Ambulatory Services

Timely, progressive, high quality medical and surgical care in the field has been the foundation of our practice from the very beginning. CGES veterinarians provide comprehensive care to our patients in the field, whether the need is urgent or routine. We take pride in the high level of care and expertise that our veterinarians provide at their patients’ home location. Our ambulatory veterinarians are each equipped with fully stocked specially designed vehicles ready for any emergency. Digital radiography, ultrasound units and endoscopy equipment are all available for use by the ambulatory staff. We offer total care to farms within a 45 mile radius and specialty care to farms within a 100 mile radius.


From yearlings with wolf teeth to senior citizens with few teeth the veterinarians at CGES are committed to the ethical, professional and diligent practice of this important part of your horses’ health care. Annual examination of your horse’s mouth allows us to identify and address problem areas before they cause health issues or impair performance. One of the most important concepts that horse owners can embrace is that prevention is the absolute key to good equine dental health. CGES offers dental services which include examination of the mouth for abnormal wear and malocclusion, cracked or loose teeth, infection and other dental irregularities, radiographs, extraction of diseased teeth and floating. Routine dental examinations are very important in the long term health of your horse. Indications of dental problems may include:

  • Dropping feed while eating
  • Holding the head sideways or tossing the head while eating
  • Episodes of choke or colic
  • Poor hair coat and condition, weight loss
  • Whole grain and long stems of hay in the manure
  • Nasal discharge, swelling of the face, bad breath, bump on the lower jawbone
  • Fighting or resisting the bit while training, head tossing or tilting, failing to stop or turn

We have a vast array of power and hand instruments that enable us to diagnose and treat most dental conditions such as enamel points, hooks, wave mouth, step mouth, excessive tartar buildup and incisor corrections. Small instruments enable us to care for miniature horse mouths as well. We also treat fractured teeth, fractured jaw bones, infected teeth, infected bones, sinusitis and oral tumors. Many of these problems can be addressed on the farm as long as proper restraint and comfort of the horse can be achieved. For some of the more involved cases, we may need to admit the horses to the hospital for proper care. Your horses’ comfort and safety are paramount to us during the dental procedure. Our facility and equipment allows us to visualize the horses’ mouth and make the necessary corrections. We encourage horse owners to attend dental procedures and learn more about their horses’ mouth. Dentistry is a rapidly evolving field and we are continuing to add the latest equipment and technology for this important procedure.
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Here is the South we have to contend with heat, humidity and the bugs! If itchy, scaly, lumpy, bumpy, oozing, crusting or going bald describes your horse then we’re here to help. From skin scrapings to skin biopsies we have the tools to diagnose and treat your horses’ skin.
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Emergency Services

The veterinarians of CGES are available for emergencies 24 hours a day. Our ambulatory veterinarians are available around the clock to give your horse the care he needs, whatever the problem may be. During office hours, our receptionists will dispatch the veterinarian who can arrive most quickly to assess and treat the patient. At night and on weekends, our answering service will page the doctor on call, and pass on the information about the emergency. In the event of an emergency remain calm, please state your name and location clearly and stay off the telephone so that we may call you back. Within a few minutes, you will receive a call from one of our veterinarians who can begin to help you. If you have an emergency and would like to reach one of our staff, please call (478) 825-1981.
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CGES has two fiber optic flexible endoscopes which enable us to take a visual tour of many parts of the horses’ body. Our ambulatory veterinarians use a portable fiber optic endoscope, while our hospital is equipped with a video endoscope, allowing all present to view the image on a video screen. Our small endoscope will pass easily up even the tiniest of noses to view the nasal passages, pharynx, larynx, and guttural pouches. We can visualize the internal surface of the bladder as well as the urethra and accessory sex glands in stallions and geldings. In additional our longer scope has allowed us to perform hysteroscopy of the mares’ uterus. Read more about hysteroscopic insemination, a state of the art reproduction technique under our reproduction section.
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At CGES we understand just how much you’ve anticipated the birth of your new foal. We also understand the financial investment you’ve made breeding your valuable mare. The foaling barn at CGES is equipped with video cameras; we like to call it “Mare TV”. In addition we utilize the Foalert System. The Foalert System involves placing an electronic monitor on the vulva of each mare as she nears parturition. The Foalert system is activated when a mare actively enters labor. Our system is wired into a surveillance system with 24 hour monitoring. We know that it is seconds that count when a mare is in labor. An attended foaling allows us to assist the mare with delivery, correct minor problems and attend to the foal immediately. Our system of private paddocks allows us to place foaling mares and mares with young foals where they can be seen at all times. After hundreds of deliveries we believe strongly in good prenatal care, an assisted birth, imprint training of foals and excellent postnatal care for the mare and her newborn.

