Specialities
Dr Felipe Corrêa is an equine surgeon with an extensive experience gained from working in leading practices and universities in Chile, Canada, South Africa, Egypt and Estonia, as well as externships in Brazil, United States, Italy and the United Arab Emirates. EMÜ Equine Clinic has the equipment and the latest in technology in the surgical suites, anesthesia rooms, recovery stalls and treatment rooms enable our surgery staff to achieve superior results in soft-tissue and orthopedic cases. The hospital is equipped to undertake any recognized surgical procedure and can boast one of the busiest surgical caseloads in the country.
Orthopedic surgery
Arthroscopic intervention
Selected when minimally invasive approaches will allow for correction of the abnormalities. A small 4 mm scope attached to a camera is inserted into the joint and while the joint is distended with sterile fluids the surgeon can remove the diseased tissues. This form of surgery is considered one of the safest techniques in equine surgery with complication rates as low as 1 in 100,000 cases. With the magnification provided from the scope this type of surgery allows the surgeons at the EMÜ Equine Clinic to perform very precise procedures.
Arthrodesis techniques
Some fractures require radical open repair to help provide a good quality of life. While these types of repairs do not allow the animal to be athletic they are designed to allow the animal a comfortable life and breeding potential.
Soft tissue surgery
The major disciplines in equine soft tissue surgery are abdominal surgery and airway surgery. Other common types of soft tissue surgery include urogenital surgery, and cutaneous (skin) tumor removal.
Abdominal (Colic) surgery
Colic is one of the most common life-threatening abnormalities seen in horses. The EMÜ Equine Clinic is a premier regional facility for treatment of these conditions. We employ a team of surgeons with experience in the treatment of colic from simple displacements to aggressive small and large intestinal resections.
The equine general surgery service provides both elective and emergency care. We work as part of a team with a broad range of specialists including anesthesiologists, internists, dentists, radiologists, and other areas to ensure our patients receive the most comprehensive care possible. Our experienced staff provides nursing care 24 hours a day.
Dystocia
Dystocia describes difficult foaling. The condition is life-threatening for both the mare and foal. Upon arrival to the hospital the team starts to work immediately. This problem usually can be solved with the mare standing under sedation. But If not possible to be resolved, surgery Is Indicated. Whilst the surgeon makes an initial assessment, the team prepare the mare for general anesthesia and surgery so that no time is wasted if it is needed to proceed with either. Most mares presenting to the hospital will be anaesthetized and attempts made to deliver the foal. If progress cannot quickly be made, progression to surgery follows for caesarean section. Once the live foal is delivered the medicine team work to revive the foal and further assess requirements for ongoing treatment and care.
Laparoscopic intervention
Laparoscopic techniques use minimally invasive techniques to explore body cavities. These techniques use a 10 mm telescope that can be inserted into the body. While the horse is distended with sterile gas the scope can be used to examine the contents of the body. These techniques are used to remove retained testicles in cryptorchid stallions, remove ovaries in mares, and explore the abdomen and chest to search for neoplasia. With the latest instrumentation in vessel sealing devices available in the clinic these laparoscopic surgeries are now safer to perform in a shorter period. These surgical advancements alleviate the requirement for general anesthesia in most cases, result in smaller incision sizes, and can result in a more rapid return to work.
Respiratory tract surgery
Upper respiratory tract conditions are a common cause of poor performance and exercise intolerance in racehorses and sports horses. At EMU Equine Clinic our surgeons perform surgeries on the larynx and pharynx to improve airway dynamics.
Epiglottic entrapment is one of the upper airway problems in athletic horses. Epiglottis is a lid covering trachea when the horse swallows. In normal situation it is positioned on the soft palate, allowing breathing through the nose only. Its´ entrapment can be expressed as poor performance, roaring sound at high speed, cough (especially when eating) and epistaxis (blood from nose). The route of problem lies in epiglottis getting stuck under a certain mucous membrane fold and thereby being in abnormal position. The mucous membrane fold gets stretched out and injured at intensive breathing, which can cause bleeding.
