Reflections from Europe: Looking through the doors of World-Class Equine Referral Hospitals

There are lots of different types of tourism: eco-tourism, wellness tourism, professional tourism. However, for a horse-loving veterinary nerd, nothing makes me happier than a bit of veterinary tourism! Over the last 20years I've seen my share of stand out equine practices particularly in Europe. This latest trip felt like a good opportunity to give our Australian clients a glimpse inside some of the newer, world-class equine hospitals overseas.

For those of you who have not been following my newsletters, I am currently undertaking the Equine Gait Analysis (EGAS) course this year (https://www.egas.academy). It is a specialised education program designed to advance how veterinarians assess, interpret and apply objective gait analysis. Most recently I have had the opportunity to visit two of Europe's leading equine referral hospitals, De Bosdreef Equine Clinic in Belgium and the Sporthorse Medical Diagnostic Centre (SMDC) in the Netherlands, while completing the third module of my EGAS education.

Although both clinics are internationally recognised, they operate quite differently. De Bosdreef is a large referral hospital providing specialist medicine, surgery, hospitalisation, and a 24-hour emergency service.

SMDC, in contrast, is focused exclusively on the diagnosis and management of the sport horse.

SMDC has a broad multidisciplinary team, including sports medicine veterinarians, internal medicine specialists, physiotherapists, a farrier, and a dentist, all working together to investigate and manage complex performance cases.

De Bosdreef Equin Clinic

At times, I was left wondering whether I was walking through a hotel or an equine hospital. As with several of the newer facilities I have visited in Europe, the quality of the build was incredible. These clinics are designed to manage large numbers of complex lameness and performance horses, with advanced imaging, multiple veterinary teams, and a strong commitment to evidence-based medicine.

Walking through these hospitals, it is impossible not to be impressed by the scale of the facilities and access to advanced imaging such as MRI, CT, and nuclear scintigraphy. These technologies play an invaluable role in complex cases, particularly when answers cannot be found through more conventional diagnostics.

However, the biggest lesson I brought home was not only about the advanced technology.

It was a reminder that great diagnostics begin long before advanced imaging. Whether working in a world-class referral hospital or assessing a horse in the field, the most important tools remain a thorough clinical examination, careful observation of movement, systematic investigation, and thoughtful interpretation of the findings.

What I found particularly reassuring was seeing that the approach to investigating lameness was remarkably similar to the one we provide every day. The initial work-up of a case, including the history, clinical examination, gait assessment, diagnostic reasoning, and methodical plan of investigation, followed the same evidence-based principles that underpin our ambulatory practice.

While referral hospitals have access to advanced imaging modalities that are not available in the field, the vast majority of horses first require a thorough diagnostic work-up to determine whether those technologies are even indicated. That process is where experience, clinical reasoning, and a systematic approach make the greatest difference.

Another consistent theme was the growing emphasis on objective measurement and longitudinal monitoring. Rather than waiting for horses to become obviously lame, many clinicians are increasingly focused on identifying subtle changes earlier, tracking movement over time, and using data to support clinical decision-making.

This shift from reactive medicine to proactive monitoring is something I believe will continue to shape the future of equine sports medicine.

Visiting these clinics and completing another EGAS module has reinforced why I continue to invest so heavily in ongoing education. Every discussion, every case, and every new idea adds to our understanding.

The goal is always the same: to improve the quality of our diagnostics so we can make better clinical decisions, provide clearer answers for owners, and ultimately achieve better outcomes for our patients.

Our horses deserve the most thorough, evidence-based care we can provide. By continually refining our knowledge and applying advances in equine sports medicine, we can support not only soundness and performance, but also the long-term health, welfare, and longevity of every horse we assess.

I can't wait to bring these new insights home and continue applying them to my everyday case management. Every refinement in the way we investigate our patients helps improve the quality of our diagnostic work-ups, giving owners greater confidence in the answers we provide and allowing us to deliver the best possible care for every horse we assess.

Do you have a question about your horse? Contact us here.

Other related articles:

• Why You Shouldn't Wait for the Early Signs of Lameness in Horses

• What Happens During a Lameness Work-Up?

• How Nerve Blocks Help Identify Lameness in Horses

• Objective Gait Analysis & Lameness Assessment

FAQ's

What is an equine referral hospital?

An equine referral hospital provides specialist veterinary services for horses, including advanced imaging, surgery, internal medicine, and multidisciplinary care for complex cases.

What is the difference between an equine referral hospital and an ambulatory equine veterinarian?

Ambulatory equine veterinarians investigate and manage many musculoskeletal conditions in the field using clinical examination, gait assessment, diagnostic analgesia, ultrasound, radiography, and other diagnostic tools. Referral hospitals provide additional facilities such as MRI, CT, surgery, and hospitalisation for cases requiring advanced investigation or treatment.

When should a horse be referred to a specialist equine hospital?

Referral may be recommended when advanced imaging, surgery, intensive medical care, or multidisciplinary management is required after an initial veterinary investigation.

What did you learn from visiting European equine hospitals?

One of the biggest take-home messages was that although referral hospitals have access to advanced technology, the foundations of good diagnostics remain the same: thorough clinical examination, careful gait assessment, systematic investigation, and evidence-based clinical reasoning.