Spinal ligament pathology

Advances in the Clinical Diagnostics to Equine Back Pain: A Review of Imaging and Functional Modalities

Back pain is common in ridden horses. Back diseases in horses include Impinging Dorsal Spinous Processes, Ventral Spondylosis, Osteoarthritis of Articular Process, Intervertebral Discs Disease, Vertebral Fractures, Conformational Abnormalities, Desmopathy of the Supraspinous Ligament, Desmopathy of the Intraspinous Ligament, and Longissimus Muscle Strain. Back pain may also develop as a result of lameness (particularly hindlimb lameness). A poorly fitting saddle and an unbalanced rider are also considered important factors influencing the development of back pain in horses. The conventional diagnosis of equine back pain includes a clinical examination and diagnostic imaging examination using ultrasound, radiography, and thermography. Advanced diagnostic modalities of equine back pain involve the objectification of standard procedures through the use of algometers, a lameness locator, biometric mats, and the geometric morphometrics method. In addition to modern diagnostic methods, such as computed tomography and scintigraphy, advances in the diagnosis of equine back pain include the use of electromyography and functional electrical stimulation. The aim of this review article is to familiarize clinicians with the usefulness and capabilities of conventional diagnostic protocols and advanced diagnostic modalities. Although orthopedic examination and traditional diagnostic methods will remain the foundation of the diagnosis of back diseases, modern methods meet the growing expectations towards high-performance horses and allow for deeper diagnostics and objective monitoring of rehabilitation and training progress.

Behavioral Disorders in Mares with Ovarian Disorders, Outcome after Laparoscopic Ovariectomy: A Case Series

Owner complaints of estrus-related behavior in mares are a common cause of referral for laparoscopic ovariectomy. Granulosa cell tumors are a common neoplastic condition affecting the equine ovary, causing behavioral changes at rest and reduced performance. The reported success rate of ovariectomy in treating behavioral disorders is 64-86%. The aim of this study was to retrospectively evaluate the long-term follow-up of laparoscopic ovariectomy in mares in our case series, focusing on the owner's perspective of the behavior of the mares after surgery. In addition, the histopathological features of the removed ovaries were investigated. The clinical records of mares that underwent laparoscopic ovariectomy between 2015 and 2022 were retrospectively reviewed. Owners complaining of poor behavior were interviewed about the main behavioral problem leading to referral and its eventual resolution after surgery. Eleven mares were included. The most common complaints were increased sensitivity on both flanks (10/11, 91%) and general riding problems (9/11, 82%). In 5/11 cases (45%), both ovaries were removed by laparoscopic ovariectomy. Histopathologic findings consistent with GCT/GTCT were found in five out of six examined ovaries (five granulosa theca cell tumors, GTCT). According to owner interviews, the scores assigned to each behavior improved significantly after surgery, regardless of histological findings. Although many factors can influence the behavior of horses, granulosa cell tumors (GCTs) proved to be a common cause and, as reported by the owners, ovariectomy resulted in improvement or complete resolution of the abnormal behavior.

Detecting Welfare in a Non-Verbal Species: Social/Cultural Biases and Difficulties in Horse Welfare Assessment

Simple Summary

There is a paradox about the welfare of horses in the domestic situation: on the one hand, horses are beloved partners for most owners, but on the other hand, scientific studies are converging to show that there is a high prevalence of welfare problems. There seems to be a mismatch between theoretical knowledge and field applications. In this review, we aim at disentangling the possible factors explaining such a paradox. Among them, we consider the impact of anthropomorphic and cultural biases, popular beliefs, but also overexposure to horses with compromised welfare state, which can change owners’ representation of what is a “normal” horse, on the undervaluation of horse welfare state. We suggest that, rather than simply having knowledge on what should be done, identifying the horse welfare state using validated animal-based indicators is essential to identify and promote best practices.