Foaling mares should arrive at CGES 30 days prior to foaling so that the mare may become accustomed to her new surroundings. Pre-foaling vaccinations are administered at this time. Newborn foals receive a complete neonatal examination, navel care, probiotics, an enema if needed and IgG testing. Foals born to high risk mares may receive additional laboratory testing. Foaling mares receive a complete postnatal examination, deworming, pain medication if needed and oxytocin to promote uterine involution. Foaling mares may be bred back at the appropriate time if the owner desires.
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Geriatric Care

We like to call them “Special Seniors” and senior horses get extra attention at CGES. We recommend an annual physical exam, routine lab screen and dental exam for our older patients. Many older horses have unique medical needs whether it is pain medication for arthritis, nutritional supplementation, Equine Cushing’s Syndrome, cataracts or a host of other maladies that are common in older horses. We find that taking a little extra care with our older patients is time well spent.

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Internal Medicine

Coughing, sneezing, itchy skin, diarrhea, colic, too fat, too thin, lumps, bumps and “just not right” are just a few of the symptoms we routinely tackle in our internal medicine cases. Using a wide variety of diagnostic tests we aim to get to the bottom of your horses’ problem. Our hospital facility is equipped to handle large volume fluid administration using special IV sets and an apparatus that allows your horse to move freely. We also have the capabilities to administer fresh frozen plasma as well as whole blood transfusions for life threatening conditions. Pneumonia, Chronic Obstructive Pulmonary Disease, Equine Cushing’s Syndrome, Metabolic Syndrome and Equine Protozoal Myelitis are commonly seen. From a biopsy to a spinal tap we’ll do our best to solve the case.
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When your horse is sick you want answers right away. Our modern laboratory equipment allows us to process complete blood counts, chemistry profiles, electrolytes and urinalyses in minutes, not days. This allows immediate assessment of emergency and critical care patients without delay. New foals receive an IgG test that lets you know precisely if your foal is protected, we don’t take chances with newborns. Fecal samples are tested using a McMasters fecal analysis test which gives you precise information. You’ll know what type of parasite we see and exactly how many. No more guessing about which dewormer to use. CGES maintains relationships with a wide variety of outside laboratories that provide all other types of laboratory testing and clinical pathology services.
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Lameness/Sports Medicine

Lameness diagnosis and sports medicine is a highly specialized area of equine practice that requires significant expertise. This area of practice requires a complete understanding of anatomy, a keen eye for gait analysis, and sensitivity in detecting subtle abnormalities. A thorough review of the case history, physical exam, lameness exam and knowledge of current therapies and treatments are necessary. A combination of diagnostic joint and nerve blocks are often used to help isolate the injured or abnormal area in a horse exhibiting lameness or decreased performance. Lameness clinicians also must be experienced in the use and interpretation of radiography, ultrasound, and other diagnostic modalities. Once the cause of the lameness is diagnosed, treatments can include therapeutic joint and tendon sheath injections, shockwave, arthroscopic surgery, and many other options. Lameness examinations can be performed on the farm but some cases are best performed at CGES, which allows full use of our equipment and facilities. We ask that owners and trainers of performance horses please bring your tack and equipment as many cases will be worked under saddle, in the round pen or on a lunge line during the examination. Please do not medicate horses coming for performance examinations as this may obscure the exam findings.
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Neonatal Care

