Referral Hospital Services

Large Animal Hospital Entrance

Monday - Friday 8:00 am to 5:00 pm

SATURDAYS - 8:00 am to 12 noon

The equine referral hospital provides unique patient care from the outpatient to the inpatient, from a basic examination to the intensive critical cases. The 25,000 sq. ft. facility housing the referral hospital, diagnostic buildings, isolation, ICU, CCU and elective stall barn allows us to offer the best level of care for both the patient and the owner while having the latest technologies as well as state-of-the-art equipment at our fingertips.

24/7 Care and Monitoring

24 hour nusing care - Photo courtesy of Hope For HorsesAt Pilchuck, we offer 24/7 care and monitoring of equine patients at our hospital for inpatient treatment or for emergencies. Our team of skilled, compassionate doctors, technicians and assistants provides excellent, individualized care to your horse and brings peace of mind in uncertain and sometimes-scary situations. Our seven-stall ICU and four isolation stalls are equipped with video cameras so we can monitor patients continuously from the nurses’ station. We are proud to offer the level of careful monitoring and responsive nursing care that only a 24-hour facility can, and to help provide the  environment that allows your horse the best-possible chance to heal. Photo courtesy of Hope For Horses


Large Animal Hospital Surgery Our surgical center is equipped to handle any elective or emergency surgical intervention necessary including colics, orthopedic, soft tissue, laser and minimally invasive laparoscopic procedures. Our surgical facility houses 3 dedicated surgical suites with state of the art air-mattress recovery systems to minimize the risk of recovery complications. Our four staff surgeons are board certified by the American College of Veterinary Surgeons and have completed advanced training and as well as nationally published research in their respective fields of interest. The ultimate goal of our veterinary team and surgical center is to provide our patients with superior pre and post-operative care as well as a broad range of expertise while performing about 1200 surgical procedures in a year. 


Our equine hospital houses 3 ICU stalls which are the center of our internal medicine department. The ICU and Neonatal unit is designed for around-the-clock observation and treatment of critical patients and equipped to provide respiratory and parenteral support to critical care neonates. These stalls are also equipped with a hoist system to manage neurological cases. The hospital has 4 CCU/colic stalls and a 6 stall isolation facility equipped to meet the challenges of infectious disease and support critically ill horses with 24 hour video monitoring. Availability of advanced diagnostics and on-site laboratory provide the ability to quickly diagnose and closely monitor our patients’ condition.  One of our greatest assets is the skilled and dedicated Interns and nursing staff that provides patients with attentive assessment, care and comfort.

In addition to our leading internal medicine clinician who is board certified by the American College of Veterinary Internal Medicine, we have the resources to have on-premises consultation with a board certified radiologist, cardiologist and clinical pathologist.

Diagnostic Imaging

Large Animal Diagnostic Imaging Diagnostic imaging is an exciting, rapidly changing area of equine medicine. Using non-invasive techniques such as radiology, ultrasound, CT, nuclear scintigraphy and MRI, we are able to visualize nearly every structure in the equine body. Fifty years ago, obtaining this type of highly detailed information was not possible. Within the last 10 years our ability to use these diagnostic imaging techniques in the horse has allowed us to make specific    diagnoses of problems, find these problems earlier, and treat horses with more targeted therapies.


Large Animal MRIMagnetic resonance imaging (MRI) uses strong magnetic fields and radiofrequency pulses to produce images with superior bone and soft tissue detail.  MRI is capable of sectioning the limb in multiple planes in many thin slices. This allows the clinician to view all tissues of the region from numerous angles in order to precisely identify and locate the problem.  MRI provides a more sensitive evaluation of all the ligamentous, tendinous and bony structures within the horses hoof capsule when radiographs and ultrasound have failed to reveal the source of the problem. We routinely use this imaging technique to diagnose lesions in lower limbs, brain, and upper airway.

In many cases, MRI is considered the gold standard. The addition of our low field open Magnetic Resonance Imaging (MRI) system in 2006 has allowed Pilchuck Veterinary Hospital to be one of a handful of private equine hospitals in the country with this level of MRI technology. MRI’s are performed under general anesthesia after a thorough lameness examination has been performed. Localization of the area of concern is essential to ensure that accurate information can be obtained from the study as this is not a screening procedure.

Digital Radiography

All services in the Equine hospital have the use of three portable Idexx sytems to provide the benefits of digital radiology to our clients, improving image quality and speed of processing. These units consist of a preliminary storage and viewing unit and a digital plate to capture the image. The plate collects the image which is then immediately transferred to the storage and viewing unit via a fiber optic cable.Large Animal Digital Radiography

The veterinarian can examine, manipulate, and optimize the image, significantly reduces the number of retakes, as the radiograph quality can be assessed at the time of the initial examination. The images are then brought back to the hospital where they are uploaded onto a central server for storage. Workstations with high resolution monitors and image viewing software are used to make final diagnoses.

Our in-hospital overhead Amrad radiology system provides the ability to obtain high quality radiographs of the abdomen, chest, neck, back and pelvis in standing as well as anesthetized patients. We are one of only a few private practices in the country with a powerful, high-speed1000MA radiography machine in place to perform these radiology surveys.


Large Animal UltrasonographyUltrasound is a specialized imaging technique that uses inaudible sound waves to create an image of soft tissue structures. It is one of our most frequently used non-invasive diagnostic tools.  The lameness experts on both our ambulatory and in-hospital teams have the ultrasound capabilities to perform complete tendon, ligament, joint and soft tissue ultrasound examinations. In hospital abdominal, thoracic and heart ultrasound examinations are performed by boarded specialists.  Anytime we would benefit from "seeing" within a soft tissue structure to aid our diagnostic endeavor, we reach for the ultrasound machine.


Nuclear Scintigraphy (Bone Scan)

Nuclear scintigraphy, or bone scan, has become an integral part of the equine veterinary diagnostic process. The procedure begins with injection of a radioisotope intravenously. Soft-tissue scans of a specific area are obtained in the first 15 minutes, and then the bone images are acquired two to three hours later. The unit is housed at Pegasus Training and Rehabilitation Center. The scans are performed by Pilchuck’s Dr. Jim Bryant and Pam Poole, LVT, and Katie Gilmur, rehab assistant at Pegasus. Learn more about nuclear scintigraphy as an equine diagnostic tool, including indications for use. 


Video Endoscopy capabilities are available for full assessment of the upper airway and sinuses, as well as examination for gastric disease.

Laboratory Services

Large Animal Endoscopy24-hour availability of comprehensive, reliable test results is a vital function of the continuous care provided at Pilchuck Veterinary Hospital. Our lab is lead by Dr Lester, a board certified Clinical Pathologist who is continually adding new tests and services to the laboratory roster to enable us to perform the most current and useful lab work in-house. That roster includes hematology, blood gases, serology, serum chemistry, bacteriology, cytology, parasitology, and limited endocrinology.

The Pilchuck Veterinary Hospital Laboratory also provides laboratory services to veterinarians in the Snohomish area. Our lab provides prompt reliable results, with same day service for many tests (see individual test list for result time). For information on our services veterinarians may call (360)568-3111.