“A twisted segment of intestine will slowly begin to die if the situation is not corrected in a timely manner -- as soon as one to two hours depending on the vascular insult,” Dr. Downs says. “Prompt correction of a twisted segment of intestine will generally allow for dramatic increase in patient survival.”

Other factors that historically contributed to poor outcomes were inappropriate anesthetic equipment and drugs, inadequate recovery facilities and protocols, and lack of availability of intensive care monitoring and treatment after surgery.
Today the situation is much improved. Private practice equine hospitals such as Merritt & Associates, located in Wauconda, IL, have emerged in areas with dense horse populations and have made timely surgical intervention a possibility for most equine patients. There is also a better understanding of equine anesthesia and critical care procedures.

“Our fully trained staff is on call 24 hours a day to provide emergency surgical services for horses when success and failure may be separated by minutes,” Dr. Downs says.
Emergency surgeries performed at MAEH include colic, fractures, and dystocia (reproductive/foaling emergencies). Elective surgeries, such as minimally invasive arthroscopic (joint) and laparoscopic (abdominal) surgeries are also performed. These procedures are
accomplished through small incisions with a video endoscope (camera), which can result in fewer complications and a shortened recovery time.

At Merritt & Associates a dedicated closed-ventilation system provides clean, climate-controlled air to the large operating suite, prep area, and two padded induction/recovery stalls. The large surgery prep area is located between the induction stalls and the operating suite itself in order to provide for the sterile preparation of the horse prior to entering surgery. Once the horse is rolled into surgery on the hydraulic surgery table, the final aseptic preparation of the surgical site is overseen from the sterile scrub room through a large observation window by Dr.
The two recovery/induction stalls are fully padded rooms designed for the hospital’s method of controlled assisted anesthetic induction and recovery. Because horses self-recovering from anesthesia may be at risk for injuries, the staff assists the horse’s recovery with head-and tail-support ropes.

Adjacent to the surgical prep area is a full service laboratory so that the anesthetized patient’s blood work results are immediately available to the surgical and anesthetic team.

When horse owners are in need of a fully equipped equine hospital, it is reassuring – and important – to know that there is one in their local area with state-of-the-art, full-service facilities such as those at Merritt & Associates. Founded in 1990 by Dr. Keith Merritt, the hospital and ambulatory practice, has grown to include seven veterinarians and 25 support staff with diverse specialties including lameness/sports medicine, surgery, diagnostic imaging, regenerative medicine, nuclear medicine, internal medicine, and complimentary therapies such as acupuncture, and veterinary chiropractic.

A Sound Way of Life

Meet Dr. Keith Merritt - Equine Sports Medicine Expert
by Sandy Kucharski

Dealing with lameness issues has to be one of the horse owner’s most frustrating challenges. Whether it’s rehabilitating a horse after a major injury, or pinpointing the cause of a subtle change in his way of going, the process can be difficult and overwhelming when you consider the vast variety of ways to approach it. Keith Merritt, DVM, embraces these challenges and tackles them head on in his practice every day.

Internationally recognized as an equine sports medicine expert, Dr. Merritt has a wealth of experience in diagnosing, treating and rehabilitating performance and pleasure horses. In 1990 he established Merritt & Associates Equine Hospital, located in Wauconda, IL. It is one of the few veterinary hospitals in North America committed to the health and soundness of sport and race horses, as well as serving pleasure horses. The practice is comprised of highly trained veterinarians and staff dedicated to preventing, diagnosing, and treating injuries and illnesses in horses.

Developing the practice

You might detect from his slight southern accent, that Dr. Merritt grew up in southeast Mississippi. He received his DVM from Mississippi State University and worked in the area for several years. He developed an interest in equine sports medicine and focused on that specialty, learning everything he could from a variety of experts in the field.

In the early 1990’s, Dr. Merritt followed the demand, for his area of expertise, to Northern Illinois. With a major thoroughbred racetrack, two standardbred tracks, and a healthy hunter/jumper industry, he never lacked for patients with soundness issues. In 1995 he bought the farm in Wauconda where he lives with his family, and on that property, he built Merritt & Associates Equine Hospital.

The facility is a state-of-the-art equine hospital, with a wide range of diagnostic equipment including: Nuclear Scintigraphy (bone scans) - allows the visualization of changes in the metabolic activity of bones or soft tissue.

Digital Radiography -superior to traditional film x-rays because it allows diagnosis of subtle tissue abnormalities and can be easily manipulated on a computer

Digital Ultrasounds- provide views of the chest and abdomen to diagnose and monitor internal diseases. The digital ultrasound is also used for guided biopsies and is equipped to perform echocardiography

Endoscopy - uses a video camera to image the horse’s airways, essential in diagnosing the cause of chronic respiratory diseases and infections
Gastroscopy - video camera imaging of the stomach

Dr. Merritt believes strongly in proper diagnosis to avoid unnecessary and ineffective treatments which can delay appropriate care and negatively impact a horse’s recovery. He likes to quote one of his mentors, Dr. Kent Allen of Virginia Equine who always told him, "Medicine is poison, surgery is butchery, and internal medicine is witchcraft without correct diagnosis."

