Monthly Archives: October 2010

New MRI machine brings CUHA to the forefront of medical imaging

CUHA has upgraded its Magnetic Resonance Imaging (MRI) capability, offering unprecedented opportunities for advanced medical imaging. As part of the Janet L. Swanson Imaging Suite, the MRI and the recently installed 16-slice Aquilion LB CT scanner mark a huge leap forward in the Hospital’s clinical and research capacities, continuing CUHA’s commitment to innovation.

New System Features
The 1.5T Toshiba Vantage Atlas MRI scanner employs a high-field magnet capable of scanning any animal up to the size of a large dog, some large farm animals, and the limbs or heads of horses. A moveable table allows an anesthetized horse to be brought close enough to the magnet to scan those parts that can be pulled into the bore. Most veterinary colleges have similar systems though this model has the latest software and hardware available at 1.5T field strength. It is a “work-horse” scanner in the human imaging field.
“The exceptional detail and clarity of the image quality make it easier to diagnose more accurately,” says Dr. Peter Scrivani, radiologist at CUHA’s imaging department. “We are able to get more information about the patient’s health and disease status during the same length of examination, because the image acquisition time is shorter and the new scanner has additional functionality. The extended clinical applications offer a major advancement. We expect to use the machine mostly for neuroimaging and musculoskeletal imaging, and there is potential for thoracic or abdominal applications.”

Scanner Facility
Summer renovations at the Hospital ensured that the MRI can be operated with optimal efficiency and safety. The control room provides easy viewing of the scanner and patient and connects to a fully equipped anesthesia room for small animals. Equine anesthetic induction and recovery stalls are adjacent to the scan room. A large door at the back of the exam room opens directly to the large animal hospital, making it easy to accommodate imaging needs for equine and other large animals. A full complement of MRI-compatible monitoring equipment keeps anesthetized patients stable throughout the exam.

Available Services
The Toshiba MR and CT scanners comprise the Janet L. Swanson Imaging Suite and are now operational and available for CUHA patients by referral. Small animal MR scans are available daily. Horse scanning is progressing and protocols are under development. Veterinarians who would like to discuss the use of these modalities for their patients are welcome to contact the Imaging Section at the CUHA for advice and referral information. Please call 253-3060 for appointments or -3241 to have a radiologist consultation.

Diagnosis on the run

Athletes of all kinds use exercise machines to evaluate and improve performance, but it’s a rare machine that can handle the world’s largest and fastest athletes. Horse trainers and referring veterinarians can bring race horses to Cornell’s Equine Performance Testing Clinic, where a horse-sized treadmill, an array of examination equipment, and a team of seasoned technicians and surgeons work together to evaluate the performance of equine athletes. The Clinic’s treadmill can bring horses to racing speeds of up to 40mph while allowing veterinarians to examine patients under the same strain they experience on a race track, revealing problems that may otherwise be difficult to diagnose. Since its inception in 1989, the Clinic has run over one thousand horses in a safe, weatherproof indoor environment, using the treadmill as a diagnostic tool to find causes of poor performance and determine better ways of treating them.

The Clinic is equipped to examine a wide variety of problems, including upper and lower respiratory disease, neurological issues, high-speed lameness and orthopedic problems using flexion tests and gait analysis, and cardiac abnormalities such as arrhythmia using EKG, blood gas analysis, and exercising ultrasound. Upper respiratory problems comprise the bulk of cases, including issues such as pharyngeal collapse, palate displacement, laryngeal paralysis, and epiglottal entrapment. Video endoscopy can examine the upper respiratory tract while a horse is running. Sound spectrograms can reveal acoustic abnormalities during inspiration and expiration, and airway pressure determination and airflow analysis may indicate airway obstructions during exercise.

An internist, a cardiologist, and several technicians and equine surgeons comprise the Clinic’s team, which has found that the majority of upper airway problems can be managed with surgery if diagnosed early. Headed by Dr. Norm Ducharme and Dr. Jon Cheetham, the group investigates ways to diagnose diseases more accurately while expanding the toolbox of techniques for their treatment. Several projects have had immediate clinical impact, while others may have future applications in human medicine.

Research Highlights:

–Laryngeal tie-forward treatment: a widely-used surgical procedure developed at the Clinic in 2001 to treat palate displacement with an effectiveness of 80-85%.

Cornell Collar: an external device developed at the Clinic and patented by Cornell, providing a non-surgical alternative treatment for soft palate displacement.

Laryngeal Pace-Maker: an electrical implant placed into the muscle or around the nerve to stimulate the muscle to open the laryngeal cartilage (aretynoid) during exercise.

