Treatment procedure
Radiation Therapy in Horses in 10 Steps
von Dr. Jan Kuntz & Team // 12. February 2025
Step 1: Preparation
After a thorough pre-anaesthetic examination, our patients are already given a light sedation in the stable. This prepares them for their upcoming treatment in a calm atmosphere and any stress is intercepted right from the start. A long fasting period is not necessary for horses before radiotherapy. This preparation and calm and routine handling provide the best conditions for a good and gentle course of treatment.
Step 2: The Way to the Treatment
The way from the stable to the treatment is only a few metres long. Nevertheless, there is a short stop on the way, where the mouth is thoroughly rinsed. This way we are prepared for anything, even in case of unforeseen events. To ensure that the patients arrive safely despite sedation, there are always two people to assist directly at the horse.
Step 3: Induction of Anaesthesia
For radiotherapy, a short general anaesthetic is necessary so that the animals can be positioned and treated precisely and calmly. For the induction of anaesthesia, the patients are led to a special support stand. Here they are supported from all sides to prevent them from falling over uncontrollably. In order for the animals to lie down as gently as possible and without injury, they are supported by trained staff on the tail, mane and especially on the head. The head should be the last to touch the ground.
Step 4: Protection of Eyes and Ears
Once the patients are safely placed and the anaesthesia is deep enough, the animals do not notice the measures around them. The eyes are routinely treated with ointment so that they do not dry out during the anaesthesia. The eyelid reflex, which otherwise protects the eye, and blinking are strongly impaired by the anaesthetic medication. In order to isolate the animals acoustically during and after the anaesthesia, they are given surgery swabs in their ears. This muffles the noises, agreements and the buzzing of the linear accelerator.
Step 5: Transport to the Treatment Couch
The fastest way to transport a horse under general anaesthesia is to use a crane. Patients only hang on for a few moments until they are safely positioned on the treatment couch. With our huge indoor crane, we can reach every spot in the preparation hall and save valuable anaesthesia time due to the speed. With a payload of 2,000 kg, there is a sufficiently large buffer even when transporting very large horses. The patient table, a special design for equine radiotherapy, is also suitable for horses of almost any size.
Step 6: Precise Positioning
Once the horse has been placed on the patient couch, it is taken to the linear accelerator, the actual radiation unit. Here, the tumour is precisely positioned so that it can be irradiated accurately while the surrounding normal tissue is spared as much as possible.
Step 7: Leaving the Radiation Bunker
During the irradiation, no one except the patient is allowed to be in the irradiation room, the so-called bunker. After everyone has left the radiation bunker, a heavy radiation protection gate closes. The actual irradiation often lasts no longer than 90 seconds, immediately after which the entire team can return to the patient.
Step 8: Monitoring and Controlling
The actual irradiation is triggered via computer systems outside the irradiation room. While one part of the team takes care of the smooth technical process, the other part monitors the patient. Not only the live images from several cameras are transmitted to the control console, but also the vital parameters, the current ECG and the oxygen saturation are permanently monitored. If any of the values deteriorate, the radiation can be interrupted at any time and the entire team is directly at the patient in a few moments. With the short anaesthesia, however, unexpected situations occur only very rarely.
Step 9: Transport to the Recovery Box
Immediately after completion of the irradiation, the patient can be transported to the prepared recovery box. This is done quickly and gently with the indoor crane. Once in the recovery box, the patient is gently placed on his or her side. In the low-stimulus environment of a specially padded box and with ear protection, they sleep off their anaesthesia and usually get up calmly and without stress. Even the repeated anaesthesia is not noticeably more stressful than the first anaesthesia. Professional patients stay in the prone position for as long as possible and only get up after the anaesthetic has worn off sufficiently.
Step 10: Recovery in a Quiet Environment
Even after getting up, the patients often stay in the recovery boxes for a while. Here it is quiet, warm and the animals are under constant observation, directly or via a camera system. The horses can continue to regain their strength before they are allowed to return to the stable and make contact with their conspecifics. If the animals are particularly stressed, sweaty or tense after the anaesthetic, they can relax in a solarium in addition to personal care. As a rule, the animals can be exercised in our round pen again a few hours after the start of the treatment and have put the entire procedure behind them.
