Referral Services

Referring Veterinarian and Client Communication

Communication with the client regarding the services provided by the Piedmont Equine Practice can be handled by the referring veterinarian or Piedmont Equine, at the discretion of the referring veterinarian. Communication with the referring veterinarian is available via phone, fax or e-mail.

Surgical Services

Sarah Dukti, D.V.M., Diplomate* of the American College of Veterinary Surgeons, Diplomate of the American College of Veterinary Emergency and Critical Care manages medical and surgical colic cases, joint lacerations and infections. Dr. Dukti has been offering surgical services on site since June 2011, including emergency and elective soft tissue and orthopaedic procedures. Dr. Dukti and her team of interns and technicians provide 24 hour emergency surgery and critical care coverage.

We are also pleased to announce that Michael W. Ross, DVM, Diplomate of the American College of Veterinary Surgeons is available for elective orthopaedic surgery. Dr. Ross is the Director of the Nuclear Medicine Program, Professor of Surgery and Program Director of the Large Animal Surgery Residency Program at New Bolton. He brings with him a wealth of expertise.

Internal Medicine Services

Dr. Amy Polkes, DVM, Diplomate of the American College of Veterinary Internal Medicine provides internal medicine services at The Piedmont Equine Practice. A complete diagnostic work-up can be performed by Dr. Polkes at the hospital. Phone consultations with referring veterinarians are available at no charge, and estimates for services can be provided. All patients will be returned to the referring veterinarian for long-term case management.

Services include:

Detailed ultrasonographic evaluation of internal organs such as liver, kidneys, lungs and gastrointestinal system
Cardiac evaluation with electrocardiogram and echocardiography with color flow Doppler
Respiratory system evaluation for infectious respiratory disease as well as chronic respiratory problems including thoracic ultrasound, thoracic radiographs, BAL, thoracocentesis, and transtracheal wash
Neurological evaluation including cerebrospinal fluid analysis and cervical spine imaging
Gastrointestinal examination including gastroscopy, complete abdominal ultrasound, abdominocentesis, absorption testing, and rectal and duodenal biopsies
Urologic evaluation including cytoscopy and ultrasound
Ophthalmic examination including evaluation of difficult cases, tonometry, grid keratectomies, and lavage system placement
Complete evaluation of chronic diseases such as chronic weight loss, chronic colic, and chronic respiratory disease
In-house management for medical cases such as gastro-intestinal cases, respiratory cases, renal and liver diseases, and sick foals
Dr. Dukti and her staff are available 24/7 for any emergency, and provide 24/7 hospital coverage
There is a separate isolation facility at the clinic

Diagnostic Services

Many of the veterinarians at Piedmont Equine Practice devote considerable time to continuing education in the diagnosis and treatment of lameness and are members of I.S.E.L.P., the International Society of Equine Locomotor Pathology. This group is dedicated to developing and perfecting techniques to combine the use of ultrasound and radiography to diagnose soft tissue, bone and cartilage injury in equine joints.

The Piedmont Equine Practice’s advanced diagnostic imaging modalities include:

Nuclear Medicine - Bone scans are performed using a state of the art digital gamma camera manufactured by MiE. To learn more about nuclear scintigraphy click here.
Digital Radiography - An Eklin DR system and a Sedecal 500 ma x-ray generator produce high resolution images of necks, backs and shoulders in addition to the distal limb.
Digital Ultrasonography - Evaluation of soft tissue pathology is enhanced using a high resolution Biosound, Mylab50 and M Turbo ultrasound.
Interpretation of diagnostic images by a board certified radiologist is available often the same day or the following day due to our high speed internet transfer of diagnostic images.
MRI- referral to teaching hospitals for MRI scans available
Lameness Locator-by Equinosis is the culmination of almost 20 years of research on gait analysis at the University of Missouri's Colleges of Veterinary Medicine and Engineering with the support of the E. Paige Laurie Endowed Program in Equine Lameness. Lameness Locator objectively detects and quantifies body movement assymetry in a horse using small, wireless, body mounted inertial sensors and a hand- held tablet PC. Instrumentation of the horse is quick, easy and completely non-invasive. Data collection is in real time and veterinarians are free to perform their usual lameness evaluation routine without distraction. The Lameness Locator is a system that enables a veterinarian to objectively identify lameness in horses. The system provides an analysis that indicates where the horse is lame, an amplitude of the severity of the lameness, the limb or limbs involved, and the part of the motion cycle at which peak pain is occurring (impact, mid-stance or push off).

