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♘ مدیریت انجمن اسب ایران ♞
Your reining horse isn't sinking as deeply into his hocks as he used to. Your hunter refuses jumps that should be no big deal. Your dressage horse isn't bending properly. Your endurance horse flinches when he's saddled up. It's an old story: Acute or chronic pain that hinders a horse's performance. The traditional treatment usually involves anti-inflammatories coupled with rest or exercise modification. But in the last 30-some years, acupuncture has emerged as an increasingly important component in keeping the performance horse performing.
Different Strokes
Performance-robbing pain is often musculoskeletal in nature. Causes for muscle, joint, or limb pain include poor or excessive riding or training, less-than-optimal conformation for the intended sport, shoddy shoeing, incorrect balance, and physical disorders such as osteoarthritis and navicular syndrome.
In Western sports, hind end soreness is the most common form of discomfort for the performance Quarter Horse. Brad Luckenbill, DVM, a practitioner at The Pony Express Veterinary Hospital in Xenia, Ohio, and president of the American Academy of Veterinary Acupuncture, states, "Often, training and showing of the Western horse puts pressure on the hind legs, creating inflammation in the ligaments and joints of the hock. Muscle soreness in the lumbar region of the back, over the hips, and around the stifles is also common. Western pleasure horses frequently experience sore feet or heel pain, while cutting and rodeo horses often encounter knee problems. Reining horses develop hock problems similar to the Western pleasure horse, but we see suspensory ligament and tendon problems in reiners, as well."
Rhonda Rathgeber, DVM, PhD, of Hagyard Equine Medical Institute in Lexington, Ky., a certified acupuncturist through the International Veterinary Acupuncture Society (IVAS), reports dressage, racing, endurance, and eventing horses tend to develop sore backs, reluctance to bend in the dressage ring, refusals at fences, and choppy gaits.
Owners of dressage and eventing horses often report subtle changes in balance and gait, notes Mark Crisman, DVM, MS, Dipl. ACVIM, Certified Veterinary Acupuncturist of IVAS, professor of large animal internal medicine at Virginia Maryland Regional College of Veterinary Medicine.
Crisman says in hunter/jumper horses, problems most frequently encountered include stifle, hock, or carpus lameness; pelvic and cervical pain; tendon and ligament strains; and obscure lameness issues such as myofacial pain.
Feeling Better
Lameness is the most common for which acupuncture is used, so acupuncture lends itself quite well for keeping the performance horse sound. "Depending on the individual case, I usually use acupuncture as an adjunct or additional therapy for chronic problems," says Rathgeber. "But I also use acupuncture as a drug-free alternative for pain or discomfort in both acute and chronic cases for shows or if an owner does not want to use drugs. Some horses are very sensitive to anti-inflammatory agents; they don't experience side effects with acupuncture."
Crisman employs a similar approach: "Depending upon the particular injury, integrative medicine (combining Eastern and Western diagnoses and therapy) has proven most beneficial. Often this implies a combination of therapies including chiropractic, massage, and hydro and laser therapy, to name a few."
One reason for applying acupuncture, Crisman states, is there are generally no or very minimal side effects. "Risks associated with acupuncture are minimal: Infections very, very rarely occur, disease transmission is very uncommon (especially since most veterinarians use disposable needles), and you avoid toxicity issues and all the other problems associated with drug therapy. For example, a gram or two of phenylbutazone every day on a short-term basis is not dreadful, but long-term could result in ulcers or kidney problems. If we can address and solve the problem with acupuncture, or reduce the dosage of the drug, I believe you have done a service to that horse."
Another reason for using acupuncture is for more effective healing when dealing with muscle soreness. Explains Luckenbill, "If the horse has muscle soreness as the primary complaint, acupuncture therapy affords the practitioner an alternative approach to treating the horse without using systemic medications. Joint injections are often used to mask or alleviate pain in the affected joint. However, intrarticular injections are not a complete solution when there is muscle soreness in addition to the joint pain. Acupuncture can address the muscle soreness or compensatory pain associated with joint soreness."
Also, acupuncture by itself will not mask pain to the extent that the horse could further injure himself, Luckenbill says.