Epiglottic entrapment can be managed by a simple surgical procedure using a special hook to transect the mucous membrane fold and free the epiglottis. Most often the horse can compete successfully after the surgery.
Equine General Surgery
*Urogenital surgery including routine and cryptorchid castration, ovariectomy, cesarean section, repair of foaling injuries, treatment of penile injury or neoplasia
*Sinus surgery for cysts, neoplasia, dental disease
*Wound management and reconstructive surgery
*Therapy for skin tumors including equine sarcoid, melanoma, squamous cell carcinoma
* Thoracic surgery (chest wounds)
Whether your horse requires routine elective surgery, emergency surgery, ‘key-hole’ procedures (laparoscopy), our hospital is staffed and equipped to provide the expertise and technology to ensure the best outcome.
We work in a collaborative environment that brings together a diverse group of veterinary specialty services including Anesthesiology, Internal Medicine, Farrier Services, Imaging, and Clinical Nutrition to provide comprehensive veterinary care for your horse.
In the Estonian University of Life Sciences equine clinic, we have a team of veterinarians providing anesthesia service for equine patients undergoing general anesthesia and sedation for a variety of diagnostic and surgical procedures. Each horse gets an anaesthesia protocol prepared depending on their character and the procedure being performed.
General anaesthesia
During surgeries sophisticated monitoring equipment, anesthesia machines equipped with controlled mechanical ventilation capability and safest medications are used to minimize the anesthesia risks. The hospital is also equipped with a padded recovery box to reduce the risks associated with the recovery process.
Sedation
For a lot of procedures standing sedation with a local anaesthesia is sufficient to provide enough restraint and analgesia for the patient. It is safer for the patient and if possible, is always preferred to the general anaesthesia. For example, sedation is used for the oral examination, x-ray examinations, and surgeries.
Pain management
Pain is monitored and management plan is made accordingly for each patient going through a surgical procedure or being admitted to the clinic with a painful condition. Adequate pain management is important for horse’s well-being and to avoid any further complications that can arise from a long-term untreated pain. Pain can be managed with different type of medications and adjunct therapies (cold therapy, physiotherapy, laser treatments).
The staff of the internal medicine service are responsible for the diagnosis, treatment and management of all equine medical disorders. A comprehensive range of advanced diagnostics are employed enabling the targeted treatment and management of medical conditions affecting any body system (respiratory, renal, hepatic, cardio-pulmonary etc.) arising from a wide range of causes from athletic activity to infectious disease. They also provide clinical support to the Hospital’s surgical team ensuring the provision of the best possible veterinary care for every patient.
General internal medicine
The internal medicine department routinely diagnoses and treats all medical conditions that affect horses. Most commonly, these include gastrointestinal and respiratory problems.
Among gastrointestinal problems, colic occurs the most commonly. Colic is a broad term used to describe abdominal pain. This can mean anything from gastric ulcers to a large intestinal impaction or even a displacement or torsion. In any horse presenting with colic, a thorough diagnostic evaluation is undertaken to determine the cause. This includes blood sampling, rectal examination, abdominal ultrasound evaluation, and, if needed, additional diagnostics, such as gastroscopy, abdominal radiography or peritoneal fluid sampling. Colic patients are managed medically or, if surgery is indicated, referred to our surgical team.
Respiratory diseases commonly manifest themselves as cough, nasal discharge or labored breathing. Horses are prone to develop various respiratory illnesses. These range from simple respiratory viruses to a severe bacterial pneumonia. The most common non-infectious respiratory disease is equine asthma syndrome. Airway diagnostics include blood samples to determine the presence of an infection; airway sampling is required to determine if there are infectious agents present; and deeper airway sampling (bronchoalveolar lavage) is performed when there’s a suspicion of equine asthma syndrome. Airway endoscopy is a valuable tool for visualizing both upper and lower airways. That way, the origin of nasal discharge or a loud respiratory sound can be determined.
Other, less common medical problems include kidney diseases, urogenital problems and hepatic diseases.
