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such as hock problems. “Today we use it more commonly for soft tissue injuries, such as ten- dons and ligaments. There are benefits using shock wave with some of the bony issues, but the cost-benefit ratio is more questionable,” says McClure.
The first paper published on shock wave use in horses was from a study done by Dr. McCarroll in Oklahoma, looking at treatment of 90 lameness cases that included 47 hock problems involving the tarsal joints where 79 sites were treated with shock wave.
“In these lower hock issues, or bone spavin, we definitely saw improvement. But over the years, we’ve transitioned into using other methods to treat these hock conditions. Today we often use other ways to deal with them such as facilitated fusing with alcohol, lasers, etc., rather than shock wave because they are a little bit more definitive.”
Navicular syndrome is another problem where shock wave has been tried and showed some response. “But navicular is a chronic degenerative condition. Even if you make it a little better, it’s still a chronic degenerative con- dition,” he says. The shock wave therapy might relieve pain for a while and make the horse more comfortable, but it’s not a cure.
“Other things have come along for treat- ment of navicular, such as the drug Tildren,
so shock wave is not used very much anymore for treating this problem. It is more commonly used for ligaments, tendons, backs and necks, where it appears to have significant benefit,” says McClure.
“There have also been studies on treating wounds with shock wave. These studies have shown that shock wave can stimulate wounds to heal faster. Dr. Johnson in California, had a case report on a burn wound horse that shock wave helped heal. We did a controlled study here, and there was another study done at Guelph. We can definitely stimulate faster wound healing, but
is it worth the additional financial input for the shock wave therapy to get these wounds to heal 2 or 3 weeks quicker?” he asks.
“On the human side, the use of shock wave to help heal diabetic ulcers, burn wounds, etc., is rapidly increasing and great benefits are seen. There’s been a lot of use and research in trauma centers, for instance. When it comes to horses, however, the cost-benefit ratio may not be quite as beneficial. We do use shock wave on some of the more challenging wounds, but for the every- day situations, it’s not cost-effective,” he says.
Dr. Bruce Connally in Buffalo, Wyoming, utilizes a portable machine in his mobile equine practice, specializing in sport horse medicine and lameness. He started this practice in the spring of 2012 after being a field service veterinarian at Colorado State University for many years.
Shock wave therapy being used on the leg
When he set up his practice, he chose to not build a physical structure or have a building
to work from. “I bought a Suburban and put $80,000 worth of equipment in it. I can drive to anybody’s barn and take x-rays with a digital x-ray machine, view the x-rays on my computer screen right there, do digital ultrasound and shock wave treatment,” says Connally. He bought his first shock wave machine in 2000.
He uses it on horses with ringbone, sore backs, tendon injuries and navicular syndrome. “It really works well on sore backs and tendon injuries.
If a horse has a small ringbone, shock wave can help. It’s not very effective on big, ugly ringbone, however. I don’t think it will cure ringbone, but you can buy the horse a lot of time,” he says.
“To my knowledge, there are very few side effects. In people, we occasionally see some bruising or redness on the skin in the area where it’s used, but I’ve never seen this happen on a horse. I’ve used it on areas where we’ve shaved off the hair and I’ve never seen any red- ness. I don’t know of any other side effects.”
Shock wave therapy works very well as a painkiller. “You can get 2 to 4 days of pain relief from it, so it’s illegal to use on the race- track. You can’t test for it (there are no residues in the body), so it’s a hard thing to enforce. Some trainers have bought their own shock wave machines and we just have to rely on their honesty and ethics on how long ago they used it on the horse,” he says.
Some of the early use of shock wave therapy was on hocks and other joints. “I’ve only used
it a little on hocks. This is like using it on navicular; it made the horse feel better for a few months, but it’s not a cure,” says Connally.
By contrast, shock wave works very well on soft tissue injuries to speed healing and reduce scar tissue in the healed area. He recently worked on a horse with a torn hamstring muscle. “It was a huge tear. With ultrasound
I could see a big blood clot in there, bigger than my fist. That horse was very lame. I’ve never seen a hamstring tear that badly. So we shock-waved that horse using several treat- ments over a 6-week period, and after that he was completely sound at a walk. It hastened the healing tremendously,” he says.
“Whenever there’s a bad hamstring tear,
we always worry that it will end up with a lot of scar tissue, which can make the horse less functional. This horse has an athletic career, so we didn’t want any scar tissue. I am very excited about the way this injury is healing and I think the shock wave therapy had something to do with it,” says Connally.
How It works
“Many people think it’s an electric shock, but it’s actually an energy wave,” says Connally of shock wave therapy. “The best way I can explain it to clients is that it’s like an ocean wave. The wave goes through the ocean and the water all stays in the same place until that wave and its energy hit the beach. When it hits the beach, rocks move. We can send this energy through the body without damaging anything,
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equine health
Dr. Bruce connally