Equilibre

08/08/2024

📣📣📣Last minute availability tomorrow morning for up to two horses. New or existing clients.

Friday 9th August 2024.

14/11/2023

Last minute availability tomorrow (Wednesday) morning due to cancellation. For new or existing clients.

Read more about our services here:
www.equilibrevet.co.uk

14/10/2023

It’s been an absolute pleasure helping Kiara on her rehabilitation. ❤️

Physio day for Kiara, she thoroughly enjoyed her treatment and the improvement from beginning to end really showed. ❤️ We're to continue with her stretches and walk exercise both inhand & ridden when possible to really build up her core & hindend muscles as well as her fitness 😊
Equilibre

20/07/2023

Such a great weekend at the Riding for the Disabled Association (RDA) National Championships 🐴❤️

19/07/2023

It was lovely to see George’s improvement today. This gorgeous boy has been far from easy for his very patient rider and owner Lyndsey, but she continues to invest in him and has shown spectacular commitment. The results speak for themselves. Last time I saw him he was struggling to strike off correctly and hold right canter lead after a number of orthopaedic issues which had been successfully treated. We have targeted his compensations and weaknesses and Lyndsey has worked hard on his exercises and schooling, whilst keeping his brain fresh but focused. Today he cantered beautifully on the lunge, striking off correctly and maintaining his balance and rhythm well. So lovely to watch him grow. ❤️ And she managed another photo without me realising. 😂

Today Mr George had a visit from Equilibre .. lovely Lorna watched G on a trot up .. then on the lunge.. and then he had a physical examination. Im please to report there is a noticeable improvement 💪🫶🏻💪

On Lorna’s last visit, she left us with clear bespoke exercises and stretches. I’ve really tried to implement them into George’s daily routine.

Now ridden wise .. i have noticed an improvement.. and I was hopeful Lorna would notice the same 💪

I feel like we are really turning a corner.. (as we all know.. horses are great levellers.. 🫣) buttttt fingers crossed we keep moving forward. 🫶🏻

I’m really in a positive place with G .. far from perfect.. but definitely positive.

He really enjoyed his treatments today ..we are now armed with current and new exercises.

Massive thanks to Lorna. 💗

Honestly highly recommended!

19/07/2023

Last weekend, Equilibre equine vet and physiotherapist Lorna Brokenshire-Dyke had the pleasure of volunteering her time at the Riding for the Disabled Association (RDA) National Championships held at Hartpury, Gloucestershire.

This event is the highlight of the RDA calendar and gives the opportunity for adult and child competitors, volunteers and supporters, to all come together during an intensive weekend competition schedule covering a wide variety of disciplines, from vaulting to carriage driving, to dressage and showjumping. Lorna provided veterinary cover for the showing classes, dressage arenas and the endurance classes - which were new to the championships this year. She was also able to provide veterinary physiotherapy to equine competitors as needed.

RDA is an inclusive and diverse organisation welcoming all clients with physical and/or learning disabilities of all ages. RDA horses and ponies benefit the lives of over 17,000 disabled children and adults with a comprehensive network of member groups and nearly 500 RDA centres throughout all corners of the UK.

Speaking about the event, Lorna said “The National Championships is a wonderful event that showcases the incredible abilities and talents of RDA members. The therapeutic health benefits of horses is well recognised and it was wonderful to see such a huge variety of fabulous horses. RDA provides the opportunity to celebrate the progress and achievement of disabled riders and carriage drivers, removing barriers and providing adaptations where necessary.”

Lorna was especially delighted to meet up with nine year old Ezzy Hodge (Ezzys wish to walk) who is absolutely pony mad. Ezzy was competing at her first RDA Championships in dressage and rode a beautiful test with RDA superpony Jim. Ezzy has Cerebral Palsy and horse-riding helps improve her balance, coordination and core strength. But mainly she just loves horses. 🐴❤️

To read more about RDA’s work, please visit:
https://rda.org.uk

Please click on each photo for further details.

06/07/2023

This is great advice regarding feeding oil from SPILLERS. This is something I often talk about with clients. Oil can be so useful to promote safer weight gain without increasing bulk.

Our top tips for feeding oil to horses

10/06/2023

Lovely to see fabulous Connemara Rolo out and about today after a recent routine physiotherapy session. 🐴❤️

06/06/2023

Calling all veterinary surgeons! 📣📣📣

It would be absolutely fantastic if you could spare a few minutes to complete this survey please.

https://www.surveymonkey.co.uk/r/navp-vets

National Association of Veterinary Physiotherapists (NAVP) have recently experienced significant changes in their executive leadership team. They have also recruited external market researchers and are planning an imminent re-brand following this period of consultancy with key stakeholders. The association is very keen to hear from veterinary surgeons, both small and large animal, about their experiences of working with NAVP and their members, and specifically how they choose and recommend veterinary physiotherapists to clients.