Any patients that require more intensive diagnostics or treatment are housed in the hospital stalls. There, all necessary monitoring and treatments can be undertaken.
Dermatology
Skin conditions can be diagnosed at the stable or in the clinic. Thorough diagnostics is essential to determine the cause of the problem. This includes a thorough clinical examination, skin scraping for cytology and culture, skin biopsies to investigate deeper reaching skin conditions, and sometimes also allergy testing if there is a suspicion that the condition is allergic in nature.
Infectious Diseases
The most common infectious diseases affecting the equine patient are respiratory tract infections and gastrointestinal tract disturbances. For the safety of other patients, any horse with a suspected or confirmed infectious disease is isolated from others. For this purpose, the Equine Hospital has a dedicated isolation unit which is equipped with separate boxes. There, it is possible to undertake all necessary diagnostic procedures and provide treatment, including intensive care.
Ophthalmology
The most common problems affecting equine eyes are corneal traumas resulting in ulceration; conjunctivitis and uveitis. For simple problems, a stable visit and at home care may suffice. More complicated cases require hospitalization. For frequent administration of medications, a sub palpebral lavage system is placed. For complicated cases, including more complicated surgical procedures, the internists in the clinic regularly consult with Dr. Andžela Lehtla, DVM, a specialized veterinary ophthalmologist.
Cardiology
Conditions affecting the heart, such as murmurs or arrhythmias, are rare in horses. However, when they do arise, specialist evaluation is needed to determine the nature of the problem and the implications for the horse’s intended use. The Equine Hospital is extremely lucky to be able to use the services of a certified veterinary cardiologist. Dr. Paul F. Mõtsküla, DVM, PhD, DipECVIM-CA, European specialist in veterinary cardiology, will provide his invaluable insight and knowledge in all matters of the equine heart.
Neonatal Medicine
Neonatal medicine deals with the youngest of patients: newborns and young foals up to 2 weeks of age. Newborn foals can be affected by many life-threatening conditions such as prematurity or dysmaturity, perinatal asphyxia syndrome or sepsis. All of these require comprehensive diagnostics which include a full blood panel, ultrasound and radiological examination, and miscellaneous other tests, and intensive monitoring and care. Foals that require intensive care and round the clock monitoring are kept in a separate small stall next to the mare. That way, the mare is still in contact with the foal, while the foal is receiving all the care it needs. For any orthopaedical or surgical problems such as angular limb deformities or septic arthritis, the medical team works closely together with the surgeons.
Routine Dental Examination and Dental Rasping
Horse teeth "grow" (emerge from the bone) throughout the entire horse's life. Sharp edges are commonly formed due to the normal side-to-side movement of the jaws while eating. Various other irregularities and sharp points can occur, especially when the occlusion of the horse is not ideal. All horses need oral examination and, if necessary, rasping at least once a year. Old and young (2 – 6 years) horses or horses with known problems should have their teeth checked more often. Contrary to common belief, problems cannot be ruled out based on a horse's good body condition and appetite.
In our clinic, we perform comprehensive oral examinations with dental rasping for all types of horses. All of our oral examinations are performed on a sedated horse using a mouth opener. This is to ensure the safety of the horse and people around the horse, and to carry out thorough inspection that otherwise would not be possible.
To find a solution that suits the best for the treatment of a specific horse, we can use different types of hand rasps and motorized equipment. As an additional diagnostics, oral endoscopy and dental radiographs can be used. In addition, computed tomography can be used for foals and miniponies.
We can also visit your stable for routine dental work. To carry out the procedures in your stable, at least a shelter is needed to allow fixing the horse during the procedures and afterwards as due to the sedation horses must be withheld from feed for 2 hours. Water source and electricity should be nearby to allow us to work smoothly.
Removal of Wolf Teeth
In our clinic, we remove wolf teeth routinely. Removal of wolf teeth is performed using sedation and local anesthetic. Wolf teeth can be removed at any age, but removal at age 1-2 years is preferred as removal is easier and risk of breaking the root is less more likely. This also allows wolf teeth to be removed before horses are in full work and gaps in training can be prevented. Gingiva usually heals very fast and does not need any special care besides not using bit for 14 days.
