Your primary care veterinarian calls in a specialist for your sick horse; you didn't know there were veterinary specialists. You are familiar with the specialty system in human medicine. Most of us have been to an ophthalmologist, some to an internist, a cardiologist, or a dermatologist. Since about 1972, specialty organizations have become more prominent in veterinary medicine. These organizations oversee the post-graduate training and examination process required to achieve board certification. So, someone who is a veterinary specialist has completed a training program following graduation from vet school, a minimum of two or three years of residency, and subsequently submitted credentials to the certifying organization to be approved to take a comprehensive examination.

How does the specialist fit into the scheme of things for your horse? Usually, the specialist confines his/her clinical practice to one specialty, maybe reproduction or internal medicine. In some cases, a specialist might work in general practice as he develops a specialty offering in a particular region. In most cases, a general practice veterinarian will refer a patient (your horse) to a veterinary specialist for evaluation and care of a problem requiring more in-depth care or experience. The specialist and the generalist become a team to try and provide the best care for your horse.

What does a specialist do? It depends on the problem. A dermatologist might perform a skin examination with certain diagnostic tests, then suggest a course of treatment. An internist might conduct an in-depth physical examination followed by ultrasound and/or endoscopic exams, biopsies, and other diagnostic tests in order to make a specific diagnosis and develop a treatment plan.

Surgeons might evaluate the animal to determine if surgical management is appropriate. Many clients' first experience with a surgeon might be when a horse has to have abdominal exploratory surgery for colic. Others might need orthopedic surgery for developmental limb problems or fractures.

An ophthalmologist might perform an in-depth examination of the eye, including the interior aspects. He can perform additional diagnostic tests to determine which treatments might be needed, such as cultures and cytology of material from a corneal ulcer.

A theriogenologist can perform an in-depth evaluation of a stallion for breeding soundness, or investigate the reason for pregnancy loss or failure of a mare to conceive. A pathologist might be involved as a source of diagnosis by examining surgical biopsies or by performing a necropsy examination on an animal.

All of these individuals focus their efforts on a particular system or group of systems with the goal of providing the most advanced medical care to your horse. Some specialists are your primary care provider, but in most circumstances, specialists work with your primary care veterinarian to take veterinary medical care to the next level. The specialist invests quite a bit of time in studying the latest literature in his area of interest and attending continuing education programs in that particular area, sometimes even attending programs for the parallel specialty in human medicine to try and adapt the latest technology to equine patients.

Some specialists that horse owners might utilize include: American College of Veterinary Internal Medicine (ACVIM); American College of Veterinary Surgeons (ACVS); American College of Veterinary Radiologists (ACVR); American College of Theriogenologists (ACT); American College of Veterinary Dermatologists (ACVD); American College of Veterinary Pathologists (ACVP); and American College of Veterinary Emergency & Critical Care (ACVECC).

Depending on your region, you might find that your primary care veterinarian will suggest a specialist or perhaps contact him for input on the management of a case. The goal is to develop a team process to provide the best medical care for the best outcome. Your primary veterinarian is integral in this process, as she is the one that knows your horse through routine interactions. Teamwork is the face of veterinary medicine in the new millennium, and the horse is the one that benefits.

Editor's Note: Because veterinary specialists have more advanced training and experience in specific areas, The Horse identifies these individuals with their Diplomate (Dipl.) status so readers know the credentials of the person providing information.

About the Author

Fairfield Bain, DVM, MS, Dipl. ACVIM, Dipl. ACVP

Fairfield T. Bain, DVM, MS, Dipl. ACVIM, Dipl. ACVP, specializes in internal medicine and pathology. He is a Clinical Professor of Equine Internal Medicine at the Washington State University College of Veterinary Medicine.

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