The Practitioner & the Gardener

BY KRISTEN MANNING

Ever hear the joke about the nuclear medicine practitioner and the landscape gardener?

Well no, because there isn’t one. But there is a story about how two men with these rather differing backgrounds came together in an endeavour that is helping the modern thoroughbred to stay sounder, healthier and happier.

Chris Cowcher and Pete Tually, whose wives had been friends for years, are co-founders of TeleMedVET, an Ascot based group that provides diagnostic services whilst also undertaking a number of very interesting and very exciting research projects.

Repurposing hospital standard nuclear medicine scanners, Tually came up with a way of extending their purpose... by getting them into vet clinics.

Over a bottle of wine during a night out, Tually mentioned this idea to Cowcher who started to ask around, discovering that trainers were well aware of scintigraphy being put to good use in the eastern states - but not so much in the west. With no huge ambitions (“it was a bit of fun really, we thought we’d just scan a few horses and see how that worked out”), Cowcher and Tually set about putting this idea into place and in September 2018 an ungraded scanner - one which had helped thousands of rural patients across Western Australia in the preceding years - was installed, leading to the establishment of TeleMedVET.

As is the case with xrays and CT scans, the fundamental technology underlying nuclear medicine has not, Cowcher said, changed drastically over the past couple of decades. Rather it is the ability to process the information and to detect issues that has - and will continue - to improve. Especially with the advent of artificial intelligence - a specialist area of research for the scientific team at TeleMedVET.

Which is why these scanning machines - which have been refurbished and integrated with state-of-the-art processing capabilities - have been able to be put to a good second use. Helping horses, such as eventers and thoroughbred racehorses. And it is a lifelong interest in the latter that saw Chris Cowcher willing to give up his more lucrative landscape gardening career to embark on this passion project.

“I took a punt and it has become my life!”

“My uncles on both sides were trainers and there were horses on the farm as I was growing up,” he said. “I’ve had shares in horses, a few slow ones, a few decent ones and I absolutely love it.”

And what he loves most of all is ensuring that horses have the best racing career they can possibly have and central to thatand to what TeleMedVET is about - is “the early detection of lameness.”

Especially when said lameness cannot be detected by traditional methods. Such as was the case with the talented galloper Last Of The Line - the 2021 Listed Detonator Stakes winner whose trainer Stephen Miller and whose vets were at a loss trying to figure out why he was sore after an unplaced run at Ascot in the spring of 2021.

TeleMedVET’s scintigraphy machine was put to good use, a stress fracture in the pelvis detected - enabling just the right sort of rehabilitation to take place. And when the horse was

back in winning form at Belmont last July there were cheers not only from the stable and the happy owners - but from everyone at TeleMedVET.

“We cheered him like we owned him!” Cowcher enthused, “we could not have been happier.”

Working in partnership with Amelia Park’s Peter Walsh, the Perth Equine Hospital and different universities, researchers and vets around Australia and beyond, TeleMedVET has gone from strength to strength in a short time.

Cowcher and Tually have been keen to keep costs down, making diagnostics affordable whilst putting any profits back into the business - into upgrading their facilities whilst also embarking on research projects.

Some of the upgrading includes the world’s first and still only only three-dimensional equine nuclear scanner, one which is enabling the TeleMedVET team to conduct a study of biomarkers.

“Biomarkers indicate the presence or extent of a biological process, which is directly linked to the clinical manifestations and outcome of a particular disease. Identifying biomarkers or biomarker profiles will be an important step towards disease characterization and management of disease in animals.”

Moore RE, Kirwan J, Doherty MK, Whitfield PD. Biomarker discovery in animal health and disease: the application of post-genomic technologies. Biomark Insights. 2007 Jul 10;2:185-96. PMID: 19662203; PMCID: PMC2717813.

Noting that researchers have narrowed down six relevant biomarkers, TeleMedVET staff take blood samples of a horse on the morning of the nuclear scan - enabling an analysis of what is happening on that very day.

“The holy grail,” Tually said, “is to develop a blood test which can detect bone fatigue.”

A pilot study has shown early promise - only a small group of horses but there were definite links between what was showing up in the test and what was happening with those horse’s soundness.

Which attracted the interest of the Hong Kong Jockey Club who are now sending blood samples to TeleMedVET. And more can happen should funding increase, Cowcher and Tually hopeful that the racing industry can step in. Especially now that the European College of Veterinary Diagnostic Imaging has published the findings in a prestigious journal that Cowcher describes as being “a Group One publication.”

Will Baxter, Dr Bec Caslick, Jack Meadows & Chris Cowcher

POD (palmar/plantar osteochondral disease) lesions are one example of injury that it would be of great help to predict. Graded from one to three, they are career ending at their most severe whilst early detection (and thus intervention) is vital. Studying the development of bone density is another area of interest - CT scanning able to detect changes over periods of time.

Also an issue at TeleMedVET is keeping radiation as riskfree as possible; hence their machinery utilizing cone beam technology as opposed to fan beam... cone beam “using a fraction of the radiation, meaning that you can conduct more tests on each horse.”

Which helps not only the individual horse but the sport of racing as a whole.

“It is,” Cowcher said, “better for us to be proactive in regard to horse soundness than reactive.”

Which keeps horses racing for longer, making racing more viable for owners and everyone involved. All things that can only be good for all of us!