Alex Knott Equine Veterinary Services is an independent veterinary practice dedicated to the performance and wellbeing of the equine athlete. Having worked in equine practice for over 20 years, Dr Alex Knott has developed a focus on lameness investigations, ultrasonography, radiography, endoscopy, and pre-purchase exams for equine athletes. The evolution of mobile diagnostic equipment has enabled him to offer hospital-level diagnostics on the yard with a battery-operated DR radiography system. VET.CT met with Alex to discuss how he applies the principles of radiation safety for himself, his clients and his patients on the yard.
General considerations
“Whenever I consider imaging on the yard I always have three key principles in mind:
1) Are my equipment and practices compliant with radiation safety legislation?
2) How can I limit radiation exposure while still obtaining high quality diagnostic images?
3) How can I optimise safety for the horse, handler and myself?
“I have invested in a high quality digital radiography (DR) machine and make sure it’s serviced annually and checked regularly to ensure it’s in good working order and look for any signs of damage. I also have plate holders, lead gloves and gowns, and make sure I gain signed consent for handlers and assistants - anyone within the radiation zone during exposures - prior to taking X-rays. This consent form includes acknowledgement of the risks of ionising radiation, and confirmation that they’re over 18 and not pregnant. Much of this is to ensure I’m legally compliant with ionising safety regulations of course.”
Patient Selection
“As a sole practitioner, all responsibility for radiation safety lies with me alone and I take this responsibility seriously as part of my professional duty. Before I even reach for the X-ray machine, I consider what I am hoping to achieve by taking the images, and how the findings will affect patient management and outcome. As I’m on the road I have to take a pragmatic approach and narrow down to a likely diagnosis before considering what images I might need to take. For example, in an older, heavier horse I’m likely to see changes in multiple joints that may not be clinically relevant. What is the clinical presentation and what do I need to consider to ensure the patient is treated correctly?