| Inspiritus Equine, Inc. Integrated Soundness Solutions (sm) |
| ...Reveal the Equus Within! (TM) Dr. Joanna Robson, DVM, CVSMT, CMP 707-738-7110 |
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| Integrative Healing Options When ‘Stall rest and Bute’ is not the answer Your horse doesn’t have to have a head nod to be deemed unsound. Furthermore, your horse doesn’t have to have a head nod to be in pain. Perhaps your horse isn’t performing to his utmost. He’s not lame, but he’s not quite right. He’s switching behind, having trouble with his lead changes, is chipping or refusing fences, is jumping over his shoulders instead of being snappy in front, and he’s cranky when saddled. Or, perhaps you’ve been in a situation where your own horse, or the horse of someone you know, was diagnosed with a condition, put on stall rest, and administered bute. He eventually recovered, but he still switches behind, or acts cranky, and you or your friend don’t know what to do. Chalk it up to bad behavior? Continue to bute him, shrug your shoulders, and keep pushing? Sell or retire him? Western medicine has made major advances in the diagnosis and treatment of many equine ailments. Barbaro is a prime example of the measures surgeons can take to repair catastrophic fractures, and some horses even have prosthetic limbs! With the development of standing MRI, CT scans, nuclear scintigraphy, thermography and more, we can gain a better understanding of the physiology and biomechanics of our equine partners. But many times, even if these modalities identify a problem, the quick answer is to inject a joint with steroids, administer an oral or injectable anti-inflammatory, or put a horse on stall rest, without fully considering the full breadth of diagnostic, treatment, and rehabilitative options available. Integrative medicine employs both Western and Eastern medicine for the best possible diagnosis, treatment, and maintenance of the patient. It is a true whole animal approach that considers the physical, chemical, and emotional qualities of the patient, and often, the client/owner as well. Take, for example, the case of Maji, a 5 year-old 1400lb Friesian gelding trained in dressage. His owner reported that she’d attempted a cross-rail which the horse mis-jumped, and he is now off in his front end. The referring veterinarian examines the horse, prescribes a course of Bute twice daily, and stall rest. Hand-walking can eventually turn into under saddle work, but not until the horse is sound in-hand. Two weeks later, Maji’s owner is frustrated. The horse still isn’t sound, she’s losing precious training time, and she worries about long- term N-SAID administration causing stomach ulceration or diarrhea. She approaches me to examine the horse. Putting the pieces together is the specialty of my integrative equine practice. Under saddle, it’s obvious that as the horse walks and turns, he’s painful when he has to hike his inside shoulder around the bend. This is visible in one direction, but not in the other. The inside leg has a tighter radius and has to elevate further so as not to get stuck in the dirt. When he places the limb, it buckles slightly, and he slaps the hoof down. This looks exactly like a person with a biceps tendon injury who can’t support weight on the arm (such as in a push-up). So now what? Examining Maji, I can palpate that his biceps is taut and inflamed, and the tendon is not quite aligned in the boney groove. This can be demonstrated to the owner who can feel the difference between the two sides. An acupuncture scan confirms that the shoulder is the trouble area, as opposed to the foot, and a chiropractic adjustment (head to tail, not just the shoulder) is performed. Indeed, in one adjustment the shoulder, which had a greatly reduced range of motion, feels better. Acupuncture is performed for pain control, and for better holding of the adjustment. The horse is taken off his bute, and the owner is instructed to hand walk the horse later in the day, and to attempt under saddle work the following day. Maji was completely sound in his ride at the walk the day after his first exam, and the owner began 5 minutes of trotting the subsequent day. He was rechecked in 3 days to ensure he was still healing, and she was back to a full one-hour lesson by the end of the week. Though not all cases are so straightforward, the results speak for themselves. Countless horses have been helped by alternative therapies, and by practitioners who take the time to educate the clients about the options for healing, how to put the pieces together, and about uncovering the underlying causes of performance problems – as opposed to the ever popular Band-Aid approach. So what are the options? Veterinary Chiropractic: Also known as Veterinary Spinal Manipulative Therapy (VSMT) works by using the body’s innate intelligence to restore more normal motion to joints through a high-velocity, low-amplitude thrust. Depending on state statutes, VSMT must be performed only by a