(first appeared in the November 2014 issue of The Equiery)
by Katherine O. Rizzo
When most people in Maryland have a horse emergency needing more care than their ambulatory veterinarian can handle, they either ship their horse north to New Bolton in Pennsylvania or south to Marion duPont Scott in Virginia. This might make it seem that Maryland as a state has no big equine hospital of its own, but that is not the case.
The Marion duPont Equine Medical Center (EMC), located at Morven Park in Leesburg, Virginia, is actually part of the Virginia-Maryland Regional College of Veterinary Medicine. It is a unique dual-state collegiate teaching hospital just a short drive from central Maryland and is funded jointly by Virginia and Maryland.
Since the facility opened its doors 30 years ago, hundreds of future equine veterinarians have walked its halls and made significant advancements in diagnostics and treatment in equine medicine. Students from all over the world come to EMC annually for its residency program and students from the college do internships at EMC and residencies at some of the country’s other top equine hospitals.
The hospital is highly regarded for both its emergency medicine and its surgical team as well as cutting-edge elective treatments, such as regenerative therapy, and top-of-the-line diagnostic tools, such as the only free-standing full body MRI in the region.
So exactly how do the college and EMC work together to create one of the country’s top equine research and treatment centers? Here are things you might not know about the school and hospital.
Although specifics of budgets change each year, the Virginia-Maryland Regional College is the only school in the country in which two states work together to subsidize the program. The funds given by both states go directly into the college’s working budget and help offset the tuition costs so that both Maryland and Virginia residents are considered “in-state.”
Currently, in-state tuition is just over $21,000 a year while non-Maryland or Virginia residents pay just over $46,000 a year. The curriculum is a four-year program.
As for the hospital, about 65% of its operating budget comes from its clients with only 25% coming from the college. The rest of the funding comes from private donations.
The college currently has 120 students with about 30 students annually hailing from Maryland and 50 students annually from Virginia. Forty students come from “at large,” meaning out of state. Dr. Michael Erskine, interim director of EMC, stated that the ratio of Maryland to Virginia students has been the same since the program first started 30 years ago but the at-large student body has increased over the years.
Interestingly, the majority of the student body is actually on the small animal track with only about 19 students a year declaring equine medicine as their desired field. Most students declare their focus after the first year of school.
Dr. Erskine commented that these equine students “are basically self-selected. They have all grown up around horses and are very experienced with basic horse care before they even start their internships at the hospital.”
Interns, Residents and Research
The EMC attracts graduates to its residency program from all over the world. These are the students who will become future specialists and come to EMC to study with some of the best surgeons in the country and perform clinical research. They provide a comprehensive service for the hospital’s clients and over the years, advancements in colic surgery and regenerative medicine, as well as in other areas, have been a result of the program.
Currently there are two interns at EMC and three residents. Two are surgical residents and one is focusing on internal medicine.
The VA-MD Regional College feeds students into the residency program as well and also sends its students to other hospitals throughout the country. “It is a very open door sort of program, which is very beneficial for everyone,” Dr. Erskine explained.
Probably one of the biggest benefits of bringing a horse to EMC for lameness issues is its wide array of diagnostic tools including its standing MRI suite. EMC offers the only open magnet full body MRI in the region, installed in 2004. This allows a horse to be scanned with basic sedation while standing, versus complete anesthesia.
The hospital also has both digital and computed radiography as well as orthopedic, abdominal and cardiac ultrasounds. Upper airway and gastroscopic endoscopy is offered as well as dynamic endoscopy, which allows veterinarians to view a horse’s airway while it is being exercised.
In addition to the MRI, EMC has a nuclear bone scan suite (nuclear scintigraphy) and can perform laparoscopy, arthroscopy, fluoroscopy and electrodiagnostics. And that is just what they currently have.
EMC is currently preparing to offer the region’s first equine CAT scan services. “We have the device in hand but are still looking for more funding in order to have it fully installed and ready for use by early 2015,” Dr. Erskine reported. As with the MRI, the CAT scan can be used while a horse is standing under basic sedation.