Abstract

Horses were domesticated for more than 5000 years and have been one of the most emblematic species living alongside humans. This long-shared history would suggest that horses are well known and well understood, but scientific data raise many concerns about the welfare state of most domestic horses suggesting that many aspects have been largely misunderstood. In the present review, we will examine some of the possible human factors that may explain the huge prevalence of welfare problems, despite horses being of special importance to humans. First of all, as horses are non-verbal, current management practices rely upon what one thinks is good for them, which opens the way to subjective interpretations and projections, based on one’s own subjective experience but probably still more on cultural/social norms and influences, traditions and beliefs. The lack of recognition, identification, or even the misinterpretation of signals are other potential reasons for welfare issues. Lastly, the over-exposure to animals with expressions of compromised welfare may lead to lower sensitivity of owners/professionals. That is why we lastly suggest that instead of simply providing information on what to do, we should promote validated visible indicators that leave less room for personal interpretation.

Clinical assessment and grading of back pain in horses

Background

The clinical presentation of horses with back pain (BP) vary considerably with most horse's willingness to take part in athletic or riding purpose becoming impossible. However, there are some clinical features that are directly responsible for the loss or failure of performance.

Objectives

To investigate the clinical features of the thoracolumbar region associated with BP in horses and to use some of the clinical features to classify equine BP.

Methods

Twenty-four horses comprised of 14 with BP and 10 apparently healthy horses were assessed for clinical abnormality that best differentiate BP from normal horses. The horses were then graded (0–5) using the degree of pain response, muscular hypertonicity, thoracolumbar joint stiffness and overall physical dysfunction of the horse.

Results

The common clinical features that significantly differentiate horses with BP from non-BP were longissimus dorsi spasm at palpation (78.6%), paravertebral muscle stiffness (64.3%), resist lateral bending (64.3%), and poor hindlimb impulsion (85.7%). There were significantly (p < 0.05) higher scores for pain response to palpation, muscular hypertonicity, thoracolumbar joint stiffness and physical dysfunction among horses with BP in relation to non-BP. A significant relationship exists between all the graded abnormalities. Based on the cumulative score, horses with BP were categorized into mild, mild-moderate, moderate and severe cases.

Conclusions

BP in horse can be differentiated by severity of pain response to back palpation, back muscle hypertonicity, thoracolumbar joint stiffness, physical dysfunctions and their cumulative grading score is useful in the assessment and categorization of BP in horses.

Testing optimal methods to compare horse postures using geometric morphometrics

The study of animal behavior, especially regarding welfare, needs the development of tools to identify, quantify and compare animal postures with interobserver reliability. While most studies subjectively describe animal postures, or quantify only limited parts of the body, the usage of geometric morphometrics has allowed for the description of horses’ and pigs’ upper body outline and the comparison of postures from different populations thanks to robust statistical analysis. We have attempted here to optimize the geometric morphometrics (GM) method already used in horses by introducing the outline analysis with sliding semilandmarks (SSL), by eliminating the balance movement of the neck and by focusing only on parts of the upper line. For this purpose, photographs of 85 horses from 11 riding schools, known for differing in terms of housing and working conditions, were analyzed with previous and new GM methods and these results were compared with each other. Using SSL and eliminating the neck movement appeared to better discriminate the horse populations than the previous GM method. Study of parts of the dorsum proved efficient too. This new methodology should now be used to examine if posture could be an indicator of horse welfare state, and similar studies should be performed in other species in order to validate the same methodology.

