Thoracic Radiography in Equine Practice: Technique and Interpretation

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-08-11

Key Takeaways

• Thoracic radiography in horses requires high-capacity equipment (100-120 kVp, 20-40 mAs) and grids (8:1-12:1 ratio) due to the large thorax and high scatter. Digital radiography offers a wide dynamic range but necessitates monitoring exposure index to avoid marginal quality.
• Diagnostic quality is critically dependent on patient preparation, including pulling forelimbs forward to minimize superimposition over the cranial thorax, and exposing during the expiratory pause for optimal lung parenchyma visualization.
• The primary limitation of equine thoracic radiography is the inability to fully evaluate cranioventral lung fields due to forelimb musculature superimposition; thoracic ultrasonography is complementary and superior for peripheral lung surface and small pleural effusion detection.
• Common pathological patterns include alveolar (fluffy opacities with air bronchograms indicating pneumonia or edema), interstitial (reticular or nodular opacities suggesting neoplasia or granulomatous disease), and bronchial (thickened bronchial walls seen in chronic bronchitis).
• Sedation with alpha-2 agonists like detomidine can alter esophageal function, mimicking grass sickness findings, which must be considered when interpreting contrast studies of the esophagus.
• Interpretation requires a systematic approach, evaluating extra-thoracic structures, trachea, cardiac silhouette, pulmonary vasculature, parenchyma, pleura, mediastinum, and diaphragm, comparing findings to normal anatomy and recognizing common artifacts like motion blur and forelimb superimposition.

Thoracic radiography in the horse presents a unique combination of technical challenge and diagnostic reward. The equine thorax is large, the required exposure factors are high, and the patient is often standing and unsedated or lightly sedated. This article provides a structured approach to obtaining diagnostic thoracic radiographs in horses and to interpreting the common patterns of equine thoracic pathology. It is written for the practicing veterinarian who performs or interprets equine thoracic radiography and who needs a practical framework for image acquisition, quality assessment, and pattern-based diagnosis.

The clinical questions that thoracic radiography answers in the horse include the presence and distribution of pulmonary interstitial or alveolar disease, the detection of pleural effusion or pneumothorax, the identification of mediastinal masses, and the evaluation of the cranial mediastinum and cardiac silhouette. Radiography complements thoracic ultrasonography, which is superior for detecting small volumes of pleural fluid and for evaluating the peripheral lung surface. The two modalities are often used together, with ultrasonography guiding the decision to perform radiography and radiography providing a global view of both hemithoraces that ultrasound cannot achieve.

This article assumes familiarity with basic radiographic physics and positioning principles. It focuses on the specific adaptations required for the equine patient, including equipment capacity, exposure technique, and the interpretation of findings in the context of equine respiratory disease.

At a Glance

Physical Principles and Equipment Requirements

The adult equine thorax has a dorsoventral thickness of 30 to 40 cm and a lateral width that requires a primary beam of substantial penetration. Standard small animal radiographic units, typically rated at 300 mA and 125 kVp, are often insufficient for the adult horse because the required exposure factors exceed their tube loading capacity. A unit capable of generating 100 to 120 kVp and 20 to 40 mAs is generally necessary, and a high-frequency generator with a rotating anode tube is strongly preferred. The American College of Veterinary Radiology provides specialty standards for diagnostic imaging practice that include equipment recommendations and radiation safety expectations for veterinary facilities.

Digital radiography systems, both computed radiography and direct digital detectors, have largely replaced film-screen combinations in equine practice. The wide dynamic range of digital detectors reduces the frequency of repeat exposures due to under- or overexposure, but it also introduces the risk of accepting images of marginal quality because they are viewable on a monitor. The exposure index should be monitored to ensure that the detector is not being used outside its optimal range.

Grids are essential for thoracic radiography in adult horses. The scatter-to-primary ratio in the equine thorax is high, and a grid with a ratio of 8:1 to 12:1 is recommended. A moving grid is preferred to avoid grid lines, but a stationary grid with a high line frequency is acceptable if the focus-to-grid distance is matched to the grid focal range.

Patient Preparation and Positioning

The horse should be positioned in a stocks or against a wall to minimize movement. The forelimbs should be pulled forward, either manually or with ropes, to move the triceps muscles and humerus cranially and to reduce superimposition over the cranial thorax. This maneuver is critical for evaluating the cranial mediastinum and the cranioventral lung fields. The head and neck should be extended and held in a neutral position.

