Page 305 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

280 CHAPTER 1

VetBooks.ir 1.528

Fig. 1.528 Acoustic shock-wave therapy
can be used to address lumbosacral pain.

and disc abnormalities have been reported, but FRACTURES OF THE PELVIS
they have not been directly correlated with clini-
cal signs. In a recent study, mildly heterogeneous Definition/overview
echogenicity of the lumbosacral disc was found to Any of the bony components of the pelvis can frac-
be a normal variation, with mild ventral protru- ture, including the ilial wing, tuber coxae, ilial shaft,
sion of the lumbosacral disc seen in 32/43 (74.4%) pubis, obturator foramen, acetabulum, sacrum and
of horses. ischium. Pelvic stress fractures, mainly at the wing
Clinical examination findings and elimination of the ilium, are known to be a common cause of
of other possible differential diagnoses must there- hindlimb lameness in the racing Thoroughbred.
fore be the basis of any evaluation of these cases in
the horse. MRI and CT would be the ideal imaging Aetiology/pathophysiology
modality for this region but the limited bore width Complete fractures of the pelvis occur as a result of
of currently available scanners does not allow this at external trauma, falls or as an end stage of stress frac-
present in adult horses. tures in horses in training or racing. It is widely
acknowledged that such stress fractures occur as a result
Management of repetitive, high- intensity loading of the skeleton,
In a similar way to SI region pain, altered work leading to damage accumulation and bone fatigue. The
focusing on building core strength and local and incidence of pelvic stress fractures in racehorses has
systemic medication, acupuncture, chiropractic, been demonstrated to increase with increasing distance
mesotherapy and shock-wave therapy (Fig. 1.528) cantered, and an effect of both track surface and trainer
have all been advocated for lumbosacral pain, but on stress fracture incidence has also been reported. In
no well-founded reports exist on which to base horses older than 6 years, the wing of the ilium is the
exact recommendations. It is generally thought most commonly fractured, while in younger animals the
that poor muscling may make the problem worse, other types of fracture occur at similar rates.
and that therefore complete (stall) rest is contra-
indicated. Additionally, it is critical to address Clinical presentation
and treat other concomitant sources of pain that Affected horses are usually presented shortly after
may exist. the time of the suspected incident (1.5 days in a