Latest news from the lab

More news from the lab

Using “Grey-zones” in interpretation of lab results

If all results of diagnostic tests were clearly either positive or negative then our lives would be simpler! Unfortunately that is not the case and we are all used to seeing borderline values. This is probably an inevitable result of progress and the fact that we now tend to get presented with early-stage disease cases of all types, rather than end-stage disease which rarely presents diagnostic difficulties. Many diseases are not simply either “present” or “not present”, and may exist along a spectrum of development. With many lab tests we have to use judgement as to when a mild increase merits further action versus further monitoring. For example, if GGT is normally <50 iu/L, should we be concerned when it increases to 55, or 75, or 150………?
We are now offering further guidance alongside our seasonally adjusted ACTH values and you will now see a “grey-zone” on the lab forms alongside your result. For example, this week we suggest an ACTH cutoff value of 49 pg/mL with a grey zone from 20-73 pg/mL. This indicates that a PPID case is very unlikely (P<0.05) to have an ACTH <20 pg/mL, and a normal horse is very unlikely (P<0.05) to have an ACTH >73 pg/mL.
The ACTH result should be interpreted in the context of the degree of clinical suspicion and we will always help you with this where you have time to enter clinical history on the submission form. If a test is being run in quite a speculative fashion with no strong clinical suspicion of PPID then the result ought to be above 73 pg/mL (this week) to be reasonably convincing for PPID. On the other hand if you are pretty convinced clinically that a horse has PPID then you should remain suspicious even with values as low as 20 pg/mL, and perhaps advise TRH stimulation testing as the next step (NB. TRH stimulation tests are hard to interpret at this time of year, although a negative result makes PPID unlikely).

VETPD – INTERNAL MEDICINE CHALLENGES FOR ADVANCED PRACTITIONERS – A 2-DAY INTERACTIVE & PRACTICAL COURSE

Fri 6th Nov 2020 – Sat 7th Nov 2020
 
@ Liphook Equine Hospital
 
For more information and to book your place, please click here:

Experienced Equine Vet 

Due to expansion of our ambulatory team, we are looking to recruit a highly motivated and experienced equine ambulatory vet.  A minimum of 5 years’ experience in equine practice is required.  We have a diverse client base but with an increasing number of high level competition horses and stud clients. Experience in all aspects of equine ambulatory work is essential and specific expertise and knowledge of reproduction is of particular interest. Our ideal candidate will either have or aspire to achieve a post graduate qualification in their chosen field.  Excellent client communications skills and ability to work as part of a team are vital.

We currently have a team of ten equine ambulatory vets (including 7 RCVS certificate holders) with the most up to date mobile equipment such as fully wireless DR radiography systems, digital ultrasonography, endoscopy, shockwave, power dental equipment etc. The ambulatory team has full back up of our tier 3 hospital which includes 9 RCVS specialists and full range of facilities such as Scintigraphy, CT and MRI.

This is a fantastic opportunity for the right candidate to further develop their skills and advance their career. The practice offers an excellent working environment with a highly competitive package.

If you are interested in applying for the position please submit an application to Carrie Goodbourn, Business Director, Liphook Equine Hospital, Forest Mere, Liphook, Hants, GU30 7JG or by email to carrie.goodbourn@theleh.co.uk including your CV and a covering letter. Applications should be received no later than Friday 14th August 2020. For an informal discussion please call Carrie on 07917851129.

We would like to welcome and introduce to you Victoria Tannahill, who has joined our surgery team.

Victoria graduated from the University of Glasgow in 2007 and subsequently served in the Royal Army Veterinary Corps for five years, treating military working animals in the UK and abroad. She then decided to pursue a career in equine surgery and completed an equine internship at the Royal Veterinary College, a short spell in equine ambulatory practice, and an equine surgery residency at the University of Bristol. She has obtained RCVS certificates in equine practice and large animal diagnostic imaging, and became a Diplomate of the European College of Veterinary Surgeons in 2020. After a period working as an Academic Clinician at the University of Glasgow, Victoria joined the Liphook Equine Hospital surgery team in March 2020.
 
Outside of work, Victoria enjoys exploring the local area with her labrador Elsie, and she continues her commitment to the Armed Forces as a reservist.

Covid-19 Update

Just to reassure everyone with samples they wish to submit that we are still offering a full laboratory service. Our protocols have changed considerably in view of essential measures regarding coronavirus, but the only change you might notice is the telephone system will divert to various admin staff working from home now so please allow a few more rings than normal. We are all in close communication using remote means and will be able to deal with queries as well as samples as normal. I hope you are all managing at this difficult time.

Covid -19 & Liphook Equine Hospital

Covid -19 & Liphook Equine Hospital

We appreciate that with the spread of the Covid-19 pandemic through the UK that this is a worrying time for everyone. As the prevalence of the virus increases in the UK, we want to reassure you that we are taking precautions to ensure that we can continue to be available to look after our equine patients.

So what are we doing?

Ambulatory Vets

  • We are minimising contact between our ambulatory vets and other hospital staff so that if one of them falls ill, the risk of everyone else falling ill at the practice at the same time is minimised. Our ambulatory vets are working out of vehicles as normal but are basing themselves at home, with only essential trips into the hospital to restock their cars
  • Biosecurity is not a new concept for us in the equine industry, as many of you are only too aware, and so we continue to ensure that our strict biosecurity policies are maintained

Hospital

  • We will be asking office-based staff to work from home
  • We are aiming to reduce the number of personnel visiting the hospital. We  request that the number of people coming into the hospital with a horse is minimised and we will be doing more communications via telephone and email to avoid face-to-face contact
  • Enforcing social-distancing between staff and staff and clients as much as possible
  • Clients will be asked to wait in their cars or lorries rather than sit in the reception area
  • Visits to inpatients will be via prior appointment only
  • We have ensured that sufficient veterinary supplies are in stock and have a contingency plan to ensure that that continues

How can you help us?

