Client Services

Damascus Equine Associates offers a wide range of both ambulatory and in-clinic veterinary services in central Maryland. We are dedicated to providing high-quality comprehensive care, with the long-term health and well being of your horse as our primary mission.

Each of our talented equine practitioners has a fully equipped truck that includes dental, radiographic, and ultrasonographic capabilities. In the clinic, we also offer radiography, endoscopy, and advanced regenerative medicine.

While we provide 24-hour emergency ambulatory service, we also have strong, reliable relationships with surrounding referral clinicians and hospitals for advanced diagnostic, medical and surgical care. Please use the following links for more information about our individualized services.

Alternative Therapies

In addition to traditional sports medicine, Damascus Equine Associates offers a wide range of alternative therapies. When used properly by a trained veterinarian, alternative therapies can aid in your horse’s return from an injury. Currently, DEA offers acupuncture, chiropractics, mesotherapy and prolotherapy.

Acupuncture is a treatment based on the Chinese theory that pain is caused by the blockage of energy flow, or Chi, in the body. Acupuncture comes for the Latin words acus (needle) and puncture (a pricking). Acupuncture needles are inserted into specific points to relieve the blockage and restore the normal flow of Chi. Dr. Lewis is currently the only licensed acupuncturist within DEA.

Mesotherapy is used to stimulate the mesoderm (middle layer of the skin) and reduce muscle spasms and pain. Small needles are used to inject various substances that stimulate sensory pain fibers within the mesoderm.

Prolotherapy uses a dextrose solution injection around tendons and ligaments. Prolotherapy re-establishes the inflammatory process that aids in fiber repair. The new fibers promote strength within the tendon or ligament.

Chiropractic is the manipulation of the horse’s spine which allow for adjustments that restore function and reduce pain to the spine and surrounding tissues. Chiropractic is most commonly used to treat neck and back pain.

Contact your veterinarian to see if our alternative therapies are an appropriate treatment for your horse.

Emergency Medicine

Few things cause as much concern to the horse owner as an equine medical emergency. Acute illness, colic, injury or severe lameness can occur without warning and at any time

As a client of Damascus Equine Associates, you and your horse have access to emergency service 24 hours a day, 7 days a week. The veterinarians rotate emergency duty and can provide emergency phone consultations or farm visits if your horse requires medical attention.

Your observations and initial assessment of your horse’s condition are very important to determine the urgency of the emergency and formulate a plan of action. Please take a few moments to collect the following information before you discuss the case with the veterinarian on call.

Acute Illness: Appetite, attitude, temperature, presence of respiratory signs (nasal discharge, cough), presence of gastrointestinal signs (colic, diarrhea).

Colic: Degree and description of pain, temperature, appetite, presence of manure and it’s consistency.

Injury: Location of injury, amount of bleeding, drainage, swelling, sensitivity, temperature, lameness.

Severe Lameness: Degree of lameness, swelling, sensitivity, temperature, range of motion of joints, digital pulse, signs of distress (sweating, increased respiratory rate).


Diagnostic imaging is essential to Damascus Equine Associates. Our imaging modalities include Digital Radiography, Digital Ultrasonography, and Endoscopy.

Digital Radiography provides digital x-ray images of the equine skeleton while digital ultrasonography shows detailed digital sound-wave images of soft tissue structures. Endoscopy provides live video representation of the organ of intrest.

Each of these imaging techniques provide detailed diagnostic information to best serve us in determining therapeutic options for our patients, as well as education and communication with our clients.

Digital Radiography
Digital Radiography is an imaging modality that provides high-quality, high-resolution digital x-ray films for our equine patients. Each member of Damascus Equine Associates carry portable x-ray units and cassettes, which hold film that can be infinitely re-exposed. Once the cassette (and film) has been exposed, we process the film with a computed scanner located in our clinic, which converts the information to a digital image. The image can then be manipulated via magnification and contrast to highlight specific areas of interest. With a digital image, we can readily manipulate, store, share, and consult with referring veterinarians. The images are stored on our clinic server and an off-site server. Our system allows radiographs to easily be sent to our clients, farriers, and referring clinicians.