Please feel free to add any additional comments or experiences here as well. Also, please share within your own networks. Thank you.

06/06/2023

Fabulous to see Gorgeous George doing so well. Onwards and upwards for this wonderful boy. ❤️🐴🇪🇸

31/05/2023

Wow it’s the end of May already. This month has flown by and this page has been neglected a little in the process. Sorry about that! Equilibre was only registered as a limited company a few months ago and we have enjoyed settling into a new work rhythm. It’s definitely not easy juggling the two jobs - working both as a Rossdales veterinary surgeon and as a veterinary physiotherapist with Equilibre. Add in life, family and study and things sure do start to get complicated. This means both taking and posting photographs often gets overlooked. Here are some photos we remembered to take, but forgot to post, of the fabulous horses we’ve had the pleasure of treating in recent weeks. We see such a variety of horses: from international showjumpers to advanced dressage horses to show horses, from cobs to Connemaras, from rehabilitation cases post-injury to Thoroughbreds fresh from the track ready for rehoming, from baby horses just starting their careers to experienced athletes looking to maximise performance. Variety is truly the best part of this job. Thank you so much to all the amazing clients who have chosen Equilibre.

Please note there is only very limited appointment availability left in June and we are now taking bookings into July and August. Please do get in touch.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

www.equilibrevet.co.uk

30/05/2023

Great to see George going so well. He’s such a special boy. ❤️ Good job Lyndsey!

07/05/2023

Expert vets are “strongly advising” horse owners against using independent and unvalidated genetic tests for certain conditions – stating that “seemingly normal animals” have been put down as a result of their use. The British Equine Veterinary Association (BEVA) cited tests for myopathies...

30/04/2023

starts next next week. Get involved. Free webinar on Wednesday 3rd May.

📢Giveaway alert!! 📢

Attendees at our 'Taking the Heat Out of Strangles' webinar will be eligible to claim a free thermometer and Strangles information pack.

Join host Dr David Marlin for a brand new conversation about Strangles in our webinar, hosted by World Horse Welfare.

Guests include Caterina Termine, Senior Veterinary Advisor to the
Fédération Equestre Internationale and Professor Ashley Boyle, from the University of Pennsylvania School of Veterinary Medicine, a research specialist on the disease.

Plus, Piggy March has recorded a special video message, with insights into her biosecurity practices at home and at events, and we are joined by a panel of vets, horse owners and venue managers sharing their outbreak lessons.

Register to join us here ➡️
https://worldhorsewelfare.zoom.us/webinar/register/9016794980804/WN_h1l6_87CT7-Gvj2PCwyVeg

The British Horse Society
Keeping Britain's Horses Healthy
MSD Animal Health Nederland
GD
Redwings Horse Sanctuary
Dick Vet Equine
The Royal (Dick) School of Veterinary Studies
SVA- Statens veterinärmedicinska anstalt
The Horse Trust
Dechra UK
Mare and Foal Sanctuary

29/04/2023

Manual therapies (post 5/10)

Manual therapies are the mainstay of our in-session treatment techniques. They are tailored according to the unique requirements of each horse. They will typically include a combination of:

Targeted massage techniques

Myofascial release techniques

Passive range of motion exercises

Joint mobilisations

Targeted stretching

Dynamic mobilisation exercises

Manual trigger point therapy

Cryotherapy - heat and cold

Typically a patient will benefit from repeated application of these techniques and, where appropriate, the owner, trainer or groom will be clearly taught how to perform relevant techniques safely to enhance their horse’s progression.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

29/04/2023

It's World Veterinary Day and a moment to acknowledge all those that give their working days to our wonderful profession (and those that give much more than their working days). We commit to giving our professional lives over to the health and welfare of the animals in our care - often this can be at quite significant personal sacrifice. This year celebrates the promotion of diversity, equity and inclusiveness in the veterinary profession. I have been truly fortunate to be taught by a brilliant and diverse bunch of veterinary surgeons, nurses and support staff throughout my career. Thank you.

I have always been immensely proud to be a vet and I am truly lucky to still be in love with my job.

29/04/2023

📣Local people!📣

Dont miss the Bank Holiday open day at Becky Jackson Horse Riding this Monday. It’s sure to be a lot of fun! And it’s free entry! We have the pleasure of providing veterinary services to this lovely local riding school through the ambulatory team at Rossdales and over Easter Lorna had the delight of delivering a lecture on “When to call the vet” to a very enthusiastic audience.