Low plasma cortisol and fecal cortisol metabolite measures as indicators of compromised welfare in domestic horses (Equus caballus)

The hypothalamic-pituitary-adrenal (HPA) axis response to chronic stress is far from straight forward, particularly with regards to animal welfare. There are reports of no effect as well as both decreases and increases in cortisol after chronic stressors. Therefore, the first aim of the present study was to determine how measures of compromised welfare, such as chronic pain and haematological anomalies, related to cortisol levels in domestic horses (Equus caballus). Domestic horses are an informative model to investigate the impact of chronic stress (due to environment, pain, work, housing conditions…) on the HPA axis. The second aim was to determine whether levels of fecal cortisol metabolites (FCM) may be used as an indicator of welfare measures. The present study used fifty-nine horses (44 geldings and 15 mares), from three riding centres in Brittany, France. The primary findings show that horses whose welfare was clearly compromised (as indicated by an unusual ears backward position, presence of vertebral problems or haematological anomalies, e.g. anaemia) also had lower levels of both FCM and plasma cortisol. This work extends our previous findings showing that withdrawn postures, indicators of depressive-like behavior in horses, are associated with lower plasma cortisol levels. We also found that evening plasma cortisol levels positively correlated with FCM levels in horses. Future research aims to determine the extent to which factors of influence on welfare, such as living conditions (e.g. single stalls versus group housing in pasture or paddocks), early life factors, and human interaction, act as mediators of cortisol levels in horses.

Comparison of clinical examinations of back disorders and humans' evaluation of back pain in riding school horses

BACKGROUND

Questionnaires are a common tool to assess people's opinion on a large scale or to sound them out about their subjective views. The caretakers' opinion about animals' "personality" has been used in many studies. The aim of the present study was to assess whether the owners' subjective evaluation was effective to detect back disorders. Back disorders have been shown to have a high prevalence in working horses. Caretakers from 17 riding schools (1 caretaker/school, 161 horses) were given a questionnaire about their horses' health status, including back disorders. Out of these 161 horses, 59 were subjected to manual palpation of the spine and 102 were subjected to sEMG examination all along the spine.

RESULTS

The results showed that subjective caretaker-reported evaluation via questionnaire survey was not efficient to detect back disorders: only 19 horses (11.8%) were reported as suffering from back pain, whereas the experimenters' evaluation detected 80 of them (49.7%) as suffering from back disorders. While most caretakers under-evaluated back disorders, a few "over-evaluated" it (more horses reported as affected than found via clinical evaluations). Horses were less prone to present back disorders when under the care of these "over-attentive" caretakers.

CONCLUSIONS

This study showed that back pain is difficult to evaluate, even for professionals, and that subjective evaluations using a questionnaire is not valid in this case. The results also highlighted the real need for observational training (behaviours, postures) outside and during riding.

Towards a postural indicator of back pain in horses (Equus caballus)

Postures have long been used and proved useful to describe animals' behaviours and emotional states, but remains difficult to assess objectively in field conditions. A recent study performed on horses using geometric morphometrics revealed important postural differences between 2 horse populations differing in management conditions (leisure horses living in social groups used for occasional "relaxed" riding/riding school horses living in individual boxes used in daily riding lessons with more constraining techniques). It was suggested that these postural differences may reflect chronic effects of riding techniques on the horses' kinematics and muscular development. In the present study, we tried to evaluate the interest of postural measures to assess welfare in horses. This study was separated into 2 parts. First, 18 horses coming from these 2 types of populations (leisure/riding school horses) were submitted to 2 back evaluations by 1) manual examination (experienced practitioner) and 2) sEMG measures along the spine. We then measured neck roundness on 16 of these 18 horses. The results highlighted high correlations between manual and sEMG examinations over the spine. sEMG measures at the different locations were strongly correlated all over the spine. Moreover, neck postures and muscular activities were strongly correlated, horses with concave necks having higher sEMG measures both at precise locations (i.e. cervical sites) but also when comparing neck postures to the whole spine muscular activity highlighting the functioning of horses' back as a whole. Lastly, strong differences appeared between the populations, leisure horses being evaluated as having sounder spines, exhibiting lower sEMG measures and rounder neck than the riding school horses. sEMG measures and neck "roundness" seemed therefore to be reliable indicators of back disorders, easy to evaluate in field conditions. This highlights the accuracy of using postural elements to evaluate the animals' general state and has important implications for animals' welfare evaluations.