Sedation is often necessary to achieve safe positioning and to reduce motion artifact. However, the choice of sedative matters. Detomidine, a commonly used alpha-2 agonist, has been shown to produce dose-dependent changes in esophageal function, including increased transit time, retention of contrast within mucosal folds, and retrograde peristalsis, as documented in a contrast radiographic study of healthy Thoroughbreds. These changes mimic the esophageal dysfunction seen in grass sickness and can confound interpretation of contrast studies of the esophagus. For survey thoracic radiography, the effect is less relevant, but for barium swallow studies, the effects of detomidine on esophageal function must be considered when interpreting results.

The radiographic beam should be centered over the caudal lung fields, approximately at the level of the cardiac silhouette, and the exposure should be made during a pause in respiration. Horses cannot be asked to hold their breath, so the radiographer must observe the thoracic wall and expose during the expiratory pause when the lung is at its most stable and the diaphragm is most cranial. Expiratory films are preferred in horses because they reduce the volume of aerated lung and increase the relative opacity of the pulmonary parenchyma, which paradoxically improves the visibility of some lesions.

Radiation Safety Considerations

The high exposures required for equine thoracic radiography generate significant scatter radiation. All personnel should stand behind a protective barrier or wear lead aprons and thyroid shields. The AVMA practice resources provide guidance on radiation safety protocols for veterinary facilities, including the use of personal dosimeters and the establishment of safe operating procedures. The primary beam should be collimated to the smallest field that includes the region of interest, and the handler holding the horse should be positioned cranial to the beam path whenever possible.

Normal Radiographic Anatomy

The normal equine thoracic radiograph shows a clear cranial mediastinum, a cardiac silhouette that occupies the middle third of the thorax, and pulmonary parenchyma that is more opaque in the cranioventral fields than in the caudodorsal fields. The pulmonary vasculature should be visible as branching linear opacities that taper toward the periphery. The caudal vena cava is seen as a distinct linear opacity coursing cranially from the diaphragm to the right atrium. The trachea is visible as a gas-filled tubular structure that bifurcates at the level of the fifth to sixth intercostal space.

The normal lung fields in the adult horse are not uniformly radiolucent. The cranioventral lung is partially obscured by the forelimb musculature, and the caudodorsal lung is the most reliably evaluated region. The MSD Veterinary Manual provides a species-specific overview of normal thoracic anatomy and common radiographic findings that can serve as a reference for the practicing veterinarian.

The cardiac silhouette in the horse is more horizontally oriented than in small animals, and the apex is located close to the sternum. The cranial border of the heart is normally well defined, and loss of this border suggests a cranial mediastinal mass or severe pulmonary consolidation. The diaphragm is visible as a curved line that is more cranial on the right side than on the left in most horses.

Technical Limitations and Common Artifacts

The most significant limitation of equine thoracic radiography is the inability to fully evaluate the cranioventral lung fields in many adult horses. The forelimb musculature and the shoulder joint overlie this region, and even with maximal forward traction of the limbs, a portion of the cranial lung remains obscured. This limitation is clinically relevant because many horses with pneumonia have cranioventral consolidation that is not visible radiographically. Ultrasonography is the preferred method for evaluating this region.

Motion artifact is common and is caused by cardiac pulsation, respiratory movement, and patient shifting. The use of a high-speed exposure, typically 1/60 second or faster, reduces cardiac motion blur. Respiratory motion can be minimized by exposing during the expiratory pause, as described above.

Pleural effusion produces a characteriztic increase in opacity in the ventral thorax with a horizontal fluid line when the horse is standing. The fluid line is visible only if there is air above the fluid, which occurs in some cases of pleuropneumonia. In the absence of a fluid line, the effusion appears as a homogeneous increase in opacity in the ventral lung fields with loss of the cardiac silhouette and the ventral diaphragm.

Indications and Case Selection

Thoracic radiography in horses is indicated when clinical signs point to intrathoracic disease, including cough, nasal discharge, tachypnoea, exercise intolerance, unexplained weight loss, or abnormal thoracic auscultation. The technique is complementary to thoracic ultrasonography. Ultrasonography is superior for evaluating the pleural surface, peripheral lung consolidation, and diaphragmatic and cardiac silhouettes, while radiography is the preferred method for assessing the pulmonary parenchyma, trachea, and mediastinum. The two modalities should be used together instead of in isolation.

