Our Services

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Horses have always been at the heart of our practice since its foundation way back in 1850. Today, we offer a modern, friendly equine veterinary service designed to meet the needs of the individual horse owner. This philosophy starts with our equine reception team, all of whom keep horses themselves and understand your problems. We have fifteen full time enthusiastic equine vets, many of whom have post graduate qualifications in equine.

  • Dentistry
  • Digital Radiography
  • Endoscopy
  • Gastroscopy
  • Lameness Examination
  • Pre-Purchase Examination
  • Shockwave Therapy
  • Ultrasound



Dental care is very important to good horse management. Our Equine dental service is led by Dr Sam Hole MRCVS who holds a European Diploma in Equine Dentistry – this is currently the highest possible level of qualification possible in the field. Sam lectures in Equine Dentistry and examines in the subject for the British Association in Equine Dentistry. Other Vets at Pool House Veterinary Group have undertaken postgraduate training in dentistry, and the practice has invested in modern automated equipment to ensure a high standard of dental care for all our patients. We have a dedicated Equine Dental (standing) operating theatre where advanced procedures such as fillings, extractions and dental fracture repairs can be undertaken by Sam and his team as well as advanced dental health checks for performance (and other) horses.

All of our ambulatory vets are equipped with a full range of modern ‘floats’ (rasps) with tungsten carbide blades. This equipment enables dental treatment to be performed rapidly with minimal trauma to the mouth. Extensive dental treatment must only be performed by a veterinary surgeon and in our practice we have a full range of automated equipment at our diagnostic facility including radiography and, if required, general anaesthesia.

The horse is a herbivore and uses its massive molar teeth in a grinding motion to break down grass and other material into a more easily digested pulp. In the wild, horses obtain all their nutrition from grazing – sometimes up to eighteen hours per day. Domesticated horses are fed much of their nutritional requirements as ‘hard’ feeds which do not require the same degree of mastication. Therefore sharp enamel points sometimes develop on the outside of the upper molars and inside of the lower molars in domesticated horses.

Wolf teeth

Most horses develop so-called wolf teeth. These are in fact the first premolars. In some animals these small teeth cause discomfort whilst the horse is being ridden. They are usually extracted under heavy sedation, the procedure should only be performed by a Veterinary Surgeon. Anti Tetanus prophylaxis is ESSENTIAL when removing these teeth. It is NOT the case however that all wolf teeth need removing and before doing so you should be satisfied that a problem exists. As a general rule of thumb, the BIGGER the wolf tooth the LESS likely it is to cause a problem. Small sharp pointed teeth are more often implicated in problems.

Who is an Equine Dentist?

In Britain, only qualified and properly registered Veterinary Surgeons can legally act as Equine Dentists. Vets receive extensive training on the anatomy and physiology of the horse’s mouth during their five year degree courses. Treatment by any other person is against the Law. Unfortunately, in the past, equine dentistry has been a neglected area, and some people call themselves equine dentists and treat horses with no training or anatomical knowledge. There are many people claiming to be dentists today who fall into this category; although some dental technicians have received training, by law, they should only work under direct Veterinary supervision. Because of concern as to serious welfare problems that have arisen due to lay dentistry, the British Equine Veterinary Association (BEVA) has introduced a course in dental techniques for Equine Dental Technicians after which they can demonstrate their competency by taking an exam. Successful EDTs can join the British Association of Equine Dental Technicians (BAEDT). BEVA recommends that before using a lay dentist you should check that your Vet is happy with his work and that he has had proper training and is a member of the BAEDT. In the future, DEFRA may recognise this qualification with an amendment to the Veterinary Surgeons Act. All members of BAEDT should carry full insurance, unfortunately, many of the so-called ‘dentists’ have no professional insurance, so if a problem occurs neither you nor your horse will have any cover. In addition, the use of an unqualified person to treat your animal will invalidate your horse’s insurance.

Excessive dental work is as much a problem as too little. We have come across instances of over enthusiastic rasping of teeth by ‘dentists’. In some cases, even when the horse had no medical problem before the so – called treatment. Remember, removal of large amounts of tooth is rarely indicated and may significantly shorten the horse's life expectancy.

Dos and Don’ts of equine dental health

  • Do ensure a yearly dental health check for your horse.
  • Do use a properly qualified person, this should be a Veterinary Surgeon.
  • Check your horse’s mouth at least weekly for sores, and palpate the cheeks for any sharp points.
  • Do check your hay net for stones or other foreign material that can chip your horse’s teeth.
  • Do check for bad breath, facial swellings, or one-sided nasal discharges on a daily basis.
  • Don’t stick your fingers in your horse’s mouth – unless you want a serious and painful injury!!
  • Don’t use unqualified or uninsured people to treat your horse. You wouldn’t dream of letting someone with no training loose on your own teeth, so why do it to your horse? Check that any lay dental technician is a member of BAEDT as this indicates that he has basic training and has demonstrated this in an examination.