Lameness and Prepurchase Exams are available at the hospital or on the farm. The advantages of a hospital exam include:

experienced technical staff for handling horses when jogging and lunging so that clients may observe and discuss the veterinarian's findings
level asphalt jogging strip
multiple types of footing to enhance the evaluation of subtle and obscure lameness
60-foot round pen with all weather Terra 2000 dust-free professional arena footing for the safe lunging of all horses Footing generously provided by Attwood Equestrian Surfaces. Click here to learn more.
enclosed 20m x 40m sand riding arena for under saddle evaluations
packed stone dust and sand for lunging on firmer surfaces
diagnostic and therapeutic equipment readily accessible, sparing the owner the time and expense of multiple appointments to diagnose and treat

* NOTE: Please come to the prepurchase exam prepared to ride the horse being examined as part of the exam.

Therapeutic Services

High Energy Focused Shock Wave Therapy - A Sanuwave Versatron high energy focused shock wave unit is available. Click here to visit versatron.net
Bone Marrow Aspirate Concentrate (BMAC)
Stem Cell Treatment is under research at universities around the country for a wide variety of applications in equine medicine. One of the more encouraging developments to come out of this research is the use of bone marrow-derived stem cells to engender regrowth in tendon injuries. This state of the art therapy, available at the Piedmont Equine Practice, fosters the regeneration of soft tissue while maintaining tendon elasticity. Click here for more information
Platelet Rich Plasma (PRP) is a promising new treatment for tendon and ligament injuries in which blood from the patient is spun in a centrifuge to isolate plasma with a high concentration of platelets. The platelet rich plasma, or PRP, stimulates healing when injected at the site of injury. Introduction of PRP prompts the body to accelerate remodeling allowing for a swifter, more complete recovery.
Interleukin-1 Receptor Antagonist Protein (IRAP) is a treatment for synovitis (inflammation of the joint lining) and osteoarthritis. Trauma in the joint triggers the release of proteins harmful to cartilage. With this therapy a sample of the patient's blood is incubated and centrifuged to produce serum containing high levels of Interleukin-1 Receptor Antagonist Protein, or IRAP. When injected into the joint in question, IRAP prevents the inflammatory protein from binding with its receptor on the joint surface, thereby halting the cycle of pain and inflammation. IRAP is the only therapy shown to interrupt the progression of osteoarthritis.
Acupuncture is a treatment based on the Chinese theory that pain is caused by the blockage of energy flow, or Chi, in the body. In health the flow of Chi is smooth throughout the body. Injury or illness causes a blockage of the Chi. The blockages are detected by palpation and stimulation of specific acupuncture points all over the body, as well as physical exam and history. Acupuncture needles are inserted into specific points to relieve the blockage and restore the normal flow of Chi. In some cases the therapeutic effect can be augmented by transmitting a mild electric pulse through the needles. Acupuncture can be used to treat a variety of conditions, including lameness, neck and back pain, certain types of colic, and anhydrosis (insufficient sweat production).
At the Piedmont Equine Practice acupuncture is currently provided by Sean W. Bowman, D.V.M. Dr. Bowman incorporated acupuncture into his practice in 2001 after completing an intensive series of courses at the Chi Institute. Dr. Alexis Theiss completed the courses at the Chi Institute in 2009 and is qualified to practice acupuncture.
Chiropractic is the process of performing motion palpation to diagnose joint subluxations, followed by appropriate specific adjustments to restore normal function in the spine and surrounding soft tissue. Chiropractic is most commonly used to treat neck and back pain, but can also be helpful in some cases of obscure lameness or behavioral problems caused by mild back pain. A thorough lameness examination and report on the horse’s history are necessary to determine if the horse is a good candidate for chiropractic. During the exam the veterinarian will gently manipulate the horse’s spine to assess the flexibilty of the joints.
Chiropractic evaluation and treatment are provided by Joe Davis, D.V.M. and John Nolan, D.V.M. Dr. Davis and Dr. Nolan both achieved their certification by the American Veterinary Chiropractic Association after completing a 200-hour course entitled Options for Animals.
CEM quarantine is available at the clinic

* The title "Diplomate" refers to a veterinarian who is board certified in some veterinary specialty area. Board certified specialists commonly have 4-8 years of additional training after veterinary school which includes a 3 year residency. Residencies provide specific training in an area of specialization not available as part of a typical veterinary education. This process is strictly supervised by a national organization made up of those types of specialists and these colleges ensure consistency in training and adherence to high standards. Once the program has been completed, the resident must sit for and pass a rigorous examination. Only then does the veterinarian earn the title Diplomate and can be considered a specialist in that particular area.

Referral Services

In This Section