You’ve made the investment to breed your mare and now the time has finally come for your new arrival. CGES provides a full spectrum of care for neonates in a field setting. Our veterinarians perform neonatal examinations within 24 hours of birth, assessing IgG levels and the overall health and condition of the foal and dam. Special attention is given to the foal to detect any sign of infection, hernia, limb deformity or congenital defect. Newborn foals are born without any antibodies. The foal must nurse the mare and ingest a sufficient quantity of good quality colostrum to protect the foal from disease. Colostrum contains antibodies and we measure the amount of antibody with an IgG test. A low IgG level can be easily corrected with a plasma transfusion and prevent septicemia, pneumonia and joint ill. Foaling mares are checked for any sign of illness, vulvar tears and passage of the placenta. It is far easier and less expensive to treat these complications early rather than wait until disaster strikes. When a mare experiences a difficult birth, our experienced doctors provide immediate emergency attendance at the farm or at the hospital. We are experienced in treating foals with failure of passive transfer, neonatal maladjustment syndrome, prematurity, septicemia, diarrhea, limb deformities, neonatal isoerythrolysis and other conditions. Our experience and dedication to providing the most up to date care for your foal helps to insure the best outcome.
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You know how important your eyes are to you and the same is true for your horse. While some parts of a horse are very rugged the eyes are extremely fragile and vulnerable to disease and injury. Management of traumatic, infectious and immune mediated conditions of the equine eye is a frequent task of our ambulatory veterinarians. We commonly treat cases of corneal ulcers, stromal abscesses, uveitis, and ocular trauma. We place subpalpebral lavage catheters in difficult cases and utilize ultrasound to image the internal structures of the eye. Our southern exposure frequently sends us cases of ocular neoplasia. Corneal scraping, corneal debridement, intravitreal injection and surgical treatment of traumatic injuries and tumors are not uncommon. Sometimes hospitalization for intense treatment around the clock is necessary to speed healing and limit the loss of vision.
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Every Tuesday is “Farrier Day” at CGES. Our staff farrier Rick Talbert is certified with the American Farrier’s Association. Rick brings a welcome blend of technology, tools and experience to CGES. Fully equipped with hot forge, band saw, grinder, drill press, dremel tool and welder Rick has the tools to handle the most complicated case. Rick carries a large assortment of shoes in addition to bar stock of aluminum and steel for custom-made shoes. Rick is also available for routine hoof trims and balanced shoeing. With his comprehensive knowledge of different breeds and show horses Rick understands the requirements and restrictions for competition horses. He knows that you’ll need sliding plates on your Reiner as well as the exact weight of shoe and pad allowed on your National Show Horse. We commonly apply corrective shoes and devices to foals and hospital plates for clinic cases to protect hoof surgery sites. Using a combination of radiography and shoeing we are able to realign most laminitis cases.

An avid learner, Rick regularly attends continuing education seminars and clinics. He also maintains an excellent relationship with experts in his industry and consults are available on difficult cases.
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Prepurchase Examination

Buying a new horse is an exciting time and often requires a substantial investment. You’ve worked hard for your money and we want to make sure that your money is well spent. CGES veterinarians can examine your new prospect from nose to tail. A prepurchase examination includes a comprehensive physical exam, comprehensive lameness evaluation, conformation analysis, respiratory examination, ophthalmic examination, oral examination and health history. Specific concerns of the prospective owner are addressed with close attention paid to the intended use of the horse. Radiographs, blood work, drug screens, endoscopy, ultrasound and breeding soundness exams are additional components often recommended by our veterinarians or requested by prospective owners.
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Preventive Medicine

The old adage “An ounce of prevention is worth a pound of cure” is certainly true when it comes to horses. Modern medicine has developed many wonderful vaccines that will prevent some diseases. Although diseases like Rabies and Eastern Encephalomyelitis are always fatal, they can be easily and economically prevented. Deworming no longer has to be administered by stomach tube and parasites can be effectively treated using a variety of paste and granular products. Using the right drug at the right time is critical to keeping your horse healthy. CGES veterinarians can help you select the right products your horse needs whether he’s an active show horse or a trusted companion. Our pharmacy is well stocked with the products you need to keep your horse in good health.
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It’s not just about broken bones; radiography is an important part of most lameness evaluations when conditions such as arthritis and navicular syndrome are suspected. In addition radiography now plays an important role in most advanced dental procedures and an even more important role as a screening tool in the all important prepurchase exam.

CGES has recently acquired the new Vetal Digital Radiography system. Digital radiography is cutting edge technology that allows instant visualization of radiographs on a computer screen. The resulting image can be enhanced to provide optimal contrast and detail. Digital radiography also allows electronic storage of images which can now be emailed to other veterinarians and stored on CD-ROMS.
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Mares CGES offers a wide range of reproductive services to mare owners.