When most people hear their veterinarian say “Leesburg,” they immediately think surgery. But EMC actually offers several outpatient procedures and treatments as well. Laser surgery is one of the more recent developments at EMC. It is a highly refined and focused light source that can deliver energy in a very precise way. “Most commonly it is used for removing skin tumors or for upper airway surgery,” Dr. Erskine stated.
Stem cell transfer through regenerative therapies is also a newer cutting edge technology that is being perfected at EMC. The facility has a full state-of-the-art regenerative medicine laboratory.
They can also use shockwave therapy, IRAP, mesotherapy and alternative medicine treatments such as acupuncture and chiropractic work.
The facility has grown considerably through the years. It started with just two 12-stall barns. There were times in EMC’s history where they were full and had to turn away patients. Thus more barns and stalls have been added in response to the demand.
Now, the facility has 51 stalls, most of them climate-controlled, including five intensive care stalls and the eight isolation stalls. The stalls are spread out among four barns with two main medical wards, an isolation barn and a temporary housing barn for outpatient use.
The barns are regularly monitored 24 hours a day, seven days a week by a team of nurses and technicians. Students, interns and residents assist the professional staff as needed.
The majority of the equines that come through EMC are actually there for diagnostics or elective procedures and treatments. About 40% come from Maryland with the other 60% coming from Virginia or nearby states such as West Virginia and North Carolina. Over the past 30 years, EMC has treated over 55,000 horses.
“Most people come to EMC because of the extremely high level of expertise we have to offer as well as the amount of comprehensive imaging and diagnostic tools we can use,” said Dr. Erskine. This makes EMC a one-stop shop in many ways with everything your horse could possibly need housed under one roof.
The most common cases EMC tends to see are emergency colic surgeries (sometimes as many as three colic surgeries in a day), sick foals, other emergency medicine procedures and lameness exams.
There is a farrier shop at EMC headed by Paul Goodness who is on-site two to three days a week. The shop has two stalls and two work stalls and everything a farrier would need to assist veterinarians in consultations with clients.
It takes more than just a village to keep EMC running. In addition to its students, interns and residents, EMC has a technical and nursing staff of 36 people. There are on-site surgeons, two internal medicine veterinarians and five house officers. There are also 12 administrative staff members.
There are four licensed veterinarian technicians who act as case coordinators for the hospital. These positions were just created this past year so that when a patient enters the hospital, there is one person who coordinates everything that the horse needs for its entire stay from start to finish.
Out of the current roster of veterinarians, four have come through the EMC system during their education in some way. Surgeons Kenneth Sullins, DVM and Nathaniel White, DVM both graduated from VA-MD Regional College. Martin Furr, DVM (internal medicine) did his residency at EMC and James Brown, BVSc did his surgical residency at EMC.
Who Was Marion duPont Scott?
Although Marion duPont Scott was born in Delaware, she spent much of her childhood in England. Here in the States, she called Virginia’s Montpelier (once owned by President James Madison’s family) home but also established Holly Hedge in Camden, South Carolina, now know as the Camden Training Center. She went on to become one of the most influential horsewomen in the Virginia-Maryland area.
Her interest in horses was broad, as she was a show rider and foxhunter and also owned both flat track and steeplechase racehorses. In 1915, she was the first woman to ride astride at the National Horse Show at Madison Square Garden in New York. With her brother, William duPont, Jr., she developed several racing venues including Delaware Park and Fair Hill, home of the National Steeplechase Association headquarters and now the Fair Hill Natural Resources Management Area.
Probably the most well-known horse to come through her racing stables was Battleship (son of the great Man o’ War), who became the first American-bred and American-owned horse to win the Grand National Steeplechase in Aintree, England in 1938. He is the only horse in history to win both the American Grand National and the English Grand National. Annapolis was another Man o’ War son in her stables.
