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Treß D, Lischer C, Merle R, Ehrle A. International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes. Vet Rec 2024; 194:e3899. [PMID: 38379241 DOI: 10.1002/vetr.3899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/10/2023] [Accepted: 01/09/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Overriding spinous processes, also known as 'kissing spines', are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection. METHODS An online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners. RESULTS The survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first-line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy. LIMITATIONS Respondents' personal bias may have skewed the findings. CONCLUSIONS Despite a growing body of evidence, the therapeutic approach to 'kissing spines' in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation.
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Affiliation(s)
- Dorothea Treß
- Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Christoph Lischer
- Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Roswitha Merle
- Institute for Veterinary Epidemiology and Biostatistics, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Anna Ehrle
- Equine Clinic, School of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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Wild KN, Skiba S, Räsänen S, Richter CP. Pupillometry to show stress release during equine sports massage therapy. Sci Rep 2023; 13:20881. [PMID: 38012245 PMCID: PMC10682011 DOI: 10.1038/s41598-023-47590-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
Anecdotal reports state that wellness treatments for horses, such as massage therapy, relaxes the treated animal. Massage therapists and horse owners typically report an "improvement" without verifying or quantifying the treatment results. This paper shows that the effect of wellness treatment and stress release can be measured with pupillometry. One of the horse's pupils was photographed at the beginning and end of the treatment to determine the changes in the balance between the sympathetic and parasympathetic system activities. The owners assigned horses to two experimental groups: animals receiving a massage (N = 18) and horses standing with a person next to the horse for the time of a massage in the stable lane (N = 10). Six animals in the experimental group were excluded from the analysis because the pupils could not be traced. We opened the images of the pupil with Fiji (ImageJ) and used the elliptical selection tool to measure the pupils' and iris' areas. The ratio between the pupils' aperture and the iris' area was a normalized measure for pupil size. At the end of the experiment, we compared the normalized size of the pupils with a two-tailed paired t-test within groups and a two-tailed t-test between groups. For the experimental group, it was before and after the treatment, and for the control group, before and after the horse was placed in the stable lane. Comparisons between the experimental and control groups were made at the procedure's beginning and end. The treatment significantly decreased the normalized pupil area in the experimental group, on average, by a factor of 0.78 ± 0.15 (P = 0.042). For the horses in the control group, the pupil size increased, on average, by a factor of 1.14 ± 018. Changes were statistically not significant (P = 0.19). The initial pupil size of the horses in the experimental group was 1.88 times larger than that in the control group. After the treatment, the difference was reduced to a factor of 1.25. At the beginning of the experiment, the horses in the experimental group had, on average, larger pupil sizes than the horses in the control group, indicating that the horses in the experimental group were more stressed before the treatment than the control animals. The observed changes in pupil size in the experimental group likely resulted from enhanced parasympathetic and diminished sympathetic activity resulting from the treatment. Observed changes in pupil size agree with the anecdotal horse owner reports and the therapist's treatment notes.
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Affiliation(s)
| | - Stephan Skiba
- SkImagine, Fatburs Brunnsgata 26 LGH 1403, 118 28, Stockholm, Sweden
| | - Suvi Räsänen
- SR Häst- Och Ryttarutbildning, Vreta 1, 186 93, Vallentuna, Sweden
| | - Claus-Peter Richter
- Feinberg School of Medicine, Department of Otolaryngology, Northwestern University, 320 E. Superior Street, Searle 13-564, Chicago, IL, 60611, USA.
- Department of Communication Sciences and Disorders, Northwestern University, 70 Arts Circle Drive, Evanston, IL, 60208, USA.
- Department of Biomedical Engineering, Northwestern University, 2145 Sheridan Road, Tech E310, Evanston, IL, 60201, USA.
- The Hugh Knowles Center, Department of Communication Sciences and Disorders, Northwestern University, 70 Arts Circle Drive, Evanston, IL, 60208, USA.
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3
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Henneman K. Optimizing Health – Integrative Medicine & Poor Performance. Vet Clin North Am Equine Pract 2022; 38:463-474. [DOI: 10.1016/j.cveq.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Spinal Mobilization and Manipulation in Horses. Vet Clin North Am Equine Pract 2022; 38:509-523. [DOI: 10.1016/j.cveq.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Maldonado MD, Parkinson SD, Story MR, Haussler KK. The Effect of Chiropractic Treatment on Limb Lameness and Concurrent Axial Skeleton Pain and Dysfunction in Horses. Animals (Basel) 2022; 12:ani12202845. [PMID: 36290230 PMCID: PMC9597761 DOI: 10.3390/ani12202845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/11/2022] [Accepted: 10/17/2022] [Indexed: 11/23/2022] Open
Abstract
Chiropractic care is a common treatment modality used in equine practice to manage back pain and stiffness but has limited evidence for treating lameness. The objective of this blinded, controlled clinical trial was to evaluate the effect of chiropractic treatment on chronic lameness and concurrent axial skeleton pain and dysfunction. Two groups of horses with multiple limb lameness (polo) or isolated hind limb lameness (Quarter Horses) were enrolled. Outcome measures included subjective and objective measures of lameness, spinal pain and stiffness, epaxial muscle hypertonicity, and mechanical nociceptive thresholds collected on days 0, 14, and 28. Chiropractic treatment was applied on days 0, 7, 14, and 21. No treatment was applied to control horses. Data was analyzed by a mixed model fit separately for each response variable (p < 0.05) and was examined within each group of horses individually. Significant treatment effects were noted in subjective measures of hind limb and whole-body lameness scores and vertebral stiffness. Limited or inconsistent therapeutic effects were noted in objective lameness scores and other measures of axial skeleton pain and dysfunction. The lack of pathoanatomical diagnoses, multilimb lameness, and lack of validated outcome measures likely had negative impacts on the results.
