the interspinous spaces. The incision was extended through the supraspinous ligament at each site. Dr. Davis used sterile surgical equipment, known as a bone rongeur, to elevate the soft tissues and resect some of the affected dorsal spinous processes (DSPs). The rongeurs, which are similar to large pliers, were used to slowly remove the edges of the overriding bone. This process frees the space between adjacent vertebrae until widened enough that the index finger of the surgeon could easily pass in the interspinous space. The site of resection was lavaged to remove any loosed tissues. Lastly, Intra-operative radiography was used as needed to confirm location and completion of the surgery. Following confirmation, the supraspinous ligament was internally closed with absorbable sutures. The skin was closed with surgical staples and a stent was sutured in place over the incision. After several weeks of healing, the stent and staples were removed.

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The surgery was performed without complication and Blessing was provided a good prognosis. Soon after surgery, the space that was created between vertebrae filled with a non-painful, fibrous scar tissue. Blessing went home the following day after surgery. She was monitored closely at home and received routine peri-operative antibiotics (gentamicin and penicillin) and anti-inflammatories (phenylbutazone) for pain. Recently, O’Neal was given the okay from Dr. Davis to resume riding for normal exercise. O’Neal looks forward to continuing her partnership with this special mare. Thanks to Dr. Weston Davis and the team at Palm Beach Equine Clinic for their exceptional care to get Blessing back to happy and healthy!