Our portable CR is used primarily to obtain detailed images of the equine distal limb, but can also provide high quality images of the skull, dentition, spine, and chest. Our clinic houses a higher-powered, free-standing x-ray unit that more readily delivers detailed images of the skull, dentition, spine, and chest.

With CR, we can easily accomplish client communication and education, farrier collaboration, and referring veterinarian consultation resulting in a progressive and comprehensive diagnostic service.

Digital Ultrasonography
Digital ultrasonography uses ultrasound waves to create high resolution images of soft tissue structures. It is used in the evaluation of tendon and ligament injuries as well as injuries of the soft tissue structures of joints. Abdominal and thoracic examinations allow for the evaluation of internal organs including the intestines, liver, heart, and lungs, to name a few. Ultrasound examinations can be performed at the farm or in the clinic.

Endoscopy provides a live video representation of the organ of interest. Our endoscopy unit is primarily used to examine the upper airway, including the sinuses and larynx, and upper gastrointestinal tract, including the esophagus and stomach.

Internal Medicine

Damascus Equine Associates provides internal medicine services both at the farm and in our clinic. Dr. Amy Polkes provides consultation and specialty services for our medical cases as well.

Our diagnostic and therapeutic services include:
Gastrointestinal Evaluation: Gastroscopy, Abdominal Ultrasonography, and Abdominocentesis
Ophthalmic Evaluation: Subpalpebral Lavage System placement, Ocular Ultrasonography
Neurologic Evaluation: Skull and Vertebral Radiography, Cerebral Spinal Fluid (CSF) Collection
Cardiac Evaluation: Electrocardiography and Echocardiography
Respiratory Evaluation: Thoracic Radiography and Ultrasonography, Thoracocentesis, Transtracheal Aspiration, Bronchoalveolar Lavage
Urologic Evaluation: Cystosonography, Cystoscopy

Internal medicine consultations are available with Dr. Amy Polkes.
Contact your veterinarian to decide if your horse is a candidate for referral to Dr. Polkes.

Pre-Purchase Exams

Pre-purchase examinations are available to prospective buyers to assist in the decision-making process of buying a horse. A pre-purchase examination reflects the health and soundness of the horse on the day of the evaluation and is no guarantee of future soundness and suitability.

The exam includes evaluation of the cardiovascular and pulmonary systems before and after exercise, an ophthalmic exam, along with a close examination of the entire horse.

A basic lameness exam including flexion tests are also used to evaluate the soundness of the horse. The horse may also be lunged or ridden.

In addition to the pre-purchase examination, radiographs, ultrasound, blood work and drug screens are also available depending on the discretion of the prospective buyer and/or veterinarian.

Pre-purchase examinations can be done at the clinic or at the farm.

Preventative Medicine

Preventative medicine is the basis of comprehensive patient care. Damascus Equine Associates offer a variety of vaccine and deworming programs tailored to the needs of each client and patient. Other preventative medicine services include dentistry, wellness laboratory tests and Coggins tests.

Observations and consultations during wellness visits allow for discussions regarding both general health matters and specific issues pertaining to individual horses.

Every dental exam provides the opportunity to perform routine preventative dental maintenance. Waiting too long between dental exams may increase the difficulty of correcting certain conditions. Dental problems can cause discomfort to the horse, resulting in problems such as weight loss or performance issues.

During dental examinations, sharp enamel points of the cheek teeth will be removed to decrease potential irritations and trauma to the soft tissues of the mouth. Abnormalities such as malocclusions (misalignment of teeth), hooks, uneven or missing teeth will be noted and addressed. Most dental procedures can be performed in the standing sedated horse at the farm or in the clinic.

Parasite Control
Parasite infestation in the horse is a common problem that can be effectively controlled. While there are many types of equine parasites, the most common ones are large and small strongyles, tapeworms and pinworms. These parasites can cause numerous health problems including colic, weight loss, diarrhea and general unthriftiness.

Vaccination alone without proper management practices is not sufficient for prevention of disease. Vaccines can reduce the risks of infection or lessen the clinical signs but cannot guarantee total protection from that disease.

