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June 1, 2007

Your Horse Is In Good Hands With Bob Thomas

Your horse trots in from the paddock lame one morning, and you can’t figure out why. Your veterinarian recommends a bone scan at the local equine clinic to pinpoint the problem. At the clinic, you meet the receptionist who takes your admitting information and talk to the doctor who will be in charge of your horse’s case.

You probably don’t notice Bob Thomas. He’s the veterinary technician tucked away in the lab or a patient’s stall when you arrive. Thomas will be your horse’s best friend at the clinic, performing the bone scan that the doctor prescribed, checking your horse’s bandages and making sure that he’s comfortable throughout his stay.

According to Dr. Jennifer Collins, one of the seven veterinarians at San Luis Rey Equine Hospital in Bonsall, Calif., Thomas exemplifies a great technician.

“Besides his experience, Bob has very good horse sense,” said Collins. “He also has a great head on his shoulders. It’s so important to have that willingness to work and to learn. Being a technician is a hard
job, and the salary will never afford you a cottage on the Riviera. You’d better love what you do and truly want to help the horses. Bob really does.”

Thomas, 44, has been a technician at San Luis Rey for seven years. Horse owners from around the region flock to the 36-stall full-service hospital, which specializes in surgery and advanced diagnostic imagery. The clinic admits about 2,100 horses a year and is best known for its veterinarians’ pioneering treatment of Wobbler’s Syndrome in Triple Crown winner Seattle Slew.

The technicians play an important role in the day-to-day operations at the busy hospital.

“Veterinary technicians are integral to the practice,” said Collins. “The technicians are the hands and feet of the doctors, and we really rely on them quite a bit.”

Although the veterinarians prescribe each patient’s course of treatment, the technician is the one actually performing the treatments, be it taking radiographs or administering shockwave therapy.
 
Each of the six techs at San Luis Rey has an area of primary responsibility, filling in for one another as needed. Thomas’ specialty is nuclear medicine, so he performs the nuclear scintigraphy at the clinic. He also processes the lab work for the hospital, prepares the IRAP joint injections and administers shockwave therapy. All of the technicians help with daily patient care, such as placing catheters, maintaining fluids and changing bandages.

“If another tech is out I’ll assist in surgeries or order the supplies for the clinic,” said Thomas. “When the office is short staffed I can help with the billing and the office work. I can do everything except diagnose, prescribe and do surgery.”

A Day At The Clinic

Thomas’ day at San Luis Rey begins in the lab, where he has up to 20 blood samples to process before the staff begin rounds half an hour later. The veterinarians, interns and technicians do rounds together twice a day, checking on the patients’ progress and coordinating treatments. As the veterinarians visit each horse, Thomas provides the blood work results and tracks the treatments prescribed.

After rounds, Thomas meets with the patients scheduled for nuclear scintigraphy, commonly known as bone scanning. The procedure allows small metabolic changes in soft tissue or bone to be seen, often used in unsolved lameness cases.

To prep horses for the procedure, Thomas first catheterizes the horse then injects a small amount of radioisotope pharmaceuticals. The radioisotopes concentrate around “hot spots,” allowing any changes in soft tissue or bone to be seen by a gamma ray camera.

Thomas leads the sedated horse into the bone scan room where he positions the rotating camera to sink into the floor to take images of the horse’s feet from below or rotate up out of the floor to scan the legs or back of the patient. Thomas always takes images of the injured and uninjured limbs so that the veterinarian can compare the results.

The horse undergoes the procedure twice: a soft tissue phase immediately after the injection, and a bone phase two hours later after the radioisotopes have had a chance to bind to the injured area. While the patient waits for his afternoon scan, Thomas outfits him with rubber boots to protect his feet from splashes of radioactive urine.

The veterinarian examines the images that Thomas has taken and prescribes a course of treatment accordingly. Thomas waits about 24 hours—until the horse is no longer radioactive—before performing additional treatments, such as a radiograph or ultrasound.

In between the patient’s two bone scans, other horses ship in for shockwave therapy. Thomas gets to know these patients well, as they visit several times over the course of a few months for treatment.

“Compared with the clinicians, I don’t have a lot of contact with clients,” said Thomas. “But I try to help the customers I do work with by making sure that they have adequate information. The more informed they are the better everything goes.”