„Blind“ wolf teeth also occur. It means that they are present, but not erupted from gingiva. As their location is bit further away from other premolars, they are more likely to be in contact with the bit and cause problems because the gingiva can be crushed between the tooth and bit, causing pain for the horse. We can diagnose non-erupted wolf teeth by examining the horse and if necessary, use additional diagnostics as radiographs to make sure their location and other characteristics to aid the removal.
Tooth Extraction
Tooth extraction is usually indicated after tooth fracture and/or tooth root infection. Most commonly, procedure is done in standing sedation using constant rate infusions and local nerve blocks. Horse is fixed in stocks and head placed on the headstand. We have experienced anesthesiogists available to monitor the horse throughout the procedure.
Tooth extraction can last for several hours during which tooth is loosened and finally extracted.
Older horses often have loose teeth due to the fact that the teeth have been worn throughout the life and there is no longer enough tooth left in the gingiva to offer the stability for the tooth. Loose teeth can cause horse a lot of pain as they move while horse is chewing. Eating slowly, turning the head while eating, dropping food and losing weight can be signs that there is a problem.
In our clinic, we can perform all the necessary diagnostics to make sure whether a tooth needs to be extracted and we are equipped to perform extractions for multiple indications.
Treatment of Diastemas
A diastema is a space between two teeth that causes the food to be entrapped.
Diastemas can cause pain themselves and also lead to other painful conditions for the horse. As a result, horses with diastemas often have problems with weight loss due to not eating well or not using the feed efficiently. Half-chewed rolls of hay can also be noted.
Feed that gets stuck between the teeth becomes rotten and irritates the gums, which leads to gingivitis. Bad smell from the horse’s mouth is often present.
There are several types of treatment for diastemas and the treatment of the individual horse will depend on several aspects, including the characteristics of the diastema and the consequences of the condition. Regardless the chosen treatment method, diastema has to be properly cleaned every time an oral examination is performed.
If inflammation can be reduced, then allowing the teeth a time to move together, may be all that is needed for a diastema to disappear as horse's teeth can move closer to each other over time. Rasping a tooth can also have an enormous role for diastemas to resolve as often the tooth opposite to diastema is excessively high and pushes the feed material into the diastema and prevents diastema from closing. Reducing the height of this opposite tooth is very effective in this case.
Another treatment option is to make the diastema larger. The aim is to make the space between teeth large enough for the food to pass through instead of getting stuck. Alternative is to keep the horse on a diet that does not allow feed material to get stuck.
In some cases, tooth extraction can be the only option. Radiographs can be very useful to help with deciding about which tooth to extract.
Amongst everything else, our veterinarians always check the horse for the presence of diastemas during routine oral examinations. If diastemas are found, suggestions for management of specific case will be provided.
Treatment of Periodontal Disease
Periodontium is a complex of structures in horse’s mouth that’s purpose is to secure the tooth to the jaw.. Normally, these structures are well protected by horse’s normal defenses, but certain feeding practices or other diseases (diastema) can cause a periodontium to break down and gum line to recede which forms a periodontal pocket and weaken the attachment of the tooth. Periodontal disease is very painful condition for horse and the most common cause of premature tooth loss in horses.
Early recognition is very important to treat the disease and prevent tooth loss. Quite often horses do not present any signs until the disease is very severe. In this case dropping half-chewed feed, weight loss, bad breath, and issues whilst being ridden can be seen.
Amongst everything else, our veterinarians always check the horse for the presence of periodontal disease during routine oral examinations which should be performed at intervals 6-12 months. If periodontal disease is found, suggestions for management of specific case will be provided.
Sports medicine service is a combined approach to health care of sport horses of any disciplines. Our team is committed to the comprehensive evaluation, diagnostics and treatment of horses. Sports medicine team works closely with other departments like diagnostic imaging, internal medicine and surgery. Once a diagnosis is established, the choice of therapies is focused on the injury and problems of the horse.