Mare Management - Every year we provide breeding services and fertility management to a large number of mares. We are equipped with ultrasound machines to evaluate mares both in the reproductive center and in the field.
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High Risk Mare Management

Nothing is quite as frustrating as getting a mare in foal only to find that she has lost her pregnancy. CGES offers services to monitor and manage mares at high risk for pregnancy loss including transabdominal fetal monitoring, ultrasound placental evaluations, hormone analysis and placentitis treatment.

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Pregnancy Diagnosis – Ultrasound allows us to detect pregnancy as early as 12 days post breeding. We recommend examining most mares at 16 days post breeding to maximize the detection of twin pregnancy, a second exam on day 30 to assess fetal growth and heart beat and a third exam at day 45 to be sure that the pregnancy has passed through the most critical early stages.
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Twin Management

Twins pregnancies in the mare usually end in a total loss with both feti aborted. CGES clinicians can detect twins at an early stage and eliminate one embryo using ultrasound guidance. Early detection is essential for maximum success.
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Artificial Insemination

Today mares can be bred to nearly any stallion in the world using artificial insemination. Mares can be bred using fresh semen collected from your stallion or with transported cooled semen shipped via overnight delivery or via frozen semen from anywhere in the world. Timing of the insemination is critical and our management techniques have been honed over many years of experience. Mares can either be brought to our facility for breeding, or we can perform ambulatory breeding services. We offer skilled mare care and many boarding options.

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Infertility Diagnosis – CGES offers a complete line of diagnostic tools to diagnose and treat the infertile mare including ultrasound, uterine culture, uterine cytology, uterine biopsy and hysteroscopy. Uterine cultures and cytology are used to detect uterine infection. Uterine biopsy utilizes a special instrument which takes a small section of uterine lining. The tissue is examined by a pathologist with critical attention to any sign of infection or scar tissue. The biopsy score can be used to direct the reproductive course of the mare. Uterine cultures, cytology and biopsy can all be performed with the mare standing and does not require sedation. Hysteroscopy utilizes a fiber optic endoscope to enter the uterus and visually examine the entire uterine surface for adhesions, scars, fluid, cysts and tumors. Hysteroscopy is performed in the clinic with the mare standing under sedation.
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Problem Mare Management – The majority of mares will conceive with ease when bred to a fertile stallion. CGES is equipped with the tools and experience to manage the problem mare who suffers with chronic endometritis, post mating endometritis, fluid retention and ovulation failure. We carry a complete line of uterine lavage catheters and our pharmacy is well stocked with the necessary pharmaceuticals to assist your mare.
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Embryo Transfer – For mares that cannot carry a foal to full term, mares that are actively competing and cannot take a year off to raise a foal and valuable mares where more than one foal per year is desired embryo transfer may be an option. Embryo transfer involves breeding the donor mare and 7-8 days later flushing the donor mare to collect the embryo. The embryo is then transferred to a surrogate mare which carries the pregnancy and raises the foal. CGES veterinarians are skilled in embryo transfer. You may furnish your own recipient or utilize a mare from a recipient mare herd.
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Hysteroscopic Insemination – Dr. Cook traveled to England to study with renowned veterinarian Dr. Twink Allen to learn the technique of Hysteroscopic Insemination. This technique utilizes a fiber optic endoscope to place a very small dose of semen on the oviductal papillae deep within the uterus of the mare.
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Reproductive Surgery – CGES veterinarian are skilled in many reproductive surgeries including Caslick’s, perineal reconstruction, third degree perineal lacerations and rectovaginal fistulas. Caslick’s surgeries and many perineal reconstructions can be done in the field. Third degree perineal lacerations and rectovaginal fistulas require fairly extensive patient preparation and are done in our hospital.
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Stallions - CGES has extensive experience in stallion management and offers many services to stallion owners.
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Semen Collection and Evaluation

Our facility features a safe, enclosed breeding shed with a breeding phantom for stallion collection and we stock multiple types and sizes of artificial vaginas. Over the years we’ve been able to accommodate most stallions from Welsh Ponies to large Warmbloods. Chemical ejaculation is also used for stallions that are unable to mount. Semen is carefully measured and examined using our densimeter and microscope. Our microscope is fitted with a digitally controlled heated stage to assure constant temperature control. We stock a complete line of semen extenders. Stallions that are being evaluated for cooled semen transport are extended in a wide variety of extenders and semen is analyzed at 24 and 48 hours to assess viability. CGES veterinarians can collect semen from your stallion and ship it anywhere in North America.