29/04/2023

Assessment – palpation (post 4/10)

Our hands are our most useful tool! Our hands connect us to our patients, to both assess and treat. The skill of palpation builds up over time and hundreds of patients – learning what is within normal limits for the age, type and training status of each animal, detecting changes in tissue structure and understanding how these changes relate to pathology and function. Manual assessment of the horse includes palpation of all tissue types (tendon, ligament, muscle, bone, fascia and joint capsules), assessing passive joint range of motion, spinal assessment and performing specific assessments of myotatic reflex responses, eg across the spinal muscles, sacroiliac tilts and abdominal lifts.

Lorna has been palpating horses’ bodies and limbs as a qualified veterinary surgeon for 14 years. Whilst Lorna only offers veterinary physiotherapy services through Equilibre (full veterinary services are offered through her employment with Rossdales Veterinary Surgeons), Equilibre clients benefit from her extensive experience and veterinary knowledge during this assessment process – the knowledge gained from her two professional streams cannot be separated. Where pathology is identified beyond the scope of a physiotherapy session, Lorna will liaise directly with your own veterinary surgeon, continue the investigations herself within the framework of a Rossdales ambulatory lameness work up (using nerve bocks and imaging modalities where appropriate), or refer to her colleagues at Rossdales Diagnostic Centre for more advanced procedures.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

28/04/2023

Assessment – dynamic (post 3/10)

The dynamic assessment is a very important part of the physiotherapy service we provide. The way a horse moves and uses his/her body tells us so much about their natural movement patterns and any gait adaptations they have adopted in response to imbalance, weakness or pain.

As an equine vet, Lorna is well placed to identify and understand underlying clinical pathology that is driving musculoskeletal dysfunction and altered biomechanical patterns. All initial consultations will typically include examining the horse in-hand at walk and trot in a straight line from three directions. Our dynamic assessment is thorough and comprehensive and provides an opportunity to examine the horse for lameness, asymmetry or neurologic dysfunction. Depending on the individual case, further examination may be required including comparison of movement across different surfaces, dynamic assessment of three gaits on the lunge or long lines, ridden assessment or more focussed neurological tests. This is when information supplied prior to the appointment can be really helpful so that we can schedule extra time for any additional examination required.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

27/04/2023

Proud member of the National Association of Veterinary Physiotherapists (NAVP) - our professional association for Veterinary Physiotherapists. All members are level 6 or 7 qualified, ensuring the highest calibre of veterinary physiotherapists, working to the strictest professional standards.

Also proud to be on the RAMP-Register of Animal Musculoskeletal Practitioners, a voluntary register for highly qualified veterinary physiotherapists, chiropractors and osteopaths. (Must get my renewal in tomorrow).

26/04/2023

Assessment – static (post 2/10)

We perform a full clinical exam for all new cases, including static and dynamic musculoskeletal assessment and clinical palpation.

Static assessment involves looking both at the horse’s conformation and posture. The conformation is the animal’s fixed anatomy and cannot be changed. The posture is influenced by many things, primarily the horse’s musculoskeletal development – strength, conditioning and training, but also the horse’s temperament, current attitude and pain status. Beware the popular before and after photos which show huge differences, many of which can be heavily influenced by stance and attitude (eg relaxed vs alert) and therefore may not be significant. Muscle symmetry is really important, and we always take time to ensure the horse is standing square on a level surface for this to be usefully evaluated. Dorsoventral balance, limb straightness, joint alignment and foot balance and symmetry are all assessed. These can yield important clues for the horse’s biomechanical patterns, areas of weakness, tension and current or potential pathologies and unsoundnesses.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

26/04/2023

History (post 1/10)

The importance of a good history

Everything starts here. In order to fully understand any current issues, a full and thorough history is essential. It can be helpful when new clients send through a summary of their aims and concerns prior to the first appointment. (All our contact details can be found on our website www.equilibrevet.co.uk) This means that we can arrive with some understanding already in place, making our first appointment more time efficient for assessment and treatment.

Things that are useful to know include: how long you have had your horse, what you do with him/her, what you would like do or achieve with him/her ie your goals. Do you have any specific competitive plans and the timeline for this. What your horse’s current workload is. Are there any current veterinary concerns or lameness issues, or significant past veterinary concerns, including medical or surgical interventions. Are there any performance issues. What your horse’s temperament is and whether there have been any recent behaviour changes. So many things may be relevant, if you think something might be important, do let us know; nobody knows your horse better than you. We are experienced in sorting out all the necessary useful information from our consultation and using it to best inform how we work with you. Every horse and rider combination is unique and so is the service we provide to you.

