Page 85 - April 2016

won’t run the way it used to? The horse may run slower or run wide on the turns,” says Allen.
“There’s a wide variety of performance and avoidance behavior issues that are sometimes hard to pick up if you don’t know the horse’s history or if you are not looking for it. Horses with back problems often present as “girthy” and don’t like being tacked up. They do better once they are warmed up, but you start seeing performance problems that you never saw before. Horses with back pain often refuse to do something that they’ve done hundreds of times. The rider may not understand why they suddenly start backing away from what they are asked to do. They don’t want to do it because they know it’s going to hurt,” he says.
“A lot of times, it’s hard to tell whether it’s
a mental problem or a physical problem. But, the good news is that it’s easier to figure out the physical problem than it is a mental problem.” If you can fix the physical problem and the horse performs well again, then you know it’s not a mental or training problem. A good his- tory of the horse can be a starting point.
The clinical exam is also crucial. “This involves palpating the back. It can be done a variety of ways, but you have to separate the palpation of the dorsal spines (bony structures) from your palpation of the musculature. You are trying to assess each of these separately. Even though we are looking at the back, the
pelvis is also interrelated, so we always palpate the sacroiliac joint, as well.”
It is important to be able to differenti-
ate between muscular pain and bony pain. “Sometimes you can’t because it runs together.
The horse’s back
is long, with many regions at risk for injury, strain and pain.
The whole back may be so sore that you can’t separate it out. You also have to palpate the final joint in the back—the lumbosacral joint (the front part of the sacroiliac joint),” Allen says.
“Then you watch the horse move and evaluate for lameness. We have to realize that lameness may be a separate issue. The horse can have back pain from something like kissing spines or osteoarthritis of the dorsal articular processes and also have navicular disease or sore hocks.” The back soreness and the lame- ness may not be related.
Dr. Tim Holt, Colorado State University, works with many equine patients that come into the large animal hospital with lameness issues.
“We’ve found that about 80% of lame horses have back pain as well. Often we can take care of the lameness, but the horse still doesn’t want to perform. So, we look more closely at these horses to try and figure out why they still have pain and don’t want to work,” he says.
“We start looking for back problems, look- ing at sore muscles and all the facet joints in the back.” The horse has several small joints along the backbone between each vertebra.
These horses have usually already gone through the entire traditional lameness workup with nerve blocks, palpation, etc. “I am usually called in when that doesn’t lead to a diagnosis and people still cannot figure out the lameness problem,” says Holt.
He tries to pinpoint the problem and
then rehabilitate the horses via acupuncture and chiropractic manipulations. This type
of examination, as well as assessing the most important acupuncture points, can help iden- tify pathology by showing regions of pain or loss of motion in specific areas of the body and determine which points may be needed for spe- cific treatments. A thorough evaluation utilizes pressure, palpation and touch of more than 200 diagnostic acupuncture points while observing the horse’s reaction.
“It is important to not make a diagnosis just from one reactive point. You need to put the entire clinical picture together using the history of the
If the entire back of a horse is sore, a rectal ultrasound of the lumbosacral disc (the final joint in the back, shown here) may be needed to determine whether the horse is suffering from muscular pain or bony pain.
Back soreness that comes from bony problems in the back may be due to various factors: developmental malformations or metabolic bone disease during formative years; wear-and-tear; or a combination of both. There are three primary bony problems that cause soreness. The most common is referred to as “kissing spines, or impingement of the dorsal spinous process, in which the long, skinny bones that protrude from the top of the vertebrae touch each other when the horse bends his back. The second major cause is when the joints at the dorsal articular process become arthritic. The least common cause is spondylitis, or inflammation of the backbone, which occurs near the far end of the vertebral column and can result in fusion between the vertebrae and bony spurs.
SPEEDHORSE, April 2016 83
equine health