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Affiliation(s)
- Mikaela D. Maldonado
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Samantha D. Parkinson
- Department of Veterinary Preventative Medicine, The Ohio State University, Columbus, OH 43210, USA
| | - Melinda R. Story
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
| | - Kevin K. Haussler
- Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
- Correspondence:
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Parkinson SD, Zanotto GM, Maldonado MD, King MR, Haussler KK. The Effect of Capacitive-Resistive Electrical Therapy on Neck Pain and Dysfunction in Horses. J Equine Vet Sci 2022; 117:104091. [PMID: 35908601 DOI: 10.1016/j.jevs.2022.104091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/27/2022]
Abstract
Neck pain and stiffness are increasingly recognized in horses and often treated using multimodal pharmaceutical and rehabilitation approaches. In humans, deep tissue heating is reported to reduce neck pain and increase flexibility. The objective of this project was to determine the effects of capacitive-resistive electrical therapy on neck pain and stiffness in horses. A blinded, randomized, controlled clinical trial with 10 horses assigned to active and 10 horses assigned to sham treatment groups. Neck pain, stiffness, and muscle hypertonicity were assessed by manual palpation. Forelimb postural stability was evaluated using a portable media device with built-in inertial sensing components. All outcome parameters were recorded once weekly for four weeks. Using manufacturer recommendations, the treatment group received active capacitive-resistive electrical therapy to the lower cervical region (C4-C7), twice weekly for a total of six treatments, while the control group received a sham (inactive) treatment. Data was analyzed using a mixed model that was fit separately for each response variable. There were no significant differences noted over time or between groups for any outcome parameter evaluated. While neck pain and stiffness decreased by week three in both groups, the improvement was not significant. Limitations include the lack of a definitive pathoanatomic diagnosis of cervical pathology and in vivo temperature measurements. Capacitive-resistive electrical therapy was ineffective in reducing neck pain and dysfunction using the recommended treatment protocols. No short-term adverse effects were noted. Specific clinical applications and effective treatment parameters need further evaluation.
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Affiliation(s)
- Samantha D Parkinson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO; Present address: Samantha Parkinson, Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH
| | - Gustavo M Zanotto
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Mikaela D Maldonado
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Melissa R King
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - K K Haussler
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.
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Walker V, Tranquillle C, MacKechnie-Guire R, Spear J, Newton R, Murray R. Effect of ground and raised poles on kinematics of the walk. J Equine Vet Sci 2022; 115:104005. [DOI: 10.1016/j.jevs.2022.104005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/02/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022]
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Effectiveness of cranial osteopathy therapy on nociception in equine back as evaluated by pressure algometry. ACTA VET BRNO 2022. [DOI: 10.2754/avb202291040347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A horse needs to move in different gaits and carry a rider during riding. Therefore, the equine back must be in a good functional state. Preventing back disorders is one of the keys to ensuring a horse’s health. This study aimed to assess cranial osteopathy therapy as a treatment and prevention method for preventing and reducing back pain. Thirty-two thoroughbred horses were categorised by their backs’ functional status (16 without back pain and 16 with back pain). The mechanical nociceptive threshold was determined before and after osteopathic treatment by an algometer (pain test FPX 100) with pressure points between T14-T15, T18-L1, and L5-L6. The data were analysed with a significance of P < 0.05. The study found that cranial osteopathic therapy raised the mechanical nociceptive threshold average in 83.3% measured points for horses without back pain and in 50% measured points for those with back pain. This study revealed that both horses without back pain and horses with back pain had a positive response to cranial osteopathic therapy, as evidenced by the increased nociceptive threshold limits, indicating that osteopathic therapy can be used as a primary or additional treatment method for back dysfunction.