A key decision point is whether the patient can tolerate standing radiography. Horses with severe respiratory distress may not stand safely for the procedure, and the stress of positioning can worsen dyspnoea. In such cases, thoracic ultrasonography performed in the stall is often the safer first step. If a large pleural effusion is identified, therapeutic drainage should be considered before radiographic examination, as removal of fluid improves patient comfort and radiographic quality. The case of a grey horse with malignant melanoma and massive pleural effusion illustrates this principle: the dyspnoea was directly related to the volume of effusion, and imaging findings were only fully interpretable after the clinical picture was stabilized Metcalfe et al., institutional publication.

Sedation is frequently required for patient cooperation. Alpha-2 agonists are commonly used, but they have measurable effects on esophageal function. Detomidine at sedative doses prolongs contrast transit time, increases retention of barium within mucosal folds, and promotes retrograde peristalsis and pooling of contrast within the esophagus Watson and Sullivan, institutional publication. These changes mimic the radiographic appearance of grass sickness. If contrast studies of the esophagus are planned, either avoid sedation or interpret the study with this limitation in mind.

Radiographic Projections and Technique

The standard equine thoracic study consists of four overlapping lateral projections of the right hemithorax, obtained with the horse standing and the x-ray beam directed horizontally. The cassette or digital detector is placed against the horse's right side, and the tube is positioned on the left. The four projections are:

1. Cranial thorax: centerd on the thoracic inlet, includes the cranial lung lobes and trachea.
2. Cardiac region: centerd on the heart base, includes the cardiac silhouette and caudal vena cava.
3. Caudal thorax: centerd on the diaphragm, includes the caudal lung lobes.
4. Dorsal thorax: centerd on the dorsal lung field, includes the aorta and azygos vein.

Each projection should be obtained at peak inspiration. Horses do not breath-hold on command, so the radiographer must trigger the exposure during the inspiratory phase. A practical approach is to observe the thoracic wall movement and expose when the chest is maximally expanded. Expiratory films compress the lung parenchyma and can create pseudo-lesions.

The x-ray beam must be perpendicular to the thoracic wall to avoid geometric distortion. Slight obliquity rotates the cardiac silhouette and can create apparent pulmonary opacities. The detector should be positioned as close to the horse as possible to minimize magnification and scatter.

Equipment Settings and Image Quality

The equine thorax is a high-scatter, high-attenuation region. A high-output generator is mandatory. The following settings serve as a starting point, technique charts should be adjusted for patient size and detector speed:

A moving grid is preferred to a stationary grid to reduce grid lines. The exposure should be made with the horse's leg on the side of the beam advanced, which moves the triceps muscle cranially and reduces soft tissue opacity over the cranial lung field.

Digital radiography systems allow post-processing, but the raw image should be assessed before edge enhancement is applied. Over-processing can create the appearance of interstitial disease where none exists. The radiographer should verify that the trachea is visible as a gas-filled tube and that the pulmonary vessels are sharply marginated. If the vessels are blurred, motion is present and the exposure should be repeated.

Interpretation Checklist

A systematic review of the equine thorax should follow a fixed order to avoid missing subtle lesions:

1. Extra-thoracic structures: thoracic spine, ribs, scapulae, and soft tissues. Look for fractures, periosteal reaction, or masses.
2. Trachea: position, diameter, and wall integrity. The trachea should be a smooth gas-filled tube. Dorsal displacement of the trachea can indicate a cranial mediastinal mass.
3. Cardiac silhouette: size, shape, and position. The cardiac silhouette should not exceed 65% of the thoracic height at its widest point. Cardiomegaly is suggested when the heart extends beyond this limit or when the caudal vena cava is elevated.
4. Pulmonary vasculature: the pulmonary arteries and veins should be visible as branching linear opacities. Compare the size of arteries and veins in the same lung region. Enlarged vessels suggest pulmonary hypertension or increased pulmonary blood flow.
5. Pulmonary parenchyma: the normal lung is more radiolucent than the soft tissue of the heart and vessels. The lung should be uniformly dark with a fine reticular pattern of interstitial markings. Increased opacity is graded as interstitial, alveolar, or bronchial.
6. Pleura: the pleural space is not visible in the normal horse. A visible pleural line or fluid opacity indicates effusion or pneumothorax.
7. Mediastinum: the cranial mediastinum should be narrow. A widened mediastinum suggests a mass, lymphadenopathy, or abscess.
8. Diaphragm: the diaphragmatic contour should be smooth and domed. Irregularity or elevation suggests diaphragmatic hernia or paralysis.

