Simulating the Horse for Veterinary Education
A Calgary company is helping veterinary students become proficient in their diagnostic and practical skills.
By Margaret Evans
“I used to build props and worked in film and television production, and I had a shop in my garage at home,” says Russ Gray, cofounder of Veterinary Simulator Industries (VSI) in Calgary, Alberta. “My neighbour was the dean for the University of Calgary’s new Veterinary School. He knew that I built weird things, so he asked me if I could build the back end of a cow just to garner some interest for the new school at the agricultural fair in Calgary. He wanted the back end of three cows so that kids could reach up into the rectum and palpate a calf’s head. I contacted my business partner, Bryan Pfahl, and we created them for him. At the time we were doing all kinds of jobs for science centres and things like that during the course of our careers, so we just took it on as another project.”
Russ Gray, cofounder of Veterinary Simulator Industries in Calgary, Alberta.
That was 2009. In the past decade, the innovative partners have built a whole new generation of working models of cattle, horses, and more recently, dogs as educational aids for veterinary students. Their products are now marketed in 43 countries.
“We started VSI in 2010,” says Gray. “Other professors came to my shop and saw what we were building. It started the wheels turning for them because they had been unsuccessfully looking for these kinds of simulators to help teach students. They wanted to use a lot of clinical skills in their new school. They asked if we could build horses to show the GI [gastrointestinal] tract and colic. We took two of their [model] horses and modified them. They were like a tack store horse, so we refined them and created a small intestine and the GI tract. They provided us with an actual GI tract preserved with fiberglass resin, so we took that and created a rubber inflatable GI tract that could be put inside the horse model, and it could be palpated so that a student could feel the different structures.”
ABOVE: The inflatable equine GI tract is made of natural latex rubber and anatomically correct. Veterinary students can feel the various structures and learn what is happening inside the horse.
BELOW: Models of the equine spleen (top), perineum panel (left), and uterus (right).
The anatomically correct model, which is fabricated in natural latex rubber, consists of five components – left and right ventral colon, left and right dorsal colon, and the cecum. When assembled, they form the complete large intestine with the representative membranes. Each component is separately partitioned so that they can be individually inflated.
Gray says that the students really enjoyed the model since they had never seen anything quite like it before. They could get a real sense of the feel and what is going on inside the horse.
“It was a good opportunity for them to practice in a safe way,” he says. “They wouldn’t hurt an animal and they wouldn’t get hurt by an animal. Veterinary medicine is a very hands-on science and it made sense to us that having a tactile hands-on simulator would be valuable. The same kind of thing with the cows.”
Gray says that they actually produced the horses first, and then there was pressure to deliver the cows. Not only that, says Gray, the veterinary professors wanted a cow that could give birth to a calf. They had seen a simulator that was a Swiss model. It was basically a stainless steel table with a funnel shape at the end that acted as the birth canal.
VSI offers both a Hereford (shown) and a Holstein model cow, providing students with the opportunity to learn to assist with the birth of a calf before dealing with live animals.
“The initial idea was to get us to build a new table, but Bryan and I said, well, we’ve just delivered the horses and the professors saw them. We can do a cow that can give birth to a calf.”
“The horses started the ball rolling and we managed to get a grant from the (former) Alberta Livestock and Meat Agency to help in the development of the bovine model.”
What resulted was far more than ever expected. Now, the company offers both a Hereford and a Holstein dystocia model. Dystocia is the condition that causes difficult births such as a calf that is positioned awkwardly in the birth canal, a cow that has a small pelvis, or failure of the uterus and cervix to expand normally. By removing the top plate of the model cow, students can see how a model calf is realistically positioned in a clear vinyl uterine bag at birth. The calf will move into the birth canal, and a functional udder with a milk tank simulates milk delivery. To help students learn how to assist with a calf’s birth, the model also comes with a fetal extractor, obstetric chain, and head snare as well as a landing mat to prevent damage to the calf.
“The students really like these models because they gain confidence practicing some of these techniques,” he says. “With our simulators, they can call up a problem birth or a breach whereas, before, they may not get an opportunity to see one if it does not occur in an animal they happen to be working on. With our model they can practice in a low-stakes situation. They can reposition the calf and pull it using a fetal extractor. They can practice it without damage to the uterus or the calf.