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Story MR, Nout-Lomas YS, Aboellail TA, Selberg KT, Barrett MF, Mcllwraith CW, Haussler KK. Dangerous Behavior and Intractable Axial Skeletal Pain in Performance Horses: A Possible Role for Ganglioneuritis (14 Cases; 2014-2019). Front Vet Sci 2021; 8:734218. [PMID: 34957274 PMCID: PMC8702524 DOI: 10.3389/fvets.2021.734218] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/03/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Dangerous behavior is considered an undesired trait, often attributed to poor training or bad-tempered horses. Unfortunately, horses with progressive signs of dangerous behavior are often euthanized due to concerns for rider safety and limitations in performance. However, this dangerous behavior may actually originate from chronic axial skeleton pain. This case series describes the medical histories and clinical presentations of horses presented for performance limitations and dangerous behavior judged to be related to intractable axial skeleton pain. Material and Methods: Fourteen horses that developed severe performance limitations resulting in euthanasia were included. A complete spinal examination and behavioral responses, gait and neurologic evaluations, diagnostic imaging, gross pathologic and histopathologic examinations of the axial skeleton were performed on all horses. A tentative diagnosis of the affected spinal region was formulated using medical records, owner and trainer complaints, and antemortem examination findings. The selected spinal regions were further examined with gross and histopathologic evaluations of the associated osseous, soft tissue and neural tissues. Results: Ten horses showed severe behavioral responses during the myofascial and mobilization examinations. Based on an aggregate evaluation, the cervicothoracic and lumbosacral regions were the most common regions believed to be the primary area of concern. All horses had moderate to severe ganglionitis present at multiple vertebral levels. Subdural and epidural hemorrhage or hematomas were a common finding (71%) in the cervicothoracic and lumbosacral regions. Discussion: In this case series, neuropathic (i.e., structural) pain was judged to be the underlying cause of dangerous behavior. The dorsal root ganglia (DRG) serve an important role in relaying peripheral sensory information to the central nervous system and ganglionitis has been associated with neuropathic pain syndromes. This series highlights the need for more in-depth understanding of pain behavior and its clinical presentation and progression in chronic or severely affected horses. Limitations of the study are the lack of age-matched control DRG and the incomplete collection of DRG from every vertebral level of interest.
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Affiliation(s)
- Melinda R. Story
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Yvette S. Nout-Lomas
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Tawfik A. Aboellail
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, United States
| | - Kurt T. Selberg
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, United States
| | - Myra F. Barrett
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Science, Colorado State University, Fort Collins, CO, United States
| | - C. Wayne Mcllwraith
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
| | - Kevin K. Haussler
- Department of Clinical Sciences, Orthopaedic Research Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, United States
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A Systematic Review of Musculoskeletal Mobilization and Manipulation Techniques Used in Veterinary Medicine. Animals (Basel) 2021; 11:ani11102787. [PMID: 34679808 PMCID: PMC8532674 DOI: 10.3390/ani11102787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 12/21/2022] Open
Abstract
Simple Summary Neck and back pain are common ailments in animals. While there are medical and surgical treatment options available for select patients, conservative care is the most common form of management of pain, stiffness and muscle spasms. Physical therapists, osteopaths and chiropractors use mobilization and manipulation techniques to evaluate and treat muscle and joint problems in both humans and animals, but there seems to be little scientific evidence available to support their use in veterinary medicine. This study reviews the scientific literature with the goal of identifying the clinical indications, dosages, outcome parameters, and efficacy of mobilization and manipulation techniques in dogs and horses. Fourteen articles were included in this review of which 13 were equine and one was a canine study. There was a large variability in the quality of evidence that supports the use of joint mobilization or manipulation in treating pain, stiffness and muscle hypertonicity in horses. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Future studies need to establish standardized methods to evaluate the optimal dosages of mobilization and manipulation for use in animals. Abstract Mobilization and manipulation techniques are often used in small animal and equine practice; however, questions remain concerning indications, dosing and efficacy. A bibliographic search was performed to identify peer-reviewed publications from 1980 to 2020 that evaluated the clinical effects of musculoskeletal mobilization and manipulation techniques in dogs, cats and horses. The search strategy identified 883 papers for review. Inclusion and exclusion criteria were applied. The clinical indications, dosages, outcome parameters, and reported efficacy within each publication were recorded and categorized for comparison with scientific quality assessed according to a standardized grading system. Fourteen articles were included in this systematic review of which 13 were equine and one was a canine study. Seven of these were cohort studies and seven were randomized controlled clinical trials. The canine study involved carpal immobilization-remobilization and all equine studies focused on the effects of passive mobilization (n = 5) or manipulation (n = 8) of the axial skeleton. Study quality was low (n = 4), moderate (n = 7), and high (n = 3) and included a wide array of outcome parameters with varying levels of efficacy and duration of therapeutic effects, which prevented further meta-analysis. Therefore, it was difficult to draw firm conclusions despite all studies reporting positive effects. Optimal technique indications and dosages need to be determined to improve the standardization of these treatment options.
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Haussler KK, King MR, Peck K, Adair HS. The development of safe and effective rehabilitation protocols for horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. K. Haussler
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - M. R. King
- Gail Holmes Equine Orthopaedic Research Center Department of Clinical Sciences College of Veterinary Medicine and Biomedical Sciences Colorado State University Fort Collins Colorado USA
| | - K. Peck
- Department of Physical Therapy Creighton University Omaha Nebraska USA
| | - H. S. Adair
- Department of Large Animal Clinical Science University of Tennessee Knoxville Tennessee USA
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