Digital Radiography

Digital Radiography

During the last decade there has been a revolution in x-ray technology. Traditionally x-rays have been recorded on photographic film and developed in a similar process to that used in normal photography. However recent advances in digital technology have been adapted to medical / veterinary radiography. This enables the images to be stored on computer and magnified so that subtle changes that may not be visible on conventional films can be identified.

Pool House Equine Clinic was delighted to install a Kodak CR digital x-ray system in June 2006 which was our first digital system. This still relied on an x-ray film but converted the image into a digital format, that system was subsequently replaced by two ‘DR’ x-ray systems. DR uses a receiver to detect the x-ray radiation and convert it ‘directly’ into a computer image. ‘DR’ gives very high quality images.

In the past some areas of the horse such as the stifle or spinous processes have been difficult to x-ray using conventional film / screen technology. With DR technology such radiographs are now ‘routine’.



The practice has two fibre optic endoscopes which can be used to examine the upper respiratory tract. Endoscopy is particularly useful in the diagnosis of ‘wind conditions’ such as idiopathic laryngeal hemiplegia. It can also be used to obtain samples from the trachea which help in the diagnosis of chronic coughs (called tracheal washes) or to investigate problems within the gutteral pouches. Endoscopy can be performed at your own stables as long as there is a good electricity supply.



Equine Gastric Ulcer Syndrome (EGUS)

In recent years the veterinary profession has identified equine gastric ulcers (EGUS) as a major health problem for many horses. EGUS can be responsible for a wide range of clinical signs including:

  • Poor appetite
  • Weight loss
  • Poor performance
  • Dull coat
  • Behavioural changes including aggression
  • Mild / recurrent colic
  • Stretching to urinate
  • Discomfort on girth tightening
  • Linked to crib biting
  • Spending lots of time lying down (excessive recumbency)
  • Horses can have potentially serious gastric ulcers with no clinical signs at all!

Which horses are at risk?

EGUS can affect any horse at any age. Studies indicate that it is a very common problem with percentages of occurrence ranging in different groups of horses: about 35% of non – performance horses, 60% of performance horses and 90% of racehorses have been found to be affected. Foals are at a particularly high risk from EGUS and if young foals undergo treatment for any other disease, it is wise to start preventative treatment for ulcers as well.

Why do horses get gastric ulcers?

To answer this question you must first have some understanding of the basic anatomy of the horse’s stomach. Basically the top part of the stomach is lined by ‘squamous epithelium’ and the bottom half by ‘glandular epithelium’. The squamous (upper) part is easily damaged by acid secretions – causing ulceration. The glandular (lower) part is able to produce a bicarbonate – rich protective mucus layer and is less likely to be involved in EGUS – although ulcers can and do occur in this part of the stomach. The lower part of the stomach produces hydrochloric acid which is vital for the digestion of food. Splashing of that acid onto the squamous part of the stomach can result in ulcers. Usually there is a fibrous mat of food material floating on top of the acidic stomach contents which helps protect against ulcers.

All the factors that contribute towards ulceration are not fully understood but some risk factors have been identified;

Training and exercise – when exercising the blood flow to the stomach decreases resulting in reduced acid removal, this coupled with increased pressure in the abdomen results in acid being pushed up onto the squamous lining of the stomach.

Diet – horses are normally trickle feeders taking little and often rather than eating large meals and living on roughage only. Prolonged periods without food can lead to increased acid contact with the lining of the stomach. When horses are starved ulcers can form relatively rapidly. Concentrate feeds with high carbohydrate levels make the stomach more acidic.

Physical stress and illness – this might include transportation or stable confinement. Horses that have had surgery or other treatment are probably at greater risk.

Medication – using most NSAIDs (e.g. ‘bute’) at normal doses is NOT associated with EGUS however used at very high doses and combined with steroids they may be a risk factor.

Bacteria – in people bacteria play an important role in gastric ulceration (Helicobacter Pylori) but in horses the significance is still unclear. In some cases in horses antibiotics are needed to heal persistent ulcers.

Can ulcers be treated?

