TELEMEDICINE CASE 1:

From an owner's email to TEVA

“My horse got this cut a couple days ago (see attached picture), didn’t look like needed stitches, that’s why I didn’t call, but now it’s warm and swollen and he’s mildly lame. Do I need a visit, can I get some antibiotics?” [usually a dialogue with the vet begins with the vet about how long, where is the cut, how lame, what has the owner already tried topically, etc.]

Telemedicine medical record entry is made: “Left front forelimb laceration, (photo attached), 3 days old, no oral meds, owner started bute and BlueCoat ointment on their own, now warm, painful, lame. Appears to be a 2” partial thickness horizontal laceration over lateral forearm with moderate soft tissue swelling, mild serous discharge. Recommended to stop BlueCoat and switch to topical triple antibiotic ointment from grocery store, bandage with non-adherent dressing and vet wrap, start oral antibiotics, SMZ/TMS, 14 tabs, orally twice a day for 10 days. Send follow-up picture in 3 days with progress report. Call immediately is swelling persists or gets worse, no riding, limited turn out to small paddock. Owner will pick up oral antibiotics from TEVA office in 2 hours.”

TELEMEDICINE CASE 2:

Owner sent text/video to TEVA vet's phone

“Doc, take a look at these, my horse Missy is “off” but not lame. Farrier reset shoes 2 days ago, do you need to visit?” [after a few exchanges with the owner…]

Telemedicine medical record entry: “Left hind lameness 2 days after farrier, history of flat feet and soreness after some trims. It could be sole soreness/bruise, abscess developing, or other lameness. Advised owner to give anti-inflammatory for 2 days only (owner already has bute). If a bruise, it will resolve. If an abscess, it will get much worse and requires a visit. If other lameness, it may go away, then come right back, necessitating a vet visit for lameness evaluation. Office to call back in 3 days to check status of Missy.”

TELEMEDICINE CASE 3:

YouTube link sent directly to TEVA vet's phone

Regarding client potential purchase of a horse. “Hey, Dr Jay, I’m thinking about buying this horse, what do you think?” As a result, our veterinarian will review the video, usually several times, then have a small exchange with the sender asking things like what’s the intended use, how old, what work is it doing, etc.

Telemedicine medical record entry: “Client sent video of prospect. 10-year-old, children’s jumper for daughter, horse appears sound at most gaits, video of poor quality for evaluation, appears short on right hind with right hip hike. Unlikely to meet expectations but formal exam may be warranted.”