***Equilibre*** Bespoke equine veterinary physiotherapy from a qualified veterinary surgeon and veterinary physiotherapist. Promoting movement through freedom and balance.

23/04/2023

It’s been a productive weekend and we are fully caught up with reports and invoices - which is always a great feeling.🤩 I’m hoping to find time next week to write a little more about the work we do and the therapies we offer. We are fully booked for the next few weeks however we do have some availability towards the middle/end of May. Contact us to find out more or book an appointment. www.equilibrevet.co.uk

20/04/2023

This really is so important. Useful to share to you own networks.

Stress Awareness Month

Here is an infographic made alongside Vetedx that helps you understand the subtle signs of stress in our pets.

This is not an exhaustive list but teaching children, and adults, how to recognise these signs to de-escalate a situation safely is extremely important.

18/04/2023

This is a long read, but an excellent read. It’s written by a colleague I share a vet group with. She wrote it through sheer exasperation. I can assure you no vet joined the profession to make money. There are a million better career choices if that was the goal.

THE COST OF VETERINARY MEDICINE: BEHIND THE SCENES

This is a really long one, but please bear with me as it is important. And it’s required reading for the Zoom session later this month - see end of post!

We are all painfully aware of rising costs of everything at the moment. Some of us are already struggling with bills, and unfortunately many more may do so over the next few months and - dare I say - years, as the short term economic picture is not pretty.

As a profession, veterinarians are placed at the junction where decisions about the care of a living creature are often made based on money - how much the care costs, can we afford it, and how on earth can we make a decision to end a life if we can’t? Emotions run high, always - worry for the pet, empathy with their problems, stress about affording treatment (and inevitably the car breaks down at the same time, or the electric bill is due, or the kids have a school trip…), helplessness at the thought of our pets being in pain or distress, despair at the mere thought of losing them - the list is long, but through the very core of it all runs a deep vein of pure love. Love for the myriad creatures who share our lives, our homes, who fill our hearts with joy, who pick us up when we’re down and love us back unconditionally. So what price do we put on love? How can we even do so?

That is the thorny problem that veterinarians and pet owners across the globe struggle with on a daily basis, and we despair over it just as much as our clients do. As vets, knowing that we have the knowledge and the skills to help, and not always being able to because it would cost too much to do so, can be soul-destroying. As pet owners, knowing that our pets could be helped, but we just don’t have the money available to make that happen, is equally so.

Where do we go from here? Is there a solution? Our starting point is to have an understanding of the pricing structure of veterinary practices, and where the money you pay for your pets’ care actually goes.

Firstly, 20% of every veterinary bill in the UK is VAT. We are basically a glorified tax collector in that respect, and 20% of what you pay us goes directly to the government.

As for the remainder, any income a veterinary practice earns is apportioned as follows (these are approximates, and will vary between practices, more on this below):
- 40-50% on staff wages (includes vets, veterinary nurses, animal care assistants, receptionists, cleaners, practice managers, etc)
- 15-20% on overheads/fixed costs (mortgage/rent, electric/gas - and our bills have literally quadrupled in January when our contract switched over, water, phone/internet, all the many insurance policies we have to carry, accountant fees, health and safety company fees, employment law company fees, IT support fees, clinical waste disposal, regular waste disposal, card processing fees, website hosting, etc)
- 25-40% on COGS (Cost Of Goods and Services) - these are all the medications we buy in from our suppliers, all the consumables (syringes, needles, catheters, dressings, suture material, sterile surgical gowns, gloves, cleaning materials…), all the fees the outside labs charge us, the fees pet crematoria charge us; basically everything that we need to buy to help us take care of your pets
- 5-10% profit (and this profit is taxed again by the government at 25%)

If you add up the above percentages, you will notice that it is very possible for profit to be zero, or even in the negative numbers, and for some practices or in some months, it is, and some of those practices have had to close their doors as a consequence.

Profit is needed for any business to survive. Out of the profit line come equipment repairs, equipment replacement, equipment upgrade, new equipment if we want to provide an additional service (e.g. laser treatment, or endoscopy), staff raises, continuing education courses (all vets and nurses have to meet an annual quota of continuing education hours), any building repairs needed, and so on. A profit line allows us to deal with the unexpected, to be flexible, to replace that autoclave when it wears out and not go into overdraft. To have the reserves to cope with the reduced workload that came with COVID.