The good news is that EGUS is a treatable condition. A product called Gastrogard which reduces the production of acid in the stomach is curative in up to 90% of cases. But you also need to look at management and feeding practices to ascertain what can be done to decrease the chances of recurrence of the problem.

There a number of dietary supplements that can assist in the management of cases or the prevention of recurrence.

The Gastric Ulcer Clinic.

Pool House Equine Clinic has a video gastroscope and holds regular gastric ulcer clinics.

Before scoping a horse MUST be completely starved for about 16 hours (no more than 6 hours in young foals). Water should be allowed up to 2 hours before scoping. Mild sedation is usually necessary.

Phone our practice for further information about the gastroscopy clinic.

Lameness Examination

Lameness Examination

Here at Pool House Equine Clinic, lameness patients are commonly seen and treated, both at the hospital and at their home yards. Cases of lameness can occur in both pleasure and competition horses. Whilst in some horses the cause of the lameness may be easily determined, in others, a more detailed lameness work up is required. There are many different reasons why a horse may present with lameness, from foot balance issues, laminitis to tendon and ligament damage. It is also not infrequently caused by damage to joints. This may be damage to the cartilage, which lines the joint, to the fibrous capsule that surrounds a joint (the synovium) or may include a chip fracture of the underlying bone.

At Pool House Equine Clinic, all of our vets are experienced in examining lameness cases. In addition, Dr. Gil Riley MVB, Cert. EP, MRCVS holds weekly lameness work-up and poor performance clinics. Gil has many years’ experience in diagnosing lameness, so he is well qualified to work with and assess any tricky issues. Gil has obtained the Royal College Certificate in Equine Practice whilst working at Pool House, and although enjoying all aspects of his work, lameness and poor performance are his passions. To assist Gil with his lameness work-ups, we have the ability to utilise an onsite standing MRI unit, ultrasound imaging units, x-ray facilities and a digital lameness locator system.  In 2009, Gil was named Petplan Equine Vet of the Year, which is a fantastic achievement, undoubtedly through his commitment to diagnosing equine lameness.

When a horse is first presented with a lameness issue, their history is important. For example, what are the presenting signs, how long has the horse been lame, is it persistent or intermittent lameness, when do you notice the lameness, does the horse warm up and improve? All of these factors will aid us when trying to figure out the cause.

An examination of the horse is then necessary both visually and with manual palpation. This is to identify any abnormalities such as asymmetry or limb swelling which could suggest a potential cause.

Most patients will then require walking and/or trotting in a straight line, ideally on a hard, level surface. This will help to identify which limb (or limbs) the horse or pony is suffering pain in. The gait of the horse and their behaviour is also assessed as these can be important indicators. Our digital lameness locator system can also be used confirm the area of lameness.

Flexion tests are commonly performed next, which involve holding the limb (or a section of the limb) up before trotting the horse away. Flexion tests increase pressure on joints and surrounding structures and may exacerbate lameness associated with the area that has been stressed. The response (or lack of a response) will all add information when determining the site and causation of lameness.

Lunging the horse on both a hard and soft surface is also extremely beneficial. A horse may present, or change, the lameness pattern on different surfaces and different reins. If the horses’ behaviour and comfort levels allow, a ridden assessment (either by the owner, or a professional rider) can be of great assistance to the investigation.

Nerve blocks (or ‘diagnostic regional analgesia’) use local anaesthetic to ‘numb’ different specific areas. If the painful area is blocked and the lameness improves – then it can be reasonably assumed that the pain is originating from this location.

A joint block is performed under sterile, aseptic conditions. The area is cleaned and the joint or synovial structure is infiltrated with local anaesthetic. The lameness is then re-assessed.

When the origin of pain has been identified, x-ray imaging and/or an ultrasonographic examination can be performed, hopefully leading to a diagnosis.  Occasionally, more detailed imaging is required, in the form of an MRI (magnetic resonance imaging). MRI is useful for investigating foot pain as it produces 600-900 highly detailed images of the complicated soft tissue and bony structures of this area.

Once the cause of the lameness has been established, we can advise you on appropriate treatments and management strategies. This can include, but is not limited to, box rest and a change of management at home, shockwave therapy, surgeries (i.e neurectomy and fasciotomy procedures), oral pain relief, steroid injections or remedial shoeing. We are extremely lucky to have a remedial world champion farrier, Grant Moon FWCF, regularly attend the hospital for shoeing.

If you have any further queries, or wish to book an appointment with one of our vets for a lameness issue, please do not hesitate to contact our reception team on 01283 799700.

