'It starts with a story'

Assessments are both an art and a science. Thijs de Bont MRCVS explains how pattern recognition can aid veterinary diagnosis in equine orthopaedics

- Thijs de Bont MRCVS

EVEN before your vet arrives on the yard to evaluate your horse, they are already syphoning through the information they know about the case, to guide their approach and custom fit their investigation to your horse’s individual needs.

It’s important to stress that pattern recognition is not a substitute for being thorough, or a way to cut corners. Rather, it is about applying knowledge and experience to investigate and treat efficiently, giving both the horse and the client the best possible experience in what can be a stressful situation. The more a vet can filter out the noise and red herrings, the more they can focus on the problem at hand.

How do we do that? Well, it starts with a story. Historytaking is as much an art as it is a science, but to extract vital information about a case you have to be able to obtain good-quality information to begin with. Refining and revising a differential list starts with recognising patterns, which can be breed, age and discipline specific.

Not only that, but geographical differences, topography and footing all play an important role in shaping the specific injuries that your horse may sustain. Recognising that a Shetland pony with an upward fixation of the patella may have concurrent luxation (dislocation) of the hip joint at the time of presentation, allows the vet to target diagnostics towards confirming or excluding this in the first instance, rather than progressing to targeted diagnostics and treatments of the stifle.

In comparison, an identical presentation in a young warmblood showjumper would immediately result in recognition of different patterns regarding exercise and fitness levels, where a primary diagnosis of hip luxation is very rare and this condition would in all likelihood not require exclusion, prior to investigation of the stifle itself and associated muscle groups.