Partners with bad temper: reject or cure? A study of chronic pain and aggression in horses

Background

Experiencing acute pain can affect the social behaviour of both humans and animals and can increase the risk that they exhibit aggressive or violent behaviour. However, studies have focused mainly on the impact of acute rather than chronic painful experiences. As recent results suggest that chronic pain or chronic discomfort could increase aggressiveness in humans and other mammals, we tested here the hypothesis that, in horses, aggression towards humans (a common source of accidents for professionals) could be linked to regularly reported vertebral problems of riding horses.

Methodology/Principal Findings

Vertebral examination and standardized behavioural tests were made independently on the same horses. Here we showed that most horses severely affected by vertebral problems were prone to react aggressively towards humans (33/43 horses, chi-square test, df = 1, χ² = 12.30, p<0.001), which was not the case for unaffected or slightly affected horses (9/16 horses, chi-square test, df = 1, χ² = 0.25, p>0.05). The more affected they were, the fewer positive reactions they exhibited (rs = −0.31, p = 0.02).

Conclusions/Significance

This is to our knowledge the first experimental evidence of such a link between chronic discomfort/potential pain (inferred from the presence of vertebral problems) and aggression, suggesting that chronic painful experiences may act in ways similar to those of acute experiences. Chronic discomfort or pain may often be overlooked when facing “bad tempered” individuals, whether humans or animals. This experimental study confirms the importance of including chronic discomfort or pain as a major factor in interpersonal relations and models of aggression.

Human direct actions may alter animal welfare, a study on horses (Equus caballus)

BACKGROUND

Back pain is the cause of bad welfare in humans and animals. Although vertebral problems are regularly reported on riding horses, these problems are not always identified nor noticed enough to prevent these horses to be used for work.

METHODOLOGY/PRINCIPAL FINDINGS

Nineteen horses from two riding centres were submitted to chiropractic examinations performed by an experienced chiropractor and both horses' and riders' postures were observed during a riding lesson. The results show that 74% of horses were severely affected by vertebral problems, while only 26% were mildly or not affected. The degree of vertebral problems identified at rest was statistically correlated with horses' attitudes at work (neck height and curve), and horses' attitudes at work were clearly correlated with riders' positions. Clear differences appeared between schools concerning both riders' and horses' postures, and the analysis of the teachers' speech content and duration highlighted differences in the attention devoted to the riders' position.

CONCLUSION/SIGNIFICANCE

These findings are to our knowledge the first to underline the impact of riding on horses' back problems and the importance of teaching proper balance to beginner riders in order to increase animals' welfare.

Ultrasonographic evaluation of the supraspinous ligament in a series of ridden and unridden horses and horses with unrelated back pathology

BACKGROUND

Injury to the supraspinous ligament (SSL) is reported to cause back pain in the horse. The diagnosis is based on clinical examination and confirmed by ultrasonographic examination. The ultrasonographic appearance of the supraspinous ligament has been well described, but there are few studies that correlate ultrasonographic findings with clinical pain and/or pathology. This preliminary study aims to test the hypothesis that unridden horses (n = 13) have a significantly reduced frequency of occurrence of ultrasonographic changes of the SSL consistent with a diagnosis of desmitis when compared to ridden horses (n = 13) and those with clinical signs of back pain (n = 13).

RESULTS

The supraspinous ligament of all horses was imaged between T(thoracic)6-T18 and ultrasonographic appearance. There was an average of 2.08 abnormal images per horse from the whole group. The average number of abnormalities in unridden horses was 4.92, in ridden horses 2.92 and in horses with clinical back pain 4.69. No lesions were found between T6 and T10 and 68% of lesions were found between T14 and T17. No significant difference (p < 0.05) was found between the three groups in the number or location of abnormal images.

CONCLUSION

The main conclusion was that every horse in this study (n = 39) had at least one site of SSL desmitis (range 2 to 11). It was clear that ultrasonographically diagnosed SSL desmitis cannot be considered as prima facie evidence of clinically significant disease and further evidence is required for a definitive diagnosis.