The shockwave patients often suffer from chronic fractures, tendon tears, kissing spines or sacroiliac problems. Though veterinarians prescribe the treatment, decide on the area and amount of therapy, it’s Thomas who administers the treatment while an assistant holds the horse.

Like the shockwave patients, the horses receiving IRAP joint injections are largely referrals from other veterinarians, taking advantage of San Luis Rey’s on-site laboratory. The patients ship in for the day so that Thomas can draw a sterile sample of blood required to prepare doses of anti-inflammatory protein-rich serum. Several hours of careful lab work on Thomas’ part will produce the final serum for the veterinarians to inject in the patient’s joints.

San Luis Rey is an emergency hospital open 24 hours a day, seven days a week. One night per week Thomas is on call. Some nights the clinic is quiet, while some nights Thomas’ phone rings several times and he might stay at the hospital all night.

The most common call is for emergency colic surgery. Thomas works with a veterinarian and two interns for the procedure. He acts as the non-sterile technician for the surgery, which means he sets up the tables, preps the patient, helps get the horse on the table, opens the surgical packs, and helps everyone into their gowns. During the procedure he keeps the intestines moist, and afterwards he re-sterilizes the equipment and takes care of the cleaning.

“Sometimes I’ll still be cleaning up and another patient will arrive,” said Thomas. “And some nights I actually get to sleep.”

The Constant Caregiver

When he’s not at the clinic, Thomas runs Double J, a rehabilitation farm at his home in nearby Valley Center, Calif., along with his partner Jeff Cowell.

Thomas applies himself with the same dedication to his lay-up horses as he does at San Luis Rey. He arrives at the barn at 5 a.m. to feed and administer morning medications so he can be at the hospital by 7 a.m. Thomas saves major treatments for the afternoon and evening, often not leaving the barn until nearly midnight.

His experience as a vet tech makes Thomas uniquely qualified to provide the extensive medical care required of some of his rehab horses. Among his current charges are two horses recovering from thoracotomies (surgical incisions into the chest), a jumper recovering from spinal fusion surgery, an orphan foal and a Cushing’s horse.

“Just like at the clinic, the goal is always to get the horses back to what they were doing,” explained Thomas. “We’ve put race horses back in training, dressage horses back to competition, and jumpers back in the show ring.”

In addition to his lay-up horses, Thomas keeps a few Paint and Quarter Horse mares that he breeds. He rescued his favorite mare after her owner died while the young horse was being treated for pneumonia at San Luis Rey.

“The wife was elderly and asked us to put the horse down,” recalled Thomas. “The horse had been at the clinic a while: she’d had a double thoracotomy and two pastern fusions and all kinds of work done. I fell in love with her and couldn’t help but take her home.”

Thomas grew up on a hog farm in rural Nebraska and often visited his grandfather, who kept a Shetland-Quarter Horse cross for him to ride. By the time he was 18 and bought a horse of his own, Thomas was hooked.

“Everything I did after that was to lessen my expenses of keeping horses,” recalled Thomas. “When I was 20, I figured out that it was too costly to pay for a farrier, so I apprenticed in Kansas and became a farrier. Eventually, I got tired of calling the vet to the farm for every ailment, so I decided to go to the tech school to learn the medical aspect of horsemanship.”

Thomas worked his way through veterinary technician school at the Nebraska College of Technical Agriculture in Curtis by shoeing and breaking horses on the weekends. Not long after graduating he realized that there were very few technicians involved in the growing field of nuclear medicine.

Before long he found himself in the radiology department of Kansas State University Veterinary Teaching Hospital, performing hands-on nuclear medicine and radiology and teaching techniques to students.

Although his love of horses inspired his foray into veterinary medicine, Thomas hasn’t just worked at equine clinics. Throughout his 16-year career he’s has also worked with cattle, dogs, cats, snow leopards, tigers, red pandas and snakes.

“Horses are my first love, but I’m interested in working with all animals,” said Thomas. “I always want to broaden my horizons and learn more.”
 
One of the hardest parts of being a technician according to Thomas is finding a balance between compassion and detachment.

“It’s hard not to get too attached,” admitted Thomas. “You can’t completely set your feelings aside. If the clients bring their animals in to get worked on then they’re special to them, and they should be special to you too.

“We get all kinds of horses at our clinic, from pets to world-class,” he continued. “I want to give the animals as much of a chance as their owners want to give them and get them back to doing what they used to do at the end of the day. That’s the ultimate goal.”

Mollie Bailey
 
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