Her horse Mongo was named 1963 American Champion Male Turf Horse. The Eclipse Awards were then created in 1971 and duPont Scott won two; the 1972 American Champion Steeplechase Horse with Soothsayer and the American Champion Older Female Horse with Proud Delta in 1976. She also earned the Thoroughbred Breeders of Kentucky Award in 1973 and the Joe Palmer Award in 1981 from the National Turf Writers Association.
In 1981 she donated $4 million to Virginia Polytechnic Institute and State University to create the Equine Medical Center. Marion duPont Scott died on September 4, 1983.
Surgery Success Stories
With over 55,000 horses having been treated in its 30 years as a hospital, the Marion duPont Scott Equine Medican Center (EMC) has seen its fair share of surgeries. The Equiery asked its readers to share some of their EMC success stories. Here are just a few that arrived in our in boxes.
Although I wouldn’t allow myself to think about putting him down, it was fairly obvious that others traveling with me believed that this was the inevitable outcome. No, not the little foal I got at the auction when he was about three months old; the one I trained myself; the only horse I ever have owned. No.
Once at EMC, I was so very impressed by their professionalism, urgency and compassion. Better care than a hospital for people! The news came from Dr. Norris Adams that the fracture was operable. It was not a weight-bearing bone but had to be stabilized with a plate and pins.
Within a few months, Star was hand-grazed, turned out, long lined, and eventually under saddle. My bionic pony with a metal plate and 11 screws holding his ulna together (and a stuck drill bit), has been patiently rehabbed by Robert Taylor, to whose barn I moved shortly after the field accident.
Star is in no pain, with no observable lameness at the walk and canter, but a slightly shorter stride on the right front at a forward trot (but not a collected trot), which might be due to muscle atrophy, as the fracture is fully healed. Star is a work in progress to correct the slight unevenness, but he still loves to jump, and we are still together.
I’ve been told that for this sort of injury, 60% of horses are euthanized. Some 20% recover but cannot be ridden and only 20% come back to some use. Star and I are very lucky, and I think often of how the EMC helped turn our luck. Thank you, Dr. Adams and team, and also a thank you to Dr. Donatelli and to Robert and Kathy Taylor for Star’s recovery care and rehab. I have to say that my horsemanship and riding skills improved as part of bringing Star back, and he knows we saved him…he knows.
The six-year-old off-the-track Thoroughbred had just celebrated a year off the track and an introduction to eventing at the Redland Hunt Pony Club Combined Test in Olney. Taking home a yellow ribbon and enough smiles and pictures to last for months, it seemed like the month of April was destined to start the best year ever for me and my partner in crime, Airy.
A week to the day later, I brought her in from the field with an ugly wound on the inside of her right hock. Not quite sure of the severity, I washed it with Betadine and tried to cover it. Unfortunately, I was getting nowhere near that leg with bandages. A couple of hours later, the swelling had blossomed and terrified of the worst, an emergency call to my vet was the only answer. Dr. Mike Erskine’s office immediately called me back and Dr. Jim Lewis came out and determined that yes, there was joint fluid leaking out of the wound. Dr. Lewis made sure I knew all I needed to make an educated decision and arrangements were made with my parents to take Airy to EMC immediately.
An hour later and much too late on a Sunday night, we arrived. Airy walked off the trailer like a pro and followed me onto the scale. I was beyond terrified, but the staff’s knowledge and demeanor kept me relatively sane. With my parents’ support, my phone buzzing with concerned messages from my sister and my boyfriend, I watched her go into the back and waited for the X-rays. Dr. Kendra Freeman brought us in and showed us the images. A puncture wound, we believe from a playmate’s kick, broke into the joint’s sac.
She went right into surgery. A quick call to my equine insurance company and I told my sweet little girl I’d be back for her soon. Dr. Freeman told me she’d call me after surgery and gave me her card.