Common Pathological Patterns

Alveolar pattern appears as fluffy, coalescing opacities with air bronchograms. It indicates airspace filling from pneumonia, hemorrhage, or edema. Cranioventral distribution is typical of aspiration pneumonia or bronchopneumonia. Diffuse distribution suggests cardiogenic edema or acute respiratory distress syndrome.

Interstitial pattern appears as a reticular or nodular increase in opacity. A mild interstitial pattern is common in aged horses and may be incidental. A marked nodular interstitial pattern raises concern for neoplasia, granulomatous disease, or fungal pneumonia. Metastatic disease should be considered when multiple well-defined nodules are present.

Bronchial pattern appears as thickened, prominent bronchial walls, often described as "doughnuts" when seen end-on. This pattern is seen with chronic bronchitis, recurrent airway obstruction, and inflammatory airway disease.

Pleural effusion appears as a homogeneous soft tissue opacity in the ventral thorax, often with a horizontal fluid line if a horizontal beam is used. The cardiac silhouette may be obscured. Ultrasonography is more sensitive for small volumes of fluid, and radiography should not be used to rule out effusion.

Pneumothorax appears as a retracted lung margin with a gas-filled pleural space dorsally. The lung may be collapsed and the cardiac silhouette displaced. Pneumothorax is uncommon in standing horses and is usually traumatic or iatrogenic.

Mediastinal mass appears as a soft tissue opacity widening the cranial mediastinum. The trachea may be displaced dorsally or laterally. Differential diagnoses include lymphoma, melanoma, abscess, and granuloma. The case of malignant melanoma with mediastinal involvement demonstrates that melanomas can metastasise to the thorax and produce a large mass Metcalfe et al., institutional publication. Cytological sampling is required for a definitive diagnosis.

Documentation and Reporting

Radiographic findings should be recorded using standard descriptive terminology. The report should state the projection, the radiographic quality, and the findings in each region. Measurements should be included where relevant, such as cardiac size or the distance between the trachea and the spine. A conclusion should list the most likely differential diagnoses and recommend further imaging or sampling where appropriate.

Serial radiographs are valuable for monitoring disease progression or response to therapy. The same projections and technique should be used each time to allow direct comparison. Subtle changes in pulmonary opacity are easier to detect when the technical factors are identical.

Recognized Complications and Early Detection

Thoracic radiography in horses carries a low but real risk of complications, most of which relate to patient handling and sedation instead of the radiation exposure itself. Respiratory compromise is the most serious concern. Horses with pleural effusion, mass lesions, or pneumonia may decompensate when restrained in a standing position with the head elevated and a cassette or detector positioned against the thorax. Detect this early by monitoring respiratory rate and effort continuously during positioning, and by auscultating the thorax before and after the study. A horse that develops progressive tachypnoea, nostril flare, or distress during positioning should be released from restraint immediately and stabilized before any further imaging is attempted.

Sedation-related complications deserve specific attention. Alpha-2 agonists, commonly used to facilitate positioning, alter esophageal function in a dose-dependent manner. Contrast studies performed under detomidine show increased transit time, retention of barium within mucosal folds, and retrograde peristalsis, changes that mimic grass sickness and can lead to false-positive diagnoses of esophageal dysmotility. If a swallowing study is indicated, either defer sedation until after the dynamic phase or interpret the study with the knowledge that sedation itself produces these findings. The same principle applies to any contrast study of the upper gastrointestinal tract.

Vasovagal events, including bradycardia and syncope, can occur when the detector is pressed firmly against the thoracic wall, particularly in anxious horses. Monitor pulse quality and mucous membrane color throughout the procedure. Most events resolve promptly when pressure is released and the horse is allowed to lower its head.

Common Errors and Corrective Actions

The most frequent error in equine thoracic radiography is under-exposure. The equine thorax is a large, dense structure, and technique charts developed for smaller patients consistently produce films that are too light. The radiographic appearance of a normal equine lung field should show clear pulmonary vasculature silhouetting against a dark, aerated background. If the lung field appears uniformly grey or if the dorsal lung border cannot be distinguished from the soft tissue of the epaxial muscles, the study is under-exposed and must be repeated at a higher kVp or mAs.