  • We will be asking all clients requesting a visit to and visitors to the hospital a few basic questions to ensure that we are not exposed to unnecessary risk e.g. questions about recent travels; whether you feel unwell; whether you have been in contact with anyone else who is unwell. We are still happy to attend your horse but may have to take some extra measures to safeguard all involved
  • We would also be grateful if the number of personnel “horse side” is minimised where possible – it is difficult to screen unexpected “visitors” before we arrive thus potentially creating unnecessary risk for all
  • Please make sure you use the hand sanitisers available when you visit the hospital. Frequent hand washing is one of the most effective measures we can all take to protect ourselves and each other
  • If your health status changes AFTER a visit or appointment is arranged, please let us know
  • If you need to come to the  hospital for any reason (eg collect medication) please call ahead so the necessary precautions can be taken
  • We would like to avoid cash payments wherever possible so please bring you bank card for payment

 

As the current situation is rapidly changing, we will keep you updated with any changes as they occur.

 

Liphook Equine Hospital Open Again

We are very pleased to announce that the final set of test results from the horses at Liphook Equine Hospital have all come back perfectly clear.

Although we took the cautious step of temporarily closing our hospital to ensure no risk to the wider equine community, we are now fully confident that there is no infectious threat from either the hospital or the horses that have been staying here. Consequently the Hospital is now open again for business as usual.

We thank all of our clients and our veterinary colleagues for their understanding, support and patience over the last couple of weeks and of course to the team at Liphook who have worked so hard to ensure this outcome.

We send our best wishes to everyone at other yards currently awaiting test results. Please continue to follow the advice of your own veterinary surgeon regarding your personal circumstances.

8th January 2020 – Isolation of horses at the Liphook Equine Hospital

On the afternoon of Wednesday 8th January, a case of Equine Herpesvirus 1 (EHV-1) was confirmed at Liphook Equine Hospital. The single horse was managed in the Hospital under isolation conditions between the evening of the 6th January and the afternoon of the 8th January, when the horse returned home. Tests from the confirmed case revealed a very low level of virus. Some other horses on the yard from which the horse came have also developed symptoms indicative of an infectious viral disease caused by EHV-1 and known as equine herpesvirus myeloencephalopathy or “neurologic EHV”. Although not common, this disease is well recognised in the UK. We must remain vigilant about the possibility of transfer to other horses staying in, or visiting, our hospital who could contribute to further spread of the virus to horses elsewhere.

EHV-1 infection is governed by a voluntary code of practice that dictates that all movement of horses should cease while investigations take place. Thus, for the time being, all movement of horses both on and off the premises has ceased and we have chosen not to accept cases at Liphook Equine Hospital other than local life-threatening emergencies. We have contacted everyone who had a horse in the practice during this period and are confident that every precaution has been taken to implement appropriate containment measures. We remain hopeful that the period of isolation will not be prolonged, but this depends on further developments and laboratory testing.

Work by our ambulatory vets on the road will continue as normal and there will be instances where our veterinary specialists may be able to attend your horse at your premises or at a local practice in order to continue to provide services including elective surgeries, lameness investigation, gastroscopy and other diagnostic procedures. We are grateful to our veterinary colleagues in local practices who are working with us in the most productive and supportive way. Emergency referral admissions will be considered on an individual risk/benefit basis.

We believe our bold actions are essential for us to deliver on our commitment to observing biosecurity measures and to ensure the welfare of our patients and the wider horse population. We very much appreciate your understanding, patience and support during this challenging period. Please do call to discuss your individual requirements and we can run through options available to you.

For what to look for in cases of EHV-1 please see below:

Early signs of EHV-1 infection in horses are often just a fever with dullness and poor appetite. Respiratory signs such as a runny nose or cough might also be seen as well as enlarged glands under the jaw. In rarer instances more serious symptoms can develop such as abortion and abnormal neurological signs. If they develop, they frequently involve weakness and wobbliness of the hindlegs and tail and difficulty passing urine or faeces, although other odd behaviours are also possible.

Essentials of Equine Practice course: Friday 19th June – Sunday 21st June 2020

Do you have any members of the practice that would be interested in attending our Essentials of Equine Practice course?

This is a 3-day residential course held at West Dean College, Chichester, and at  Liphook Equine Hospital. The course is aimed for recent graduates and more experienced colleagues wishing to refresh their knowledge of general equine practice. The course is also suitable for final year veterinary students. The course focuses exclusively on what you need to know in ambulatory equine practice and has a very practical emphasis.

There is a charge of £495 which includes 2 nights’ accommodation, food and entertainment for all 3 days.

For further information please click here

If you would like to book a place (or places), please complete a booking form. For further information please email tasha.wilson@theleh.co.uk

VetPD 2-Day Wetlab: Ultrasound of the Equine Upper Limb, Neck, Back & Pelvis at Liphook Equine Hospital – 11th – 12th February 2020

VetPD 2-Day Wetlab: Ultrasound of the Equine Upper Limb, Neck, Back & Pelvis at Liphook Equine Hospital

11th – 12th February 2020

Early Booking Discount – Deadline: 5th January 2020

For more information, please click here.

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What our clients say

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We have been a client of LEH for nearly 30 years. From minor wounds to major surgery LEH have provided us with highest quality care. From the receptionists, nurses through to the surgeons and road vets who run our monthly clinics we have always received a friendly, helpful and professional service.

— Caroline Ewen, Hewshott Farm, Hampshire