And The Vet Said...

Shockwave and Acupuncture

Tendon, ligament and cartilage injuries can range from minor inflammation to complete rupture, which can result in permanent lameness or the end of a horse's competitive life. Once a horse has had this type of injury the risk of re-injury is very high. In the past few years there have been some new and exciting treatment options available for these types of conditions. I have seen some promising results with these new therapies and I am optimistic for the future of the horse that may experience these.

One of the new treatment options is stem cells. Stem cell-based treatments for ligament or tendon injury, osteoarthritis, osteochondrosis, and bone cysts have been commercially available to practicing veterinarians to treat horses since 2003 in the United States. Currently fat is harvested from the croup or a small amount of bone marrow is collected. This is then sent to a laboratory where the stem cells are extracted. The cells are then returned to the treating veterinarian for injection. There is also a company that is working to develop equine embryonic stem cell lines, with a goal of creating a "bank" of stem cells. This may become available in the future.

Extracorporeal shock wave therapy has also become an emerging new technology for treating musculoskeletal problems, soft-tissue injuries and bone injuries in horses. From the outside the machine generates high-intensity shock or pressure waves. These waves pulse to a site within the injured tissue. It stimulates and accelerates the healing process with a reduction in inflammation. I have seen good results in using this treatment in chronic sore backs and other soft tissue injuries. This treatment has also been used in horses with navicular disease by some veterinarians.

A relatively new system on the market for soft-tissue injuries is Game Ready.

The Game Ready System is used for post-workout therapy, chronic lameness, acute lameness, cellulitis, tendonitis, pre- and post-operative care, bowed tendons, stocked-up legs, wind puffs, and more. Delivering dry cold and active compression, Game Ready Equine utilizes the same physical therapy and athletic training principles relied on by human athletes, calling for the use of RICE (Rest, Ice, Compression, and Elevation). Several of my clients are using this system with very good results.

Elector-acupuncture is also becoming ever more popular in the equine world. Elector-acupuncture, the application of a pulsating electrical current to acupuncture needles as a means of stimulating the acupoints was developed in China as an extension of hand manipulation of acupuncture needles around 1934. The procedure is to insert the acupuncture needles as would normally be done, and then attach an electrode to the needle to provide continued stimulation. It can product a stronger stimulation, if desired, without causing tissue damage associated with twirling and lifting and thrusting the needle. Strong stimulation may be needed for difficult cases. This technique is being used to treat a large variety of conditions. We had a young horse with a fracture pelvis that developed significant muscle atrophy due to the condition. She has received several treatments with the elector-acupuncture and is showing marked improvement.

Using these treatments or often a combination of them has produced some fantastic results to horses that may have never been sound or show ready again. One particular horse had a sesmoidian ligament tear along with a fractured coffin bone. The combination of stem cell injection, shock wave therapy, routine radiographic evaluation and excellent farrier care, in combination with a dedicated owner has resulted in a horse that was back in the show ring in 7 short months. I am convinced without this new technology the recovery would have been much longer.

A two year old I examined had recently been in a training accident and tore the medial collateral ligament in the fetlock. This horse was given stem cell injections into the ligament along with shock wave therapy. I am happy to report this horse is sound with no visible inflammation in the leg. I believe this injury would also have taken much longer to heal with out the use of these modern treatments.

All of these new therapies need to be considered when facing any type of injury or inflammation. In conjunction with anti-inflammatory agents I have seen some very promising results. It is exciting to be practicing veterinary medicine with the new technology available and I am confident and excited to see what the future holds for the equine world.