Positioning errors are equally common. Oblique projections, caused by rotation of the horse's thorax relative to the beam, create apparent asymmetry between the left and right hemithorax. A normal study should show the cardiac silhouette and the aortic arch as a single, well-defined structure. If the cardiac borders appear doubled or if the sternum is not superimposed on the vertebrae, the horse is rotated and the study should be repeated. The head and neck position also matters for thoracic spine evaluation. A low head and neck position increases the intervertebral distances between adjacent dorsal spinous processes from the 8th to the 15th thoracic vertebrae, while a high position decreases them. Standardize head and neck position across serial studies to avoid misinterpreting positional variation as impingement.

Expiratory films are a third common failure. The caudal lung field is best evaluated at peak inspiration, when the diaphragm is displaced caudally and the lung is maximally aerated. An expiratory film shows increased interstitial opacity, particularly in the caudodorsal lung field, which can be mistaken for pathology. If the diaphragm is positioned cranial to the 15th rib on a lateral projection, the film is likely expiratory.

Limitations of Current Evidence

The evidence base for equine thoracic radiography is limited by the physical constraints of the modality. The large size of the adult horse means that only the caudal thorax is reliably imaged with standard equipment. The cranial mediastinum, the heart base, and the cranioventral lung fields are frequently obscured by the shoulder musculature and are better evaluated by ultrasonography or computed tomography. Radiographic findings must therefore be interpreted in the context of the entire diagnostic evaluation, not in isolation.

Expert opinion still differs on the clinical significance of mild interstitial patterns in the absence of clinical signs. Some clinicians treat these as early evidence of inflammatory airway disease, while others regard them as age-related change of limited importance. The published literature does not resolve this question, and the decision to treat should be based on the complete clinical picture, including tracheal wash cytology and response to bronchodilator therapy, instead of on the radiograph alone.

The role of thoracic radiography in the evaluation of back pain is similarly contested. Radiography of the spinous processes is one of the most commonly reported diagnostic tests for primary back pain, and impinging dorsal spinous processes are among the most frequently diagnosed pathologies. However, the correlation between radiographic findings and clinical signs is imperfect, and surgical treatment is generally recommended only after conservative management has failed. Radiographic evidence of impingement should not, by itself, be used as the sole indication for surgery.

Referral, Consultation, and Reporting

Referral to a specialist imaging service or a board-certified radiologist is warranted when the study is technically inadequate after two attempts, when the findings are ambiguous, or when the suspected pathology lies outside the reliably imaged field. Equine hospitals with computed tomography or standing magnetic resonance imaging can characterize lesions that radiography can only suggest, particularly in the cranial thorax and mediastinum. Consultation with a radiologist is also appropriate before proceeding with invasive diagnostics, such as thoracocentesis or biopsy, when the radiographic findings do not clearly localize the disease process.

Laboratory involvement is indicated when radiography identifies a pleural effusion, a pulmonary mass, or a pattern consistent with bacterial pneumonia. Pleural fluid analysis, including cytology and culture, and hematology with fibrinogen measurement should accompany the imaging findings to establish a definitive diagnosis and guide therapy. The MSD Veterinary Manual provides species-specific guidance on the interpretation of these laboratory results in the context of respiratory disease.

Regulatory reporting obligations vary by jurisdiction. In most regions, radiographs that document suspected notifiable disease, such as equine influenza with pulmonary complications or anthrax, must be reported to the relevant animal health authority. The World Organization for Animal Health terrestrial animal health standards describe the diseases subject to international notification, and the American Veterinary Medical Association practice resources provide guidance on state and federal reporting requirements in the United States. Practitioners should familiarise themselves with the requirements of their own jurisdiction before undertaking thoracic radiography in horses with suspected infectious disease.

Frequently Asked Questions

How much does thoracic radiography cost compared with thoracic ultrasound in equine practice?

Thoracic radiography requires higher initial capital investment than ultrasound. A portable unit capable of penetrating the equine thorax, computed radiography or digital radiography plates, and grid equipment typically cost several times more than a mid-range ultrasound machine. Per-examination costs reflect this equipment overhead plus radiation safety compliance, including personal dosimetry and facility shielding as outlined in professional radiology safety resources. Ultrasound is often more accessible for pleural evaluation and peripheral lung lesions. Radiography remains superior for global assessment of the pulmonary parenchyma, mediastinum, and cranial lung fields. For practices with budget constraints, referral for thoracic radiography while performing serial ultrasound in-house is a reasonable model.

What alternatives exist when a grid or high-output generator is unavailable?