When determining what to vaccinate your horse for, you first need to assess what your horse is at risk for. In addition, the efficacy of the vaccine should be noted when deciding how often to vaccinate your horse.

Your veterinarian will assist you in determining what your horse may be at risk for.

Core Vaccines
Core vaccines are recommended for all horses. These vaccines are for diseases of high significance and the available vaccines are very effective and safe.

Rabies: Rabies is a deadly and zoonotic disease (people can contract disease) which is why this is such an important vaccine for all horses. Rabies is transmitted through the saliva of an infected animal through a bite, cut on the skin or mucous membranes (eyes, mouth, nose, etc.). Following the introduction of the virus, it migrates to the brain and results in fatal swelling of the brain.

Eastern/Western Equine Encephalomyelitis (EEE/WEE): Wild birds and rodents are the natural reservoirs of the disease that is then transmitted by mosquitoes or other bloodsucking insects. Humans are also susceptible to the disease through the bite of an infected mosquito. However, horse-to horse and horse-to-human transmission is very unlikely due to the small amount of virus in the blood of an infected horse. These diseases have a high incidence of death and with changes in distribution of insects and reservoirs, it is not always easy to determine the risk of exposure for these diseases.

West Nile Virus (WNV): This virus is transmitted via mosquitoes from birds to mammals including horses and humans. The virus causes inflammation of the brain which can cause death or residual effects such as gait and behavior abnormalities. Studies have shown the vaccine to be highly effective and it is recommended that the vaccine be a part of the core vaccine protocol for all horses in the United States.

Tetanus: Tetanus is caused by a bacterium named Clostridium tetani that is found everywhere including the soil, feces, and mammalian intestinal tracts. This bacterium is usually introduced through puncture wounds, open lacerations, and reproductive tracts of mares after foaling.

Risk-Based Vaccines
Risk-based vaccines are recommended for horses at increased risk of exposure to the particular disease. The available vaccines have variable efficacy and some potential for vaccine reaction.

Potomac Horse Fever: This disease is caused by the spread of Neorickettsia risticii through the ingestion of snails and different species of flies such as dragonflies and mayflies. It is seen from late spring to early fall in Maryland with the highest incidence between July-September. Although it is not contagious between horses, when cases are found in one area, it is more likely that other horses will be at a higher risk of infection. Clinical signs of this disease include fever, laminitis, severe diarrhea, and mild colic.

Rhinopneumonitis (Equine Herpes/Rhino) : This disease is caused primarily by two types of Equine Herpes Virus (EHV): EHV-1 and EHV-4. EHV-1 causes respiratory disease, abortions and neurological disease. EHV-1 was responsible for the recent outbreaks of “equine neurologic herpes” that resulted in the quarantine of several horse facilities including racetracks, equine hospitals, and private farms throughout the United States. EHV-4 causes respiratory tract infections that can range from very mild to severe signs including fever, anorexia, nasal discharge, and cough. EHV-4 infection occurs most frequently in young horses, but it can also be seen in horses that are comingled. Because the virus is a herpes virus, horses can have a latent infection where there are no clinical signs, but can be contagious to other horses during periods of stress.

Equine Influenza (Flu): This disease is one of the most common infectious diseases of the equine respiratory tract. Quarantine of new horses for at least 14 days is one of the best ways to prevent this disease from entering your horse population. It is important that all horses be vaccinated against this disease especially those with an increased risk of infection. Equine influenza is highly contagious and spreads rapidly through groups of horses through aerosolized nasal secretions.

Strangles: This disease is caused by the bacterium Streptococcus equi subspecies equi. It commonly affects young horses but can affect horses of any age. The bacterium is spread through direct contact with infected horses, with horses that are not showing clinical signs but shedding the bacteria (carriers), or by contact with contaminated water troughs, feed tubs, stalls, trailers, handler’s cloths, etc. Clinical signs include fever, anorexia, difficulty swallowing, nasal discharge, and enlarged lymph nodes.