licensed veterinarian, or by a Doctor of Chiropractic under the direct supervision or referral of a DVM. Often, lay practitioners are illegal. This is for the safety of the patient! Anyone can thrust on a joint, but only the trained professional knows when NOT to! Restoring more normal motion to the joints allows for proper nerve conduction, stimulation of mRNA and protein synthesis (preventing cellular death!), circulation and immune system health, and connective tissue (tendon, ligament) health and function. Subluxations, or abnormal motion across joints, act like a traffic jam, preventing normal transmission from point A to point B. The brain relies on normal frequency of firing in the muscles and neuroreceptors to be optimally healthy. Motion truly is the key to life! Acupuncture: For thousands of years in China, Traditional Chinese Veterinary Medicine (TCVM) emphasizes the truly traditional Eastern medical philosophy. There are schools in the United States that teach acupuncture from a Western medical standpoint (emphasizing the anatomy and physiology of acupuncture points) but the Eastern approach truly encompasses the physical and emotional health of the patient. Acupoints are areas of increased nerve endings, blood vessels, mast cells, and decreased electrical resistance. Stimulation of these points can stimulate the immune system, improve circulation, and decrease or eliminate pain and fatigue. The Chinese medicine approach also considers the patient’s “constitution” based on the 5-Elements Theory. All of nature is in balance, as reflected in the traditional Yin-Yang symbol. Disease in the body is merely a reflection of imbalance among systems. Depending on one’s personality or environment, the imbalances occur as different specific ailments. For example, a Metal horse out of balance will be prone to heaves or respiratory disease. A Wood-type animal is prone to tendon and ligament strains and sprains, and an Earth-type animal may have gastrointestinal or muscle disorders. Acupuncturists may employ different techniques such as: Dry needling: placement of acupuncture needles in specific acupuncture points Aquapuncture: injection of vitamin B12 or saline into points for a longer-lasting effect Electroacupuncture: different electrical stimulation levels can eliminate chronic pain or treat acute inflammatory injuries Moxa: a Chinese herb that may be heated and used to stimulate specific points, especially useful in geriatric patients or those with arthritis. Acupuncture and Chiropractic performed in conjunction with one another typically have additive beneficial effects. Bodywork/Physiotherapy: Many riders employ a massage therapist or practitioner to keep their horses performing well. As anyone who has had a GOOD massage knows, the overall health benefits speak for themselves. But for those of you who haven’t experienced the positive results for yourself or your horse, the physiological results of a massage are scientifically documented. There is a place in the brain called the IML: the Intermediolateral Cell Column which is the topmost part of the sympathetic nervous system (increased heart rate, fright-flight, etc). Any motion, massage/touch, pleasant smells or memories acting on the limbic system, trigger alpha-motor neurons that have a faster conductive velocity than the C-Pain fibers, and that send a branch to INHIBIT the IML. Thus, moving, getting a massage, looking at good photos, listening to great music effectively eliminate pain. Think about the last time you banged your knee or hit your elbow. Your immediate reaction? To RUB the area – the rubbing stimulates the receptors that send a signal that is faster than the pain fibers conduct their message. Bodywork for your horse not only increases circulation to muscles, releases tension and tight fascia, clears lactic acid, but can also have a positive mental effect by releasing endorphins (the body’s natural morphine). Saddle-Fit: Saddle-fit evaluation alone is a textbook the size of Texas, but as a whole horse practitioner, saddle fit must be included here. I cannot stress enough the importance of correct saddle fit. If your saddle doesn’t fit, your horse doesn’t perform to his maximal capability. It’s that simple. The western medicine modalities described at the beginning of this article (MRI, CT, thermography, scintigraphy) have clearly demonstrated the damage done by ill-fitting equipment. From sheared scapular cartilage, to chronic scarring and nerve damage, shoulder impingement by an ill-fitting saddle can ruin your horse’s career. An example of missing the underlying cause occurs when your horse begins to have hind-end soreness. You quickly radiograph and inject the hocks and stifles. But the effects last only for a while before the injections have to be repeated. Why? Impingement of the trapezius muscle and the accessory spinal nerve (cranial nerve eleven) causes hollowing of the back, sacroiliac problems, associated hindlimb changes, and then a compensatory