Airy stayed there for seven days, I think I visited five of those. For a horse that acts like every new bandage application is the first she’s ever had, the bandage from her coronary band to her stifle was a lot to handle. Dr. Freeman sent me several emails during this time and was completely available for phone conversations. She let me know every detail and discussed Airy with Dr. Erskine and the staff. I couldn’t have been kept more up to date. Overall, the surgery was a success.
Five weeks of stall rest and a strong appreciation of Reserpine later, I had my girl back as well as what seemed like a master’s degree in bandages. Dr. Freeman walked me through the bandage process, let me take photos of every step, sent me a list of materials I needed and all the while had a positive outlook on Airy’s complete recovery. Another visit from Damascus Equine’s Dr. Suzy Welker and the stitches were out, hand walking/dancing started and eventually Airy got some turnout.
The staff of EMC made a nightmare into something I could sort of smile at. I sent Dr. Lewis, Dr. Freeman and Dr. Welker photo updates via email frequently until the previous puncture zone was no longer a worry; I always got responses within a few hours. The extra time with Airy, although trying at times, strengthened our bond far beyond what time we had spent together previously.
Today, she’s better than ever. In September we finished our first full event on our dressage score. Airy and I got lucky, as not everyone has access to Dr. Freeman and crew. Thank you all for being there during the scariest of times for us. I can’t imagine where we would be without you.
Peter the Apostle
The incision was T-shaped and closed with sutures and stapled. He also had peri-anal masses removed the same day via CO2 laser. The care that was given to Peter was extraordinary! In the pre-surgical visit, Dr. Sullins and his team did an endoscopy and an ultrasound. My trainer and I were present for both of these procedures. They examined the size of the tumor and determined its location on Peter’s cervical spine.
The staff is extremely efficient and caring! Dr. Sullins is a gifted veterinarian and surgeon. After Peter’s surgery, he came home and recovered beautifully! You can hardly tell where the scar is. Let’s put it this way, it did not affect his getting “Best Turned Out Horse” at the Thoroughbred Alliance Show Series this past April. I cannot thank the staff at EMC enough for all that they have done for my horse over the past several years.
On behalf of Jack Louth, Property Manager at Cedar View Farm and myself as Barn Manager, I’d like to share our EMC success story about our homebred filly, SuperStar. She was featured in Equus Magazine last October regarding her miraculous recovery from Cervical Vertebral Osteomyelitis/Meningitis, which in normal cases would be a death sentence.
After a few incorrect diagnoses from our normal vets, and through no fault of their own due to some very puzzling symptoms, it was mutually decided to take her to EMC for further diagnosis. On May 20, 2012, she was seen by Dr. Silva and Dr. Harold McKenzie, who did extensive blood work, nuclear scintigraphy of the neck and front limb, a spinal tap, bones scans, numerous diagnostic imaging including cervical radiographs that showed irregular appearance of the facets, an abscess in the vertebra and some gas build-up in the muscle tissue surrounding it. It was concluded that she was suffering from Cervical Vertebral Osteomyelitis with evidence of meningitis.
Her prognosis for survival was deemed poor to fair. With Dr. Silva and Dr. McKenzie’s suggestions for treatments, we decided to proceed with the process of what we were hoping would be her recovery. She was treated with extensive antibiotics and stayed at EMC for nearly three weeks, where she was carefully monitored and watched by Dr. McKenzie and Dr. Silva and their very capable staff. She was released after the three-week period and was sent home with an extensive ten-week home treatment, which required administering medications every four hours.
Three or four checkups thereafter at EMC, on July 18, 2012 Star was released from their care and given a clean bill of health. I cannot say enough about Dr. McKenzie and Dr. Silva and their staff for saving our filly. Now a five-year-old, she is thriving, has been started under saddle and has competed in two horse shows as a capable but still green show hunter. In her first show, she was champion! There have been no residual effects of the illness to date and that is credited to the skillful and capable hands of the doctors and staff at EMC. We owe them a debt of gratitude for saving this amazing filly.
