Page 569 - The Veterinary Care of the Horse

resume work.

• Non-steroidal anti-inflammatory drugs such as phenylbutazone may relieve the
VetBooks.ir • discomfort sufficiently for mild cases to continue light work.

Local injection of corticosteroids between, or close to, the affected DSPs.

• Physiotherapy.
• Acupuncture.

• Chiropractic.

• Osteopathy.

• Shock wave therapy.

• Controlled exercise to strengthen the back.
• Avoidance of activities such as jumping and lateral work which are painful for the horse.

• Particular care must be taken with saddle fit.

Surgical treatment

If there is insufficient improvement after 6 months, then surgery may be considered. There
are three surgical approaches, all of which can be performed under standing sedation or

general anaesthesia:

1 Spinous process resection: An incision is made through the skin and ligaments in the
midline of the back and the top part of one or more spinous processes is removed.

2 Interspinous ligament desmotomy: The interspinous ligament between affected dorsal
spinous processes is cut to relieve tension on the ligament and reduce the associated pain.

This procedure is less invasive and has a good success rate but may not be suitable for
advanced cases where the adjacent spinous processes have fused.

3 Cranial wedge ostectomy: The front edge of the upper part of impinging dorsal spinous

processes is removed.

The choice of surgical approach depends on the severity of the condition and the preference
of the surgeon. Following surgery the horse will have a period of approximately 4 weeks box

rest with in-hand walking out twice daily. After a month, long reining and lungeing on a
Pessoa is gradually introduced as part of the rehabilitation programme. The horse can usually
be turned out in the second month after surgery. Regular physiotherapy will help to prevent

postoperative pain and re-establish core strength and spinal mobility. Ridden exercise may be
introduced from 6–12 weeks onwards depending on the horse’s progress.