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Semen Freezing and Storage

We also offer a semen freezing service for stallion owners that wish to store semen indefinitely or ship frozen semen internationally. The majority of registries now permit the use of frozen semen. Frozen semen has many advantages; a stallion can be collected and semen frozen during the off season and not interrupt his competition schedule, frozen semen preserves the stallions’ genetic material for use at a later date in the event that a stallion becomes infertile or dies, frozen semen can also be exported to many countries provided that the USDA requirements were met.

The semen freezing process is similar to semen collection for artificial insemination. One or more collections are done to "clean-out" his reproductive tract and eliminate the old sperm stored in the reproductive tract. A test freeze is done to determine the suitability for freezing. Special preprinted straws identified with the stallions name, registration number, date and location are used to freeze the semen. After the semen has completed the freezing process, it is then immersed and maintained in liquid nitrogen in special cryogenic containers. Semen can be stored here at CGES for a monthly storage fee or in the owner’s liquid nitrogen container.

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Stallion Evaluations – CGES veterinarians use a combination of history, physical examination, ultrasound of the testes and accessory sex glands, semen collection and evaluation, hormone analysis, culture and sensitivity, serology and urogenital endoscopy to evaluate stallions in cases of infertility. Breeding soundness examinations are done as a part of the prepurchase examination. Accurate data is important to stallion managers to determine the stallions’ book for the following season.

Stallion Management

Our reproductive center also offers stallion breeding services.CGES is able to stand stallions at our facility and assist owners in selecting a stallion management plan and breeding program.We offer owners the choice of fresh, cooled/shipped or frozen semen breeding options. Our program includes collection, analysis with sperm counter, sperm morphology and motility evaluation,extender evaluation, and freezing and storage.We can train novice stallions to the phantom and can manage sub-fertile stallions.

Stallions are housed in large individual stalls with private turnout in one acre double-fenced paddocks.Working stallions have the option of daily exercise by our stallion handler to stay in fit condition.
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Stem Cell Transplantation

VetStem regenerative medicine is a newly available treatment that uses stem cells from your horse to repair injured or damaged tissues. A small sample of adipose tissue (fat) is removed from the horse and cultured at VetStem’s laboratory to produce large numbers of autologous adult stem cells. These cells are then couriered back to the veterinary clinic. They are used to treat a variety of conditions, including tendonitis, ligament injuries, osteoarthritis, and OCD defects. Stem cells are injected directly into the site of the area that requires treatment, and develop into new cells of the desired tissue type to help in repair. For more information visit
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CGES offers a variety of surgical procedures under field surgery conditions. Castration is available for all ages. A closed castration option is available for stallions at risk of herniation. Umbilical hernia repair, enucleation, scar revision, Neurectomy and a variety of reproductive surgeries are available. We frequently perform deep digital flexor tenotomies for many severe laminitis cases and inferior check ligament desmotomies in cases of club foot. Many surgeries can be done on the owner’s farm.

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Veterinarians use radiography to take pictures of bones and ultrasonagraphy to take pictures of just about everything else. An ultrasound can produce a picture of the eye, heart, lung surface, muscles, kidneys, liver, spleen, intestines, bladder, ovaries, uterus, tendons and joints. Ultrasound technology allows the examination of the internal structures of the body. Our veterinarians use ultrasound frequently to diagnose bowed tendons, detached retinas, pleuritis, abscesses and torn ligaments. In addition, ultrasound is used extensively in reproductive evaluations to monitor the cycle of the mare and for early pregnancy detection.

Ultrasound images are created by sound waves. Sound waves of a specific frequency are generated and reflected back to the probe which is held on or around the structure to be imaged. Different frequencies are used to penetrate different depths of tissue. A computer processes the image, which is then depicted on a viewing screen, much like a television. Please feel free to ask us about our ultrasound services. It is a wonderful diagnostic tool that is non-painful and non-invasive to the patient.
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