In addition to major innovations, the Clinic’s research has made improvements in several existing equine surgical procedures including laryngeal tie-back, suture replacement, bone cement, and post-surgery stabilization methods. The recently developed laryngeal pacemaker device is currently being tested on race-horses in Europe for regulatory approval, and investigations are underway for possible applications to humans with laryngeal paralysis or transplants.

The Equine Performance Clinic works in partnership with local veterinarians to understand problems with horses and how their clients want to address them. Horses have come from as near as New York’s Equine Alley and as far as Ohio for performance evaluation and diagnosis. If you would like to schedule an evaluation, contact the Clinic or visit the website for more information.

Large animal care manager helps horses at work and home

“This is Wicked Love,” says Cameron Gurney with a quiet smile as he guides a handsome yearling to reveal its shaved underbelly. You wouldn’t guess that belly was missing ten feet of large intestine; the formerly emaciated thoroughbred looks remarkably healthy after his second colic surgery. Soon he will return to Gurney’s family farm in Cazenovia, NY, where Gurney, his wife, and two daughters work together to breed and show their horses.

Gurney’s confidence and ease with horses show in every step through the barns he supervises, from navigating halls of students trotting animals to handling horses in the stalls. As Manager of Large Animal Care, Gurney is in charge of supervising a staff of animal attendants and clinic aids, keeping the facility running, maintaining a clean environment, and implementing infectious case protocols when needed. His work ensures the health of the horses, giving the animals the best possible experience while in his barns.

“I’ve been in the horse business for 20 years,” says Gurney. “At Cornell we get all sorts of different breeds coming through, and many interesting cases I wouldn’t normally see. The people are very friendly, it’s a good atmosphere. Some professionals act guarded with information, but Cornell’s doctors are very open and engaging. Even out in the field they teach as they work. I’ve learned a lot through them about horse health and care.”

That learning carries over to Gurney’s home. His wife, Jennifer, is an accomplished equestrian whose passion proved infectious. The couple moved from Long Island to Cazenovia and built a successful breeding program from the ground up. Starting as a high school social studies teacher with no equestrian experience, Cameron ended up working with horses full time as business blossomed.

“Now I bring our horses here for surgery. We’re becoming a major client!” He laughs, but with a farm of 25 horses and more on the way, Gurney is in a good position to trade business with Cornell. His farm often takes in Cornell’s lay-up cases that need to be housed off campus, usually injured horses or horses in training. The Gurneys house them, monitor their health, and transport them to and from Cornell.

“We raced two young horses in Belmont last weekend,” Gurney says, patting Wicked Love encouragingly. “They took second and third. Their future is looking promising.” The future of horses in his family looks equally promising. Twelve-year old Ava is already winning prizes at shows, and her six-year-old sister Eliza Grace has just begun to show horses herself.

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A direct link

Trouble getting through to a specific doctor?  Not sure whom to contact about a particular need?  Having any sort of difficulty communicating with a Cornell veterinarian?  Kelly Skeval is the person to call.  She has recently been appointed Referring Veterinarian Coordinator, a new position dedicated to facilitating and improving relationships between Cornell’s Hospital for Animals and the referring veterinarians with whom it collaborates.

 

“CUHA offers a wealth of expertise and opportunities for partnership,” says Skeval.  “I’m here to support communication and integration with referring veterinarians in order to provide the best possible care to patients.  Veterinarians can come to me for troubleshooting or with any concerns regarding communication.”

In addition to facilitating live communication, Skeval examines communications systems already in place in order to improve them for maximum efficiency.  She has recently worked to implement a new streamlined fax system that gets information where it needs to be faster.  Faxes used to arrive at multiple locations, but now they all go to one line, saving time and reducing delivery error.

 

Skeval is uniquely suited for her role.  She has worked in veterinary hospitals since she was 14, earned her associates degree at Alfred State College, and worked as a veterinary technician for six years, including four years at Cornell.  Her dual experience in private practices and academia gives her insight into both worlds and opportunities for them to collaborate to offer the most appropriate medical care for the condition.  With her background as a veterinary technician, she can better understand cases and relevant terminology and can communicate clearly with veterinarians about their needs.

 

You can contact Skeval at the Hospital any time Monday through Friday, between 8:30 am and 5:00 pm with concerns or suggestions – anything Skeval says, from contacting a “scheduled-to-the-minute” doctor to finding the appropriate resources for a specific case.  Call the Hospital phone room at (607)253-3064 and ask to speak with Kelly Skeval.