Practice building with Equinosis Q™
Integrating Equinosis Q™ into your lameness evaluation protocol
Incorporating objective lameness detection into your daily practice may at first seem awkward, time consuming, and perhaps a little intimidating. You have been doing subjective lameness evaluation your entire career, right?
What if Equinosis Q™ disagrees with what your eye sees? How do you process measurements your eye may not see? How do you explain the value of this device to your clients without undermining your expertise? These are all normal questions!
Interestingly, these questions share one common thread – self-confidence.
Utilizing an objective method to detect lameness should not be intimidating, it should be liberating. Like radiographs providing objective information on a painful splint. Like ultrasound providing objective information on a thickened SDFT. Using a tool that can objectively document the movement of the horse is incredibly liberating once you have the confidence to process this new information.
As veterinarians you are trained to have good palpation skills. You hone your eye to evaluate the subtleties of the lame horse. But you utilize technology every day that allows you to quantify what you feel, what you hear, what you suspect. Why should quantifying what you see be any different? That’s just good practice!
So where do you start?
Add Objectivity to Every Evaluation
One can certainly argue that the best way to get the most out of Equinosis Q™ is to put it on every case. Confidence performing any diagnostic or treatment method requires regular practice. If you only performed a complex ultrasound of the foot every once in a while, it may take you three times longer and you will be less confident in what you are looking at than if you were performing them on a regular basis. A skilled DVM or tech can instrument a horse in less than 3 minutes.
Evaluating lots of horses with Equinosis Q™ allows you to recognise normal from abnormal very quickly and to not get thrown by unusual results. Consistent use also allows you to more confidently assimilate the results to the rest of your clinical picture, even in situations where the results may differ from your subjective opinion. Most importantly, you will be able to draw conclusions more rapidly.
Integrating Equinosis Q™ into your standard lameness examination protocol rather than using it intermittently will prevent slowing down your evaluation process. It will eliminate a stopping point for discussion with your client each time you want to use the device rather than making it a routine part of your evaluations. Your clients will come to expect its use and will appreciate the added objectivity. Furthermore, adding the equipment after you have already performed your baseline evaluation creates redundancy. And attempting to add the equipment after you are four blocks into an evaluation is confounding. Spend the extra 3 minutes to instrument the horse and ensure your baseline evaluation includes the objective measures.
If you have a technician working with you, they can be instrumenting the horse while you are collecting history from your client. With an instrumentation time of 3 minutes, most techs will be waiting on you before you are ready to look at the horse!
Explain Equinosis Q™ to Your Clients
When your clients understand the technology and the objectivity it provides, they will appreciate your practice for using it. But how do you explain why it’s necessary when it wasn’t even available until recently?
Roland Thaler, VMD, DACVSMR, and ISELP certified practitioner, of Metamora Equine, USA, has been using the Equinosis Q™ for about 4 years. When asked how he communicates the value of the equipment to his clients he says, “I explain to my clients that there are two elements of the examination. There is the qualitative and the quantitative. I am still evaluating all of the qualitative elements of the horse – its movement, propulsion, fluidity… those esoteric components we all look at. But then there is the quantitative part of the exam – Equinosis Q™ is doing its thing while I am doing mine.”
Dr. Thaler added, “When you are enthusiastic about something, your clients are quite interested and intrigued.”
When asked about whether or not the Equinosis Q™ saves time, Dr. Thaler says, “I would say it reduces the amount of time doing blocks, in that I am not guessing if the horse is better or not. I move on more quickly. It also gives me confidence to continue blocking up a leg. For instance, I had a case where a forelimb lameness appeared significantly better with a PDN. However, Equinosis Q™ reported only 37% improvement. Because of this, I decided to perform an abaxial and got 92% improvement. Radiographs revealed a cyst in the navicular bone, but this finding alone was not consistent with the blocking pattern. The owners elected MRI over ultrasound and ultimately a collateral ligament of the coffin joint injury was found. I find that I am doing more blocking and imaging than I was before. Equinosis Q™ has been a doorway to other modalities. When you increase your confidence in practice, you enjoy practice more.”