problem in the opposite front limb. For example: did you know most horses are left-handed? Imagine your horse is larger in the left shoulder. The large left shoulder muscles push your already too-tight saddle to the side of least resistance – the right. As the saddle drops to the right, it puts pressure all along the left side of the spine. As a competent rider you do one of two things – either subconsciously adjust the saddle so that you think you are straight (thereby making the horse sore along the right side), or develop your OWN lumbo-sacral issues as your own back is torqued as you compensate for what’s crooked beneath you. As your horse becomes stiff through his back, a natural secondary effect to the shoulder pinching, he begins to load onto the right hind-limb and has trouble with lead changes, or develops right sacroiliac problems. Then your horse pops a splint on the left fore! How did that happen? He’s 12 years old, far beyond heavy training as a youngster! Yes, but he’s offloading from that sore right hind onto his left fore, and stresses the periosteum in that limb. Thus, when you inject steroids into the sacroiliac area or the hocks you temporarily treat the inflammation and pain, but the UNDERLYING cause remains, thus the problem returns. The answer? Employ a competent saddle-fitter and stand your ground for having clearance at the shoulders and a wide channel that clears the paraspinal ligaments. If in doubt, a simple dust-pattern test, such as the picture above, can help determine if your saddle is uneven. And when you put your saddle on, please move it a few inches farther back! Remember - shoulder clearance is more important than having that girth of yours jammed up behind your horse’s elbows. A double-elastic girth and a wither-relief saddle pad are also necessities. No foot, no horse remains true to this day. Veterinarian – Farrier relations are still rocky in some areas, but as both parties have the welfare of the horse as the bottom line, we’re really on the same team. For the average horse owner, judging their horse’s shoeing job is a difficult task. Let alone, the concerns over losing a trusted farrier or having to find a new one if you don’t like the job your horse is getting can instill fear in the strongest horse owner. However, the long-toe, low-heel syndrome that plagues our horses can often be prevented by correct shoeing. And remember, bell-boots are a cheap option to protect your horse from over-reaching, as opposed to shoeing your horse with a reduced base of support to prevent him from ripping a shoe off. The base of your horse’s support, i.e. his little feet, dictate the length of his stride, his way of going, the stress and strain on tendons and ligaments, and can be linked to pain in the shoulders and back. Find a farrier or a veterinarian who is willing to discuss what they think of the feet, and if something doesn’t look right, ASK! Cold Laser and Magnetic Therapy may also be very effective modalities for particular injuries or for influencing circulation and healing. For horses that do not tolerate needling for acupuncture, a cold laser can be used to stimulate acupuncture meridians, or to stimulate relaxation points to make the horse more accepting of needling. Herbals/Supplements: Chinese herbals are often used in conjunction with these alternative modalities. Used for thousands of years, herbals may be effective alternatives to harsher western medicines or traceable drugs not allowed in the show ring. They should be prescribed by a competent veterinarian, however, as there can be certain contraindications in pregnant mares, for example. And for the rider? Remember: the rider forms the horse. A crooked rider can quickly undo therapies performed on the horse. The human-horse bond can also dictate behavioral issues and physiologic pain. The same modalities described here for your equine partner are equally as effective for yourself. And going through them as the rider, you may better understand their effects on your equine partner. Does acupuncture hurt the horse? Why not try it for yourself? Do you enjoy massage? Chances are your horse does, too. Do you wear the same pair of shoes as a three year-old that you now wear as a 30 year-old corporate CEO? Then how can your horse wear the same saddle as a growing 4 year-old warmblood that he wears as a well seasoned hunter-jumper? There are options and resources available for a well-rounded healing approach for your horse. Don’t settle for the bute and stall rest approach without considering the myriad of alternative therapies available. Likewise, don’t settle for months of alternative care without seeking further diagnostics if your horse isn’t responding to treatment. With compassionate understanding we can eliminate pain and maximize equine performance and longevity to reveal the Equus within! |
| ...Reveal the Equus Within! (TM) Dr. Joanna Robson, DVM, CVSMT, CMP, VA, SFT 707-738-7110 |
| Joanna Robson, DVM, CVSMT, CMP, VA, SFT 707-738-7110 |