Finally, the use of medications is limited by some shows or governing organizations. Acupuncture can be used safely in those situations, Luckenbill reports. "I know of no organization that addresses acupuncture or has any rules on the books about the timing or use of acupuncture.
Acupuncture is not a choice for all injuries and disorders. "Fractured bones, severe debilitating injuries, and severe neurologic problems such as wobbler syndrome or EPM are poor responders and will not benefit from acupuncture," Crisman warns.
What to Expect
As with all therapies, the prescribed treatment regimen depends upon individual conditions--the problem being treated, severity, and patient response.
A simple case of muscle soreness following work might only require a single acupuncture treatment to alleviate soreness until the situation is repeated, Luckenbill says. "Similar results could be expected if acupuncture is used in conjunction with other therapies such as joint injections."
Chronic cases involving more serious pain or injury often require multiple treatment sessions spaced several days apart. Rathgeber generally recommends treatment two or three times a week for two or three weeks, then decreasing the frequency, depending on the response. "Acute cases would require fewer treatments," she says.
Crisman's preferred regimen usually consists of a treatment session every five to seven days for a month or two. "If we see no change after seven treatments, we need to try something else," Crisman says. "If the condition improves, some horses will require treatments at monthly intervals; others may require more infrequent treatments (i.e., three or four times a year)."
Session length varies, depending on the nature and type of therapy employed, but generally ranges between 15-60 minutes.
Prognosis also varies. "Given appropriate rest and therapeutic intervention (Eastern and Western treatments), many horses will recover their original form," Crisman says. Simple, acute conditions typically respond quickly--within one to four days--while chronic or more difficult cases could take weeks or months to show improvement. "But if the severity of the injury is significant and there is a delay in either recognition or treatment of the injury, the horse could permanently suffer functional deficits."
Prevention?
There is some debate concerning acupuncture's role in prevention, although the distance between differing opinions is pretty fine:
Luckenbill "Acupuncture for lameness problems is therapeutic in nature and is not considered a preventative form of therapy. However, one could argue that by treating pain or soreness early, further injury or compensatory pain can be avoided. In horses kept in training, acupuncture treatment is often provided at monthly intervals."
Crisman "If horses are examined and treated on regular intervals, many injuries and subtle issues can be addressed before they become serious problems."
Take-Home Message
Proponents do agree, however, that while acupuncture should be not perceived as a cure-all, the modality does play a crucial role in achieving and preserving soundness and healing.
"Acupuncture is not a panacea," states Crisman. "If, however, the ‘integrative' approach is applied thoughtfully, many horses will benefit from acupuncture. The main point is that we should use both our Western and Eastern diagnostic skills and select the treatment path that is most effective for that particular horse."
Acupuncture is still perceived by some as a last ditch effort, but that appears to be changing. "Recent experience has proven acupuncture to be very helpful in improving the health and performance of the equine athlete in areas where Western medical choices are lacking or unavailable due to medication restrictions," Luckenbill stresses. "Today, acupuncture is a widely used modality in equine sports medicine. Whether used as a stand-alone therapy or in conjunction with other treatment options, acupuncture is gaining in popularity as an integral part of the total health care approach to performance-related soreness."
How Does It Work?
How does acupuncture work to relieve pain and promote healing? "There are literally tomes written on this subject," declares Mark Crisman DVM, MS (veterinary science), Dipl. ACVIM, Certified Veterinary Acupuncturist of IVAS, professor of large animal internal medicine at Virginia Maryland Regional College of Veterinary Medicine. "Suffice it to say there are two basic theories, one Eastern and the other Western.
"The Eastern theory deals with Yin, Yang, meridians, and Qi (pronounced chee)," he says. "The technique of needling or acupuncture is aimed at balancing the Yin, Yang, and flow of Qi within the meridians. In other words, there is a universal energy (Qi) that flows throughout the body. When the flow of energy is unhindered and uninterrupted, the body is in a state of health. When the flow of energy is disturbed, blocked, or challenged, the result is pathology or disease.
"The Western theory of acupuncture deals with the concept of stimulated nerve fibers and elaboration of neurotransmitters. Acupuncture stimulates nerve fibers in the muscle, sends impulses to the spinal cord, and activates various centers in the brain and spinal cord. These activated centers in turn release a host of transmitters (morphine-like substances) that have a profound effect on the body.