“The model has a functional milk tank. Each teat has its own milk supply, but you can isolate one of those sections. Students can learn how to put on a cluster [the milking machinery that attaches to the cow] or learn how to milk a cow. We built the teats like real teats. The simulated milk just syphons. Alberta Milk, Saskatchewan Milk, Manitoba Milk all have models of ours which they take to county fairs. Alberta Milk has ours at the Stampede every year.”
Leg function and lameness issues are a constant focus of concern for horse owners, and the partners have been working on limbs for a variety of applications.
“We were working on an injection limb to inject synovial pouches on horse limbs,” says Gray. “The Equine Foundation of Canada helped fund a portion of the injection limb. It turned out that there were some pronounced difficulties injecting fluid into a model and it ended up becoming a radiology limb. The school provided us with several horse limbs. We caste the exterior, then their anatomy department took all the flesh off the bone and we caste the bone and sculpted the tendons. It worked very well as an X-ray limb, so we incorporated that into our full horse model as a removable limb. You can palpate the tendons and do X-rays.”
Currently, they are working on an equine nasogastric intubation model. With the help of the University of Calgary, they received a horse head that had been split down the middle and then plastinated, so that it was preserved in the state they needed. They have a model of the horse’s head and a model of the neck.
The equine colic and palpation model.
“We had the head 3D-scanned,” he says. “The head and neck are two components. They fit together, then fit onto the body. We are putting in all the sinuses, epiglottic trachea, and esophagus so students can basically practice learning nasogastric intubation by passing a tube through the nostril of the horse. The neck has the jugular veins with a blood supply, and we have foam pads in the neck where they would normally inject an intermuscular injection. When the students tube the horse, they run the tube through the nose and get the horse to swallow, which blocks the trachea, so you get the tube into the esophagus and into the stomach. Sometimes we have to make slight adjustments to make it work as we don’t have all the biology.”
The swallowing action is a prime example. Gray said that they consulted with Dr. Dan French, an equine surgeon with the TD Equine Veterinary Group in Calgary, who explained the swallowing procedure and the structures involved. They were then able to replicate a more simplified swallow and fit the structures into the horse’s head.
“We have a simplified swallowing action, so it gives the students an idea of what is happening. When an animal swallows, there’s a lot of muscular stuff going on. We try to replicate it in a simple way. It you make it too super complicated, it means something might fail or break. Any of the soft components will wear out or get damaged after a time. But they are made to be replaced. We are very aware of veterinary budgets. Parts have to be as durable as we can make them, yet easily replaceable.”
Gray said that there are other companies that build veterinary simulator models including a lot of companion animals. VSI has recently developed a canine dental model and a canine spay model. The simulated teeth and bones are surrounded in soft rubber gums that allow for practical simulation for scaling, probing, nerve blocks, as well as the biology to allow for intubation training.
The fiberglass herd waits patiently for completion.
An aspect of veterinary training that is both sobering and necessary is euthanasia. Part of that training is how to use a captive bolt stunning gun that renders an animal instantly unconscious without causing pain and killing it. The gun has a steel bolt powered either by compressed air or a blank cartridge. The bolt is driven into the animal’s brain.
“Beef, dairy, steer, sheep, swine are all modelled so you can learn how to target using a captive bolt gun and learn how to fire it into a canister that we have that represents the brain in the skull,” says Gray. “The students can see the depth of penetration in the area where the bolt lands so that they can target it for accuracy. First responders don’t necessarily know the proper placement of a shot to dispatch an animal. There really is no model for teaching it.
“We work with Olds College as well in their meat processing program, because a lot of their students have to learn how to do euthanasia. Right now, the first time they do that is with a live animal. They’ve never even fired a gun. It’s terrifying. If they do it in an environment where they can gain some confidence and understand the procedure, they can get some practice time as it were, without worrying about the animal. Then when they go to a real animal, they have some confidence. It takes some of the pressure off. There’s also the possibility that the EU [European Union] is going to come up with some recommendations on how your animals are slaughtered. Because of that, you need to have some training. You can’t pass it down from one line-worker to the next line-worker.”
“Mittens” up close shows the detailed recreation of the hair coat and mane.
With the success of their company, Gray says that they were delighted to be able to donate to the Equine Foundation of Canada who had so graciously provided some start-up funds back in the early days of VSI.
The demand for their products is steadily growing. They’ve come a long way from building props in the movie industry, and the bonus is that they are providing an invaluable educational service for tomorrow’s veterinarians.
Photos are courtesy of Veterinary Simulator Industries.