Dr. Merritt is a leader in developing and implementing new diagnostic techniques, and he has spent hundreds of hours consulting with colleagues and developing his eye for reading the various scans and images. With the advancements in digital technology, veterinarians can now view scans immediately on a computer and share them with experts throughout the world. He admits, however, that, "there’s more art than science," when it comes to interpreting some of this data correctly.

Once a problem has been pinpointed, the course of treatment must be determined. Always at the forefront of technology, Dr. Merritt is active in developing new treatment regimens for musculoskeletal and neuromuscular disorders. He often participates in clinical trials and advanced training programs on new technology and protocols. His practice offers a wide range of treatment options and services for their patients including: Surgery, Shockwave Therapy, IRAP, Vet-Stem, Mesotherapy, Internal Medicine, Pharmacy, Farrier, Laboratory, Peak Pulse Perform Machine, Nutrition and Emergency Medicine.

Following the crowd...

With a capable staff in place at the hospital, Dr. Merritt is able to head south in the winter to follow the performance horse circuit to Wellington, Florida. Most of the performance breeds and disciplines end their midwestern seasons in the fall, and serious competitors pick things back up in winter circuits in Florida. From January through April Dr. Merritt sees Arabians, Saddlebreds, Hunter/Jumpers, Reiners and Dressage horses. Even though the economy has slowed, he hasn’t seen a big impact on his portion of the horse industry. He reports that there is no decline in the demand for diagnostics, but has noticed that more clients are inclined to give a horse time off instead of jumping in to aggressive, more costly treatments.

Staying on top of the game

"Veterinary medicine is a lifelong learning process," explains Dr. Merritt. He keeps up with the latest in this ever-changing field in several ways such as attending meetings and seminars given by professional organizations he belongs to. The American Association of Equine Practitioners (AAEP) addresses topics of interest to equine veterinarians in general, and the International Society of Equine Locomotive Pathology (ISELP) deals with topics and provides connections specifically targeted at the Sports Medicine area of interest.
Sharing his knowledge is also a cornerstone of Dr. Merritt’s practice. He integrates his knowledge and passion with all practice members and provides critical oversight, diagnostic consulting and training to all Merritt & Associate veterinarians. He believes preventative medicine is the best way to keep horses sound and he helps trainers and owners from all disciplines design health maintenance programs. Merritt & Associates Equine Hospital also annually hosts Horseperson Education Seminars, open to clients and interested horsemen. Various experts speak on current health care topics and introduce new technologies and treatments available.

A blog on their website (www.MerrittEquine.com) allows visitors a little more insight into the daily life of an equine vet.

Giving back to the industry

Mentoring is vitally important to the veterinary field. At any given time, Dr. Merritt is hosting up to three interns as well as several externs. He explains, "Veterinary medicine is evolving so fast that a student can’t get enough experience in four years. If you want to specialize, you have to do an internship." He starts out by teaching them how he does things, and then lets them develop their own style and encourages them to adopt what works for them. Since they come from a variety of different programs and backgrounds, he finds that he learns something from each of them as well. Dr. Merritt is also an FEI veterinarian and volunteers as the team vet for Area IV Young Riders. When asked to reflect on his life’s work, Dr. Merritt said, "This is a rewarding lifestyle. I like what I do." His compassion and persistence have helped countless horses enjoy long and successful careers and productive lives. Despite all the technology he has at his disposal, he often tells people that, "More horses have walked out of here through the power of prayer, than by any other means."

Interns & Externs: Who are they and what do they do?

MAEH is a participant in the American Association of Equine Practitioners Avenues Program, which helps in the career training of newly graduated equine practitioners, to ensure that they will continue to have well trained equine veterinarians. This may help explain why we always seem to have a constant supply of fresh new faces! In case you have wondered about what is involved in an internship or externship, the following is a brief synopsis.

Interns are licensed, graduate veterinarians who wish to further their education with in year of on-the-job experience. Equine internships are an important step for veterinarians who wish to specialize in equine practice. There is simply not enough time in school to both learn all the scientific knowledge you must know as well as get practical, hands-on experience. Our Interns work closely under our senior doctor’s supervision, thus learning very valuable skills and gaining practical knowledge. Most interns are new graduates, although some have been out in practice for several years and wish to become more specialized.

We also offer other externships for senior veterinary students who have not yet graduated. Externs may wish to learn more about equine practice in preparation for graduation, or may also be interested in pursuing an Internship following graduation and licensure. Our externs come from all over North America and Europe because MAEH has gained a reputation for providing a valuable learning experience in a well equipped equine hospital.

Please see our Veterinarians & Staff page to learn about our 2010/2011 Interns.