Without a grid, scatter radiation degrades image contrast substantially in the adult equine thorax. An air-gap technique, increasing the distance between the patient and the image receptor, reduces scatter reaching the plate. This requires a higher exposure setting and a generator capable of delivering adequate output at increased distance. Collimation to the smallest field that includes the region of interest reduces scatter volume. For foals and small ponies, gridless imaging is often acceptable. When equipment output is marginal, prioritize lateral projections of the caudal lung fields, where soft tissue thickness is least. Cranial and cardiac regions may remain nondiagnostic, state this limitation in the report and recommend referral if those areas are clinically critical.

How should I interpret thoracic radiographs in a horse that has been sedated with alpha-2 agonists?

Alpha-2 agonists alter esophageal motility and can produce contrast retention, pooling, and retrograde peristalsis that mimics esophageal dysfunction. A study using detomidine demonstrated dose-dependent increases in contrast transit time and barium retention within mucosal folds, with changes similar to those seen in grass sickness. If esophageal disease is the primary differential, obtain radiographs before sedation or interpret esophageal findings with caution when sedation was required. For pulmonary evaluation, sedation-related changes are less problematic, but hypoventilation and recumbency can alter lung inflation. Note sedation drug and dose on the image label and in the report so that subsequent studies are interpreted with the same context.

What radiographic changes support a diagnosis of impinging dorsal spinous processes, and how does positioning affect them?

Impingement is diagnosed when adjacent dorsal spinous processes show reduced intervertebral distance, sclerosis, or remodelling of opposing margins. Head and neck position significantly influences these measurements. A low head and neck position increases intervertebral distances between the 8th and 15th thoracic spinous processes, while a high position decreases them. Standardize positioning for serial comparisons, ideally with the head and neck in a neutral, consistent posture. When surgical resection is considered, confirm the diagnosis with clinical examination, diagnostic analgesia, and radiography as described in the case selection protocol for dorsal spinous process impingement surgery. Scintigraphy may add information where radiography is equivocal.

How should thoracic radiographic findings be documented for medicolegal purposes?

Record the study date, patient identification, projections obtained, exposure factors, and sedation details. Store images in a PACS or comparable system with backup. Write a structured report that separates radiographic findings from interpretation and includes a list of differential diagnoses. Note technical limitations, such as underexposure of the cranial lung fields or motion blur, and state whether the study is adequate to answer the clinical question. Retain images and reports according to local record-keeping requirements, AVMA practice resources provide guidance on medical record retention standards. If images are shared with a referral facility, include a written summary of the clinical context and the specific question the study was intended to answer.

How do I explain the value of thoracic radiography to an owner who is concerned about cost?

Frame the discussion around diagnostic yield. Thoracic radiography provides a global survey of the lungs, mediastinum, and pleural space that ultrasound cannot match, particularly for interstitial patterns, masses, and cranial lesions. Give the owner a concrete plan: what the study will answer, what it will not answer, and what the next step would be for each major outcome. For example, a normal thoracic radiograph in a horse with acute onset dyspnoea redirects investigation toward upper airway or cardiac causes. Mention that sedation, if needed, adds a small cost but improves safety and image quality. Offer a staged approach, such as starting with lateral projections and adding the opposite side only if findings warrant.

Related Clinical & Scientific Guides

• MRI Monitoring of Brain Tumor Response to Therapy in Dogs
• Ultrasound-Guided Drainage of Abscesses in Small Animals
• Radiographic Monitoring of Total Hip Replacement in Dogs

References and Further Reading

• Malignant melanoma in a grey horse: case presentation and review of equine melanoma treatment options.. 2013.
• Survey of equine veterinarians regarding primary equine back pain in the United States.. 2023.
• Impingement of the dorsal spinous processes in two hundred and fifteen horses: case selection, surgical technique and results.. 2002.
• A technique for laser-facilitated equine pastern arthrodesis using parallel screws inserted in lag fashion.. 2010.
• Effects of detomidine on equine esophageal function as studied by contrast radiography.. 1991.
• Influence of head and neck position on radiographic measurement of intervertebral distances between thoracic dorsal spinous processes in clinically sound horses.. 2012.
• American College of Veterinary Radiology Resources. American College of Veterinary Radiology.
• MSD Veterinary Manual, Professional Edition. MSD Veterinary Manual.
• American Veterinary Medical Association Practice Resources. American Veterinary Medical Association.

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This article is educational professional reference material for veterinary audiences. It is not a substitute for veterinary diagnosis, individual clinical judgment, current product labeling, or applicable regulatory requirements.