Botulism: Botulism is caused by the bacterium, Clostridium botulinum, which produces one of the most potent biological toxins known. The toxin blocks impulses to nerves and causes weakness, paralysis and frequently death. There are 8 types of the toxin, but types B & C have been associated with most of the equine outbreaks. This bacterium can be introduced through a wound, by ingestion of decaying plant material or animal carcass remnants found in feed, or by ingestion of the spore itself. The incidence of Botulism has a geographical distribution.


Before breeding, a breed soundness exam is offered to ensure the reproductive health of the mare. These services include palpation, vaginal speculum exam, rectal ultrasound, uterine biopsy and uterine culture. Artificial insemination using fresh or cooled semen is also available along with post-breeding management to ensure pregnancy and overall health of the mare.

Vaccinations and deworming are an essential part of the management of broodmares and their foals. DEA offers preventative medicine management designed for broodmares and foals to ensure the health of our patients.

Sports Medicine

Lameness may represent the single most important limitation to the successful sport horse. It is associated with poor performance, disruptions in training or conditioning programs, and potentially missed competitions. Many lameness result from repetitive stress resulting in subsequent injury to the musculoskeletal tissues.

Damascus Equine Associates offer a wide variety of services used to detect and treat lameness to help keep your athlete in top condition.

Interleukin-1 Receptor Antagonist Protein (IRAP)
IRAP (Interleukin-1 receptor antagonist protein) is a treatment provided by our practice to assist in the treatment of an underlying cause of the lameness. IRAP is found to aid in joint rehabilitation in the healing quality of the joint by decreasing the detrimental effects interleukin-1 (IL-1) has on structures within the joint.

In order to harvest the IRAP, blood is collected from the patient in a specialized syringe which is then incubated, centrifuged, and harvested. It is then injected into the affected joint or lesion. Samples may be frozen for use at a later date.

Lameness Exam
Lameness exams are provided to determine the underlying cause of a horse’s poor performance. Beginning with a thorough physical exam and history, each lameness exam is performed in hand and/or under saddle to determine the limb in question.

Local nerve blocks and imaging are available to determine the causative structure for the lameness.

Once the location of the injury is located, additional therapies such as intra-articular injections, IRAP, PRP, stem cell therapy and shock wave therapy are available to aid the healing process.

Lameness Locator®
The Lameness Locator® is a wireless computer-assisted motion analysis system used to objectively detect and evaluate lameness patterns in the horse. Using sensors non-invasively placed on the horse, body movement data is wirelessly transmitted to a computer for analysis and storage. Because the sensors sample motion at 200 times per second, they are more sensitive than the human eye, which samples at only 20-25 times per second.

The resulting Lameness Locator® analysis report can be used to help determine whether a lameness exists, which limb or limbs are involved, the severity of the lameness, and the phase of stride (impact, mid-stance, or push off) that the lameness is most severe. This information can be used to help localize the lameness, guide further diagnostics and asses the response to therapy.

The LamenessLocator® can be used to assess your horse’s current status or to track your horse’s progress over time. It can become an important part of managing your equine athlete for peak performance as well as longevity. The LamenessLocator® can be used at the farm or at the clinic.

Click for sample Lameness Locator® results showing a right front lameness. (PDF)
A left fore lameness and response to a nerve block of the foot. (PDF)

Protein Rich Plasma (PRP)
PRP (protein-rich plasma) is another available therapy used in conjunction with other treatments for musculoskeletal injuries. PRP is found to improve the quality of healing as well by promoting the beneficial effects of growth factors within the patient’s blood.

PRP is harvested by collecting blood from the patient, which is then incubated and centrifuged to concentrate the plasma that is injected into the lesion. Samples may be frozen for use at a later date.

Extra Corporeal Shock Wave Therapy (ESWT)
Extra Corporeal Shock Wave Therapy (ESWT) utilizes focused, high energy acoustic pressure waves to treat a variety of musculoskeletal conditions in the horse including tendon, ligament and joint injuries.

It has been shown to decrease inflammation, promote tissue regeneration and improve healing.

ESWT is a non-invasive therapeutic modality that can be performed in the standing, sedated horse at the farm or in the clinic.

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