Pre-Purchase Examination

Pre-Purchase Examination

Buying a Horse – The Pre-purchase Examination

We strongly recommend that all prospective horse purchasers obtain a full Veterinary Examination before buying. A full Veterinary examination is often called the ‘Five-Stage’ vetting and is performed according to a procedure recommended by the British Equine Veterinary Association. Many insurance companies request such an examination before giving cover. Having a full examination cannot guarantee that the horse will never develop a problem but it should mean that you at least start off as problem free as possible. The purpose for which the horse is being purchased is very important and the Veterinary Surgeon will need to know this before undertaking the examination. A horse that is suitable for dressage may be totally unsuitable as a hunter so it is important to remember that a horse may fail an examination for one purchaser but pass for another. The examination follows a standard format which has been used successfully by vets in the UK for at least 40 years with only minor updates.

The examination and associated paper work take about 1½ hour to complete and the Veterinary Surgeon will require that there is a competent rider, a safe area in which the horse can be cantered in a large circle, and a flat concrete road where the horse can be trotted up.

Stage one

The Veterinary Surgeon will make a thorough clinical examination of the horse. This will include an ophthalmic examination of the eyes, and auscultation of the heart and chest. He will also feel the limbs for any sign of injury. At this stage skin lesions such as sarcoids will be noted – usually they will not result in ‘failure’ but will be discussed with the purchaser.

Stage two

The horse is trotted up in hand on a hard level surface. During this phase the Veterinary Surgeon is particularly concerned to observe any sign of lameness and will often perform ‘flexion’ tests on each limb. The veterinary surgeon will also circle the horse and examine the back at this stage. In most instances the vet will also wish to see the horse trotted on a lunge – usually on a firm level surface. At the clinic we have a specially constructed lunge ring which has a safe hard surface for lunging.

Stage three

Strenuous ridden exercise. The Vet will listen carefully to the horses’ wind and observe the gaits on both reins. This phase is particularly important to assess if the horse is ‘clean winded’. He will also check the heart and lungs again to see if the exercise has had any adverse effect.

Stage four

The horse is rested and the recovery rate from exercise monitored. During this phase the Veterinary Surgeon will often take detailed notes of the horses’ markings which will be used to make a certificate should the horse pass the examination. It is often common during the resting stage for a blood sample to be obtained. This sample is sent to the forensic laboratory at Newmarket where it can be tested for ‘bute’ or other forms of dope, should such tests become necessary.

Stage five

The final trot-up. Again the examining Veterinary Surgeon will watch carefully for any sign of lameness.

After the examination the Veterinary Surgeon will give the purchaser a written report detailing his / her findings, and will give a clear indication of the horses’ suitability for the purpose for which it is being purchased.

Some insurance companies only require the first two stages to be completed. This is the ‘2-stage vetting’, although it does yield a large amount of information, certain problems can be missed, for example, a horse that is lame only when ridden and breathing problems. For that reason we always recommend the full 5-stage vetting.

Shockwave Therapy

Shockwave Therapy

Swiss DolarClast Shock Wave machine at Pool House Equine Clinic.

Shock Wave therapy (more correctly extracorporeal shock wave therapy) has been used for many years in the treatment of sports related injuries in human medicine. More recently this technology has been developed for use in the treatment of a number of equine injuries.

The ideas behind the benefit of shock wave therapy are that the waves massage tissues, cause a mild inflammatory response which ‘jump-starts’ the healing of quiescent damaged tissues, increases activity of certain cells involved in the healing process and numbs nerves resulting in a reduction of pain sensation.

Conditions affecting the insertion of ligaments onto bone are frequently responsive to shock wave therapy. In particular ‘high suspensory desmitis’ can be treated. Previously this condition could only be treated by prolonged periods of rest, sometimes in excess of two years and even after this there was frequent recurrence. Other conditions that frequently benefit from shock wave therapy include back pain, lesions originating from the navicular region and degenerative joint disease. It also has applications in the treatment of angular limb deformities in foals.

Shock Wave therapy can be useful in the treatment of sore backs.

The horse is usually sedated before treatment as shock wave therapy can be mildly uncomfortable. Three sessions of treatment spaced at two week intervals is the normal basic course of therapy accompanied by a controlled ascending exercise programme.

Shock wave therapy is available at Pool House Equine Clinic.



The equine clinic has seven digital ultrasound scanners. Ultrasound is particularly useful to help in the diagnosis of tendon and ligament injuries. It is being used increasingly to examine the abdomens of horses with colic prior to surgery (or hopefully to help ascertain if surgery is necesary). Ultrasound is also the imaging system of choice for fertility examinations. Visit our FACEBOOK to see some recent scans.