She shied, then bolted, putting me on the ground. As the spring went on things got worse. Finally I figured out that she was in pain when she was in heat. After researching all sorts of options, I decided the best course of action was to spay her. After further research, it was clear that the best place to trust my mare’s future to was the Marion Dupont Scott EMC where they perform a low-risk laparoscopic surgery. The surgeon, Dr. James Brown, carefully explained the surgery, the necessary feed restrictions in preparation for the surgery, and the recovery restrictions.
We arrived bright and early on the day of the surgery and Destiny was settled in and prepared for her surgery. She sailed through the surgery. After, it was very reassuring that Dr. Brown checked on Destiny several times throughout the day. Knowing that she was in caring hands made it easier to leave her at the hospital over night. Destiny was released the next morning.
During her recovery Dr. Brown checked with us regularly via email to see how she was doing, which made me confident that we had support if we needed it. By the end of the four-week recovery period she was ready to return to work. Since the surgery, Destiny has shown no indication that she has any pain under saddle, or any sign of bolting. The trainer we are working with was amazed at how little impact the surgery had on her physically.
Everyone at EMC made this entire experience very positive for both Destiny and me. Destiny is happier and more at ease. The surgery was definitely the best thing for her. I have the calm, brave, willing, smart, and friendly mare I fell in love with again, thanks to our trainer and Dr. James Brown and EMC!
My first experience with EMC was the one we as horse owners always dread; the colic visit. It was with my older horse Rockfish Willy, aka Jack. I had only owned him for a little less than a year and I had just started competing him in eventing. After my regular vet Dr. Roger Scullin took a look at him, he just said “Leesburg.” Next thing I know, the whole barn (I stabled at Waredaca at the time) pulled together to get him safely there as it was clear I should not be the one driving. Robert Butts lent us his own rig as it was already hitched, he and Dr. Scullin loaded Jack for me and my dad drove. The last thing I asked Dr. Scullin before we pulled out was “What do we do if he falls in the trailer?” He said get there and the EMC staff would take care of everything.
Thankfully, Jack did not fall, and the trailer ride helped ease the colic. The EMC staff met us in the driveway, in the dark; it was well after hours. They unloaded Jack for me and quietly and efficiently took over, explaining everything as they went. We were lucky and he only needed to be treated with fluids. That night, I slept with my cell phone, as I requested to be called every time they checked on him. Although they probably thought this was nuts, they did just that until finally they convinced me it was okay to go to sleep.
I picked Jack up on New Year’s day and the staff had already spoken with Dr. Scullin, who had spoken with Robert, so by the time we arrived back at Waredaca, a stall was all set up for him and a “do not feed, even hay and treats!” sign was on his door with a staff-only feeding schedule chart. Dr. Scullin and Waredaca took over from there and Jack has never shown any residual signs from the incident since.
Of course, about four years later, Jack made another midnight visit to EMC, this time because of a puncture in a hock. My sister did the driving as my arm was in a sling due to a broken collarbone. Once again, we were met on the driveway and the EMC staff took charge as soon as we unloaded. The puncture did break the joint capsule and surgery was needed to flush the wound and stitch it up.
Dr. Norris Adams did the surgery, which we actually watched from one of the teaching rooms. I remember my dad saying, “It’s like a real people ER!” This time we left after Jack was awake and settled in his stall. I asked Dr. Adams to call me in the morning unless anything went wrong before then. I had full faith and confidence in everyone at EMC that my horse would be well taken care of.
The most comical part of the whole experience was probably the vet tech’s expression as she watched me change his bandage using my one good arm, my foot and knee. She commented that Jack was a superstar of a patient for standing so still for me as she instructed me on how to put on the several layers of bandages. Once again, Dr. Scullin and the Waredaca staff oversaw his home recovery.
Jack returned to eventing, competing through the Training level and schooling Preliminary. He also successfully timber raced and is still my number one foxhunter.