"There is scientific evidence to support the Western theory of acupuncture," says Chrisman.--Marcia King
Different Strokes
Performance-robbing pain is often musculoskeletal in nature. Causes for muscle, joint, or limb pain include poor or excessive riding or training, less-than-optimal conformation for the intended sport, shoddy shoeing, incorrect balance, and physical disorders such as osteoarthritis and navicular syndrome.
In Western sports, hind end soreness is the most common form of discomfort for the performance Quarter Horse. Brad Luckenbill, DVM, a practitioner at The Pony Express Veterinary Hospital in Xenia, Ohio, and president of the American Academy of Veterinary Acupuncture, states, "Often, training and showing of the Western horse puts pressure on the hind legs, creating inflammation in the ligaments and joints of the hock. Muscle soreness in the lumbar region of the back, over the hips, and around the stifles is also common. Western pleasure horses frequently experience sore feet or heel pain, while cutting and rodeo horses often encounter knee problems. Reining horses develop hock problems similar to the Western pleasure horse, but we see suspensory ligament and tendon problems in reiners, as well."
Rhonda Rathgeber, DVM, PhD, of Hagyard Equine Medical Institute in Lexington, Ky., a certified acupuncturist through the International Veterinary Acupuncture Society (IVAS), reports dressage, racing, endurance, and eventing horses tend to develop sore backs, reluctance to bend in the dressage ring, refusals at fences, and choppy gaits.
Owners of dressage and eventing horses often report subtle changes in balance and gait, notes Mark Crisman, DVM, MS, Dipl. ACVIM, Certified Veterinary Acupuncturist of IVAS, professor of large animal internal medicine at Virginia Maryland Regional College of Veterinary Medicine.
Crisman says in hunter/jumper horses, problems most frequently encountered include stifle, hock, or carpus lameness; pelvic and cervical pain; tendon and ligament strains; and obscure lameness issues such as myofacial pain.
Feeling Better
Lameness is the most common for which acupuncture is used, so acupuncture lends itself quite well for keeping the performance horse sound. "Depending on the individual case, I usually use acupuncture as an adjunct or additional therapy for chronic problems," says Rathgeber. "But I also use acupuncture as a drug-free alternative for pain or discomfort in both acute and chronic cases for shows or if an owner does not want to use drugs. Some horses are very sensitive to anti-inflammatory agents; they don't experience side effects with acupuncture."
Crisman employs a similar approach: "Depending upon the particular injury, integrative medicine (combining Eastern and Western diagnoses and therapy) has proven most beneficial. Often this implies a combination of therapies including chiropractic, massage, and hydro and laser therapy, to name a few."
One reason for applying acupuncture, Crisman states, is there are generally no or very minimal side effects. "Risks associated with acupuncture are minimal: Infections very, very rarely occur, disease transmission is very uncommon (especially since most veterinarians use disposable needles), and you avoid toxicity issues and all the other problems associated with drug therapy. For example, a gram or two of phenylbutazone every day on a short-term basis is not dreadful, but long-term could result in ulcers or kidney problems. If we can address and solve the problem with acupuncture, or reduce the dosage of the drug, I believe you have done a service to that horse."
Another reason for using acupuncture is for more effective healing when dealing with muscle soreness. Explains Luckenbill, "If the horse has muscle soreness as the primary complaint, acupuncture therapy affords the practitioner an alternative approach to treating the horse without using systemic medications. Joint injections are often used to mask or alleviate pain in the affected joint. However, intrarticular injections are not a complete solution when there is muscle soreness in addition to the joint pain. Acupuncture can address the muscle soreness or compensatory pain associated with joint soreness."
Also, acupuncture by itself will not mask pain to the extent that the horse could further injure himself, Luckenbill says.
Finally, the use of medications is limited by some shows or governing organizations. Acupuncture can be used safely in those situations, Luckenbill reports. "I know of no organization that addresses acupuncture or has any rules on the books about the timing or use of acupuncture.
