This past summer I had the amazing opportunity to travel to Australia for an externship. Gisborne Veterinary Clinic, just outside Melbourne, hosted Magda Stewart and me for three weeks. This clinic is a mixed animal practice with a large/small animal clinic and three-to-four ambulatory large animal/equine veterinarians. I rode around the beautiful countryside with the equine vets every day from eight in the morning until six in the evening.
We stayed with one of the equine vets, Dr. Kath Mitchell, for the three weeks. She is originally from New Zealand and she completed her internal medicine residency at Cornell University. She came back to work at Gisborne after her residency. Dr. Ronan is the other equine veterinarian Magda and I worked with. Ronan graduated from the University of Melbourne in Australia. Ronan did mainly the sport horse side of medicine for the clinic and some of the equine surgery. The area we were in had one of the biggest racing stables, Macedon Lodge, and Ronan was one of the main vets who would assess their lameness cases twice a week. There were many other doctors in the clinic, some of whom did only small animal, and some who did small and large animals. When we weren’t busy with calls we were welcome to hang out in the small animal clinic and help with things or learn.
There were a great variety of horses found there. We treated everything from racehorses, sport horses (dressage and eventers), pony club horses, stock horses, and many backyard horses. It was a great experience to see the wide array of horse jobs and the wide array of treatments done to help horses continue to perform jobs. Even though it was winter there, they still had a little bit of reproduction work being done.
First, I’ll talk about some of the main differences I noticed between American equine medicine versus Australian. Australians microchip most of their horses, not just the FEI horses, where the microchip is inserted into the crest on the left side at the midneck region. Australians also have the horses branded on the shoulders. They are actually starting to move away from this somewhat, but there are still tons of horses that have it. On the left shoulder you find the stud farm brand and then on the right shoulder you can two numbers. The bottom number is the year the horse was born and the top number is the number it was to foal on that particular farm (second foal born on farm, you will see a 2 as the top number). This clinic tries very hard to get owners to deworm their horses based on fecal egg count, instead of just deworming on a rotational system. I thought that was awesome since I had just learned in parasitology this is the movement horse deworming really needs to undertake in the United States.
While I was in Australia I got to see many things, but there were two things that ruled medicine for those three weeks: corneal ulcers and pastern dermatitis. This region of Australia had just experienced epic floods and lots of wet weather which was the most common blame for these problems. We saw big, little, melting, deep, and even a parasitic-induced corneal ulcer. We treated them with one or all of the following: antibiotics, antifungals, atropine, and serum. It was amazing to see an ulcer’s progression from the first time seeing it to watching it heal. I learned the importance of the drugs and the different management practices owners should try to prevent ulcers and to make patients with corneal ulcers more comfortable. I was allowed to perform auriculopalpebral and supraglenoid nerve blocks. We were called to see a large superficial corneal ulcer in a racing standardbred. The ulcer was most likely caused by Onchocerca cervicalis, a parasite whose microfilaria had migrated to the eye. The horse was experiencing a massive inflammatory response after being dewormed two days prior. The migration of these parasites in the eye was very irritating and most likely the reason the horse rubbed its head against something resulting in a large superficial corneal ulcer.
Second on the list of most frequently seen cases was pastern dermatitis or mud fever—it seemed to be everywhere and on all the horses. I became a professional crust picker. It is important to remove the crusts because the most common cause of this condition is Dermatophilus sp. which is found in the crusts themselves. Pastern dermatitis can be found, of course, on the pasterns /distal limbs, but we also saw it on the chest, back, hindquarters, and muzzle. In treating pastern dermatitis: remove all “toothbrush” crusts (take one or two to look at in lab), scrub lesions, dry, apply prescribed topical agent, wrap (if applicable), and repeat! Sometimes systemic antibiotics (rare) and NSAIDs were necessary for the severe cases. I saw many different cases in Australia, but by far, my three weeks were taken by these conditions.
I was also able to rectally palpate a horse with colic that was diagnosed with a left dorsal displacement. That was my first time to rectally palpate a horse with colic that had tight bands and I couldn’t feel the left dorsal colon in its proper location. I watched tons of race horses jogging out for lameness exams sometimes to be followed with radiographs/ultrasound/injections. Also, I helped collect a young stallion and learned the procedure for freezing semen. We had a cryptorchid surgery where I realized, for whatever reason, the left testicle is normally retained more often. I saw a goat with toxicity, and despite our best efforts, it died, but that case taught me a lot. I saw so many things at my externship at Gisborne Vet Clinic. The veterinarians were spectacular and they were great about letting me have hands-on experience, especially as they became more comfortable with me.
Besides the veterinary side of the trip, I had the most amazing month of my life. For the three weeks at Gisborne everyone invited us to dinner and for hiking at local historical places. I visited a dingo rehabilitation center and watched my first Australian Football League game. We also pampered ourselves with Dr. Kath at a spa and took wine tours in the local area. The people couldn’t have been nicer and more helpful to make us feel at home. They really wanted us to see everything veterinary and Australian those three weeks. This is one externship I would highly recommend to anyone who wants to travel and who has an interest in small, large, or equine medicine. The vets and technicians were wonderful and you will learn tons. I wouldn’t mind going back again if I ever find the time!