We develop an individual treatment and rehabilitation program based on the horse’s health condition and client's possibilities to manage the plan. The clients are encouraged to be fully involved in the rehabilitation program to give the best possible outcome for the patient.
Lameness Evaluation
Lameness is one of the most frequent problems that affects any type of horses. Before any treatment can be initiated, it is most important to find out the reason of lameness. It means first localizing the problem and then determining more exact cause. This can be quite labour- and time consuming, often demanding different diagnostic approaches with or without sophisticated diagnosing devices but also circumstances for performing sterile manipulations such as intra-articular injections.
We are able to perform lameness examination of the horse moving on different surfaces indoors and outdoors, flexion tests, local nerve blocks and diagnostic intra-articular injections, radiographic and ultrasound diagnostics.
Because of good premises and qualified staff those procedures can be made with maximum care and safety but also with maximum comfort and minimal time loss.
The basis for the lameness examination is an accurate history from the owner or trainer, including Information such as the nature and duration of the problem, how the performance has been affected and if there’s any treatments have been used.
This will be followed by a visual examination at rest and in motion, careful palpation of anatomical structures, observing movement at various gaits, sometimes it is essential to see the horse riding or working with tack, flexion tests, nerve blocks to localize the region of pain, laboratory tests if there is suspicion of underlying causes (inflammatory markers, muscle enzymes, etc.).
Once the lameness has been localized, diagnostic imaging will be used for most sports medicine lameness related problems: radiography (x-rays), ultrasound
Treatment decisions are influenced based on the level of pathology in the affected tissues.
Tendon and Ligament Injuries
Tendons are fibrous structures connecting the muscles with bones. Ligaments are also of fibrous built but they are meant to stabilize the locomotory, connecting different bones and fixing the joints in right position.
Tendons and ligaments of horse carry a huge workload and get frequently injured. Injuries can be from slight distensions to full ruptures. Typical symptoms of tendon distension are swelling, heat and lameness, severity of which depends on a degree of trauma. In more severe cases the limb looks deformed.
The most informative tool for diagnosing tendon and ligament injuries is ultrasound evaluation. Treatment includes cold procedures for first aid, rest, anti-inflammatory medication and depending on trauma, PRP (platelet rich plasma) or stem cell introduction into lesion cavity. Sometimes the affected limb has to be fixated with cast.
Because of poor blood supply, the healing of those fibrous structures takes a long time varying from 4-6 months to one year or more.
We create a suitable rehabilitation program for your horse. During this period, several follow-up examinations are performed at regular intervals to monitor healing process.
Joint Injuries
Joint is a special structure connecting bones together and allowing movement between them.
Because of their mobile character, joints are prone to distensions and luxation.
What we often see in horses is degenerative joint disease or osteoarthritis. It can be of traumatic in origin but in most cases, it is caused but wearing out the joint cartilage because of workload or degenerative process. Arthritic joint gets painful and, in more severe cases, deformed. Normal mineral metabolism around the joint and in subcartilaginous bone becomes disturbed. The cartilage gradually disappears and the body tries to compensate it. As the result of this the excess bone is modified, the joint becomes more and more rigid and loses its function as a joint. Affected joints cannot be replaced in horses.
Degenerative joint disease can be managed to some extent with intraarticular treatment with different medicines. Most often we use corticosteroids and hyaluronic acid but also PRP (platelet rich plasma) and stem cells can be used. In some cases, tiludronic acid can be helpful.
Intraarticular treatment allows the horse to function better than without it but does not stop the degenerative process or turn it back. As last option arthrodesis or joint fusing can be performed. It means connecting the bones that form the affected joint thereby making it immovable. Arthrodesis can be used in joints that have originally little mobility so making them immovable does not affect horse's quality of life too severely.
Neck and Back Problems
Neck and back problems in horses are possible cause of lost performance in almost any types of athletic horses. Many of these problems in horses are related to longstanding injuries. Also, it is common that there is more than just a one spinal lesion causing pain and poor performance. Owners often mention hindlimb lameness or stiffness and loss of impulse when ridden.