Acupuncture is not a choice for all injuries and disorders. "Fractured bones, severe debilitating injuries, and severe neurologic problems such as wobbler syndrome or EPM are poor responders and will not benefit from acupuncture," Crisman warns.
What to Expect
As with all therapies, the prescribed treatment regimen depends upon individual conditions--the problem being treated, severity, and patient response.
A simple case of muscle soreness following work might only require a single acupuncture treatment to alleviate soreness until the situation is repeated, Luckenbill says. "Similar results could be expected if acupuncture is used in conjunction with other therapies such as joint injections."
Chronic cases involving more serious pain or injury often require multiple treatment sessions spaced several days apart. Rathgeber generally recommends treatment two or three times a week for two or three weeks, then decreasing the frequency, depending on the response. "Acute cases would require fewer treatments," she says.
Crisman's preferred regimen usually consists of a treatment session every five to seven days for a month or two. "If we see no change after seven treatments, we need to try something else," Crisman says. "If the condition improves, some horses will require treatments at monthly intervals; others may require more infrequent treatments (i.e., three or four times a year)."
Session length varies, depending on the nature and type of therapy employed, but generally ranges between 15-60 minutes.
Prognosis also varies. "Given appropriate rest and therapeutic intervention (Eastern and Western treatments), many horses will recover their original form," Crisman says. Simple, acute conditions typically respond quickly--within one to four days--while chronic or more difficult cases could take weeks or months to show improvement. "But if the severity of the injury is significant and there is a delay in either recognition or treatment of the injury, the horse could permanently suffer functional deficits."
Prevention?
There is some debate concerning acupuncture's role in prevention, although the distance between differing opinions is pretty fine:
Luckenbill "Acupuncture for lameness problems is therapeutic in nature and is not considered a preventative form of therapy. However, one could argue that by treating pain or soreness early, further injury or compensatory pain can be avoided. In horses kept in training, acupuncture treatment is often provided at monthly intervals."
Crisman "If horses are examined and treated on regular intervals, many injuries and subtle issues can be addressed before they become serious problems."
Take-Home Message
Proponents do agree, however, that while acupuncture should be not perceived as a cure-all, the modality does play a crucial role in achieving and preserving soundness and healing.
"Acupuncture is not a panacea," states Crisman. "If, however, the ‘integrative' approach is applied thoughtfully, many horses will benefit from acupuncture. The main point is that we should use both our Western and Eastern diagnostic skills and select the treatment path that is most effective for that particular horse."
Acupuncture is still perceived by some as a last ditch effort, but that appears to be changing. "Recent experience has proven acupuncture to be very helpful in improving the health and performance of the equine athlete in areas where Western medical choices are lacking or unavailable due to medication restrictions," Luckenbill stresses. "Today, acupuncture is a widely used modality in equine sports medicine. Whether used as a stand-alone therapy or in conjunction with other treatment options, acupuncture is gaining in popularity as an integral part of the total health care approach to performance-related soreness."
How Does It Work?
How does acupuncture work to relieve pain and promote healing? "There are literally tomes written on this subject," declares Mark Crisman DVM, MS (veterinary science), Dipl. ACVIM, Certified Veterinary Acupuncturist of IVAS, professor of large animal internal medicine at Virginia Maryland Regional College of Veterinary Medicine. "Suffice it to say there are two basic theories, one Eastern and the other Western.
"The Eastern theory deals with Yin, Yang, meridians, and Qi (pronounced chee)," he says. "The technique of needling or acupuncture is aimed at balancing the Yin, Yang, and flow of Qi within the meridians. In other words, there is a universal energy (Qi) that flows throughout the body. When the flow of energy is unhindered and uninterrupted, the body is in a state of health. When the flow of energy is disturbed, blocked, or challenged, the result is pathology or disease.
"The Western theory of acupuncture deals with the concept of stimulated nerve fibers and elaboration of neurotransmitters. Acupuncture stimulates nerve fibers in the muscle, sends impulses to the spinal cord, and activates various centers in the brain and spinal cord. These activated centers in turn release a host of transmitters (morphine-like substances) that have a profound effect on the body.
"There is scientific evidence to support the Western theory of acupuncture," says Chrisman.--Marcia King