Let’s put this into real world terms. Your dog has had vomiting and diarrhoea for 2 days, you’ve taken her to the vets, they’ve discussed her history and symptoms with you, performed a physical examination, concluded it’s most likely a gastroenteritis, administered an injection for vomiting and sent you home with a couple of oral medications as a course of treatment, with the caveat to contact the practice should she not respond as expected. You’ve paid £120. Of that £120:
£20 goes to the government for VAT (it's actually £24 but let's keep the numbers round for ease)
£45 pays for the staff wages
£15 pays for overheads
£30 pays for COGS
£10 is practice profit (and remember: this is not true take home profit - as explained above, out of this come equipment and building repairs, staff raises, new services etc; and £2.50 of it goes to taxes)

As a real life example, we own a small practice - 2 vets, 5 nurses, a team of 14 people altogether. The break-even (without any profit) costs of running our practice are currently £60000 per month, inc-VAT, as a minimum, just to pay our bills. That is the real cost of running even a small veterinary practice. And it only scales upwards for larger practices.

What can we do about this? We can manipulate some of the numbers a little bit. Overheads/fixed costs we don’t have much control over. When it comes to COGS, we can shop around and make sure we get the most favourable prices - so if you notice that the brand of arthritis medication your pet takes is different every couple of months, that’s why. We can join a buying group, which is a way of taking advantage of bulk purchasing deals. We can make sure we are as efficient as possible, and waste as little as possible. We are all doing everything we can in this bracket.

Some of the things we can do to decrease our costs would also decrease the level of patient and client care we provide, so many of us don’t really want to do that - for example, we can decrease staffing levels (which may result in not having enough nurses available to monitor pets recovering from anaesthesia, or to maintain cleanliness, or to look after hospitalised patients), we can operate in less sterile environments, invest less in team education and supplies. Most pets will survive, but some won’t, and some will not do so well and have poorer outcomes. We can give you less of our time - shorter consults, not being available for questions over the phone, no lengthy e-mail explanations. The decision may become: do we compromise our pet and client service and take these measures, or do we increase prices again?

One question that often comes up is: why can we buy medication online for less than the vets charge? Most practices have historically used medication mark ups (meaning, charging clients more for medication than we purchase it for) in order to keep service fees (consults, surgery, hospitalisation) lower. The online retailers have thrown a massive wrench into the works here - because they purchase (and sell) drugs in such large quantities, they get big discounts from the manufacturers, so that in many cases they can sell the drugs to you for less money than vets are buying them for. And it is illegal for vets buy them online, we are strictly regulated and have to buy them from one of only 3 available national wholesalers. Whether we reduce our drug mark ups to encourage clients to continue buying medication from us, or whether we provide written prescriptions for our clients to buy medication online, the end result is the same - if vet practice drug revenue goes down, our service fees must come up to compensate. The only winners are the drugs manufacturers and the online retailers. So that is a factor as well.

The most useful thing that we can all do is talk to each other, and listen to each other’s side of the story. For our clients - I hope that you know and trust us well enough to know that you can always talk to us about your concerns, financial or otherwise. For those who are not our clients - I would encourage you to talk to your vets, get to know them over time, develop a relationship you can trust. This is, at its core, a relationship profession. The vets have your pets’ best interests at heart - helping your pets is the very reason they entered the profession in the first place. Talk about preventative care, nutrition, exercise, avoiding emergencies, various ways of keeping your pet well. When a problem arises, in most cases, there will be more than one way to deal with it. Your vet is always going to offer you the treatment option that should result in the best and safest outcome for your pet - and this is not always the most expensive option! However, if costs are an issue and option A is not affordable, there are usually options B, C, and even D. We may have to compromise a little on the outcome or cope with some side effects, but there is usually a way to provide treatment to fit most budgets. And yes, there are unfortunately some situations where there are no alternative options and then tough decisions may need to be made. But for most pets, there will be options.

We are all here, vets and pet owners alike, because we love animals and want to care for them. None of us would involve money in this equation if we could help it, but that is the reality of the world we live in. We need to communicate together with understanding, mutual respect and recognition that we all want the same thing - a happy, healthy pet to share our lives. And when our lottery win pans out, you can all come to our animal sanctuary for free treatment! Retirement goals :)

We’re planning on a Zoom meeting (or FB live, depending on what I manage to make work as technology and I are not the best of friends) towards the end of the month to discuss how we can best look after our pets on a tightening budget - I’d love for this to be a collaborative discussion so please bring all your questions and ideas! And look out for a separate post (pinned to top of page) about dates and times!

Dalya and Stan Livy

18/04/2023

You asked, we listened.

Emma Moore, as requested.

When you are passing a horse in a vehicle you need to allow 2 metres clearance. This means that if the horse turns to face towards the car or kicks out it will not hit your vehicle keeping the horse, rider and driver safe.