Diagnostic protocol for the evaluation of horses with potential neck and/or back problems include:
• History
• Clinical examination
• Visual examination at rest and in motion (often neurologic evaluation included)
• Diagnostic imaging (radiography and/or ultrasound)
• Laboratory tests if needed
• Additional diagnostics if needed
Medication and treatment options for neck and back lesions in Estonian University of Life Sciences are:
• Medical management (systemic or intra-articular)
• Mesotherapy
• Physical therapy
• Surgery
An individual treatment and rehabilitation program and instructions for owners is always included.
Other related conditions
In cooperation with internal medicine department, we are also able to investigate the upper/lower airway function and cardiovascular system of sport horses more widely.
Diagnosis of different joint problems is established by clinical signs and most often with help of radiographic examination. Normal radiograph does not always mean the joint cannot be painful and radiograph with pathological findings does not always mean this is the source of the problem.
Wounds
Wounds of different location, origin and severity are common part of horse clinic´s working day. Horses can get wounds being in paddock, during competitions or even just standing in the box.
More serious wounds need to be stitched under general anesthesia, easier ones get managed on standing horse. Horses needing aftercare can be left in hospital for as long as needed.
Bone fractures
Bone fractures must be taken into consideration whenever lameness examination is performed. Broken bone in horse does not always mean non-weightbearing limb. It can be expressed as mild lameness and might be hard to find even on the radiographs.
Fine fissures of bone can cause intermittent lameness. The horse can be lameness-free one day and, if exercised, non-weightbearing the next. After some days of rest, lameness can improve again until the fissure becomes a fracture and lameness will be permanent.
Depending in case, the purpose of horse and the plans of horse owner, fractures can be treated by rest, special shoeing, casting or osteosynthesis.
In severe cases unfortunately, euthanasia is the only option.
Our first opinion equine veterinarians can provide a comprehensive range of on-the-stable visits and health evaluation. They are all experienced, dedicated and offer high quality, personalized mobile services for you and your horse.
Appointments are available Monday through Friday from 9 a.m. to 4 p.m., while emergency service is provided 24 hours a day, year-round.
We provide on-the-stable routine healthcare as well as evaluation and treatment of sick animals. Provided routine healthcare services include: annual examination, vaccination, parasite control, nutritional consultation, and dentistry. In addition to these, the ambulatory service provides lameness and performance evaluation, evaluation of medical conditions (respiratory, skin, neurologic, gastrointestinal, and ophthalmic), and field surgery services (castration, laceration repair etc.).
We also have access to additional in-house equipment and full access to EMÜ laboratory services. Any more complex cases can be referred quickly to our equine hospital where your horse will have direct access to our specialist veterinarian, equipment and facilities.
The veterinarian's role is to provide information to the purchaser on the health status of the horse and to help to make a well-informed decision to buy a horse based on the uncovered information. A pre-purchase evaluation is not a warranty of future soundness and the conclusive decision on the purchase of the horse resides with the buyer. A pre-purchase examination can only give information about the horse`s health and condition on the day of the examination.
It is common to find some problems in the athletic horse. The next step is to find out the possibility how much will this clinical finding impair athletic performance.
Part of a pre-purchase examination Includes a general examination as well as a musculoskeletal evaluation. Additional test can be performed upon request of the client.
General examination
• Identification
• History of the horse (Seller`s information)
• Complete clinical examination
• General ophthalmological examination
• Laboratory analysis: Complete blood count, biochemistry profile
Dynamic examination
• Short neurological examination
• During walking and trotting in a straight line and on the lunge
• Flexion tests
• The horse under saddle if possible
If the horse demonstrates any significant abnormality or lameness during examination, the buyer and seller will be communicated. At this point there is the possibility to discontinue the examination if decided so.
Imaging
There is complete set of images we recommend for pre-purchase examinations. The set of images can always be expanded as needed.
Dental evaluation
We also check the horse's mouth and dentition, if arranged in advance.
Interpretation of radiographic findings and written report are included in pre-purchase examination.