Case Reports - Horses
Chest pain in a horse
Horse with sensitive chest. This Thoroughbred gelding repeatedly collapsed when his owner put a saddle on his back and attempted to tighten the girth. The owner tried to remedy the situation by calling a saddle fitter and by stretching the horse's front leg before putting the saddle on. A physiotherapist was called as well - nevertheless, the horse remained incapacitated by this unusual condition and the owner was understandably very hesitant to ride him.
The initial veterinary/acupuncture examination revealed a marked sensitivity along several peripheral nerves in the horse's low neck, withers and on the chest. It was assumed that the condition developed as a consequence of a major accident or fall, although the owner never witnessed this happen. Several acupuncture treatments using injections of saline with vitamin B were necessary to calm the irritated nerves and the condition improved within 2 weeks. I have then treated the horse once or twice a year and have given him a booster treatment using acupuncture needles (see the photo). The horse has been ridden regularly and has never collapsed again during the last 2 years.
Carlos: Nerve damage
The owner of this 7-year old Friesian gelding, Carlos, called me as she noticed that the horse became lame in his right rear limb overnight.
On my arrival to the Stable, I noticed that he dragged the limb, obviously unable to lift the toe off the ground. The condition was not noticeably painful but it was indeed distressing for the horse to move in this way. The diagnosis of paralysis of the femoral nerve was established.
Selected acu-points on the affected limb and in a section of his low back were stimulated using injections of the saline solution with vitamin B.
Shortly after, the owner was happy to report back about the quick and complete recovery of the horse';s condition.
On an enquiry seven months later, the gelding was still sound and could be even used as a stunt horse in production of movies.
"I nearly put this horse down at one stage. I have never seen
such a bad locking stifle as on the day you treated him. We keep him in work
now and haven't looked back. He turned out to be one of our top film horses
and lead actor's horse."
Injuries to nerves can be manifested in numerous ways including pain, atypical lameness, muscle weakness or wastage, localised skin sensitivity or sweating.
Depending on the location of the particular nerve, the horse can display numerous riding problems including head-shaking, stiff neck, abnormal sensitivity of the chest and so on.
The common causes of nerve damage are local injury or over-stretch of the nerve. Also, nerves can be entrapped between two adjacent vertebrae in the back or neck.
While nobody witnessed any accident in this case, we can only speculate that the nerve was damaged (overstretched or bruised) while the horse got casted in his box the night before.
It was fortunate that the nerve was not severely damaged or inflamed, and that the acupuncture treatment was given soon after the injury occurred.
Indeed, a substantially longer course of treatment might be necessary, should the nerve damage be more severe.
The prognosis can be unfavourable whenever the particular nerve has been totally disrupted, when there is a major inflammation, infection or scar around the nerve, or when the treatment has been initiated too late.
Defensive behaviour, sensitive chest and muscle spasm in a show-jumping horse
The owner of a 10-year-old Warmblood gelding was concerned that her horse was tripping behind during the regular exercise. Additionally, he was kicking out with his hind limbs and resented tightening of the girth. Stiffness on the left rein during jumping exercises was mentioned.
The initial clinical examination revealed a major muscle pain and spasm in the horse’s low back, hind quarter muscles as well as in his abdominal muscles. The horse was visibly upset when touched and he moved away as I attempted to insert acupuncture needles in his low back and hind quarter area.
I have thus opted for an alternative approach of needling distant acupuncture points located in his upper back and on the jaw. The horse did not object to this treatment and became progressively calmer throughout the treatment.
With respect to the horse’s busy competition schedule, the follow up treatment was scheduled the next day. This time, the horse was markedly quieter and allowed me to carry out detailed clinical examination without being defensive or resentful.
The residual muscle tenderness in his shoulders, low neck and low back was treated using a few acupuncture needles inserted in relevant points. The horse was then ridden and jumped next day, and the owner reported a markedly improved performance.
Riding problems such as unruly behaviour, bucking, stopping etc. are often related to the horse’s discomfort associated with muscle spasm or irritated peripheral nerves. Detailed diagnosis is the key element to acupuncture treatment of these soft tissue injuries.
Sport injuries in a show-jumper
Even with the best of care, injuries can occur in any performance horse which is illustrated by this case report on a top South African show jumper.
In order to maintain its fitness and soundness, the Warmblood stallion was under a complex management programme including regular acupuncture treatments throughout the competition season. Over a number of years, there were two particular occasions when we were facing serious soundness problems. On the first occasion, the horse became distinctly lame on the right hind limb shortly before an important event. A detailed clinical examination revealed a muscle strain in several croup and hip muscles of the affected limb. The needling of ten acu-points was followed by a complete release of the painful spasm. As the condition was addressed immediately and there was no major inflammation in the area, the horse recovered fully and could be jumped successfully shortly after the accident.
Eight months later, the horse's rider noted a weakness in the right hind limb on the take-off. While the change was imperceptible to an outsider, it started to affect the horse's otherwise excellent performance. The clinical examination revealed an extensive ligament strain and irritation of several nerves along the horse's low back and croup. The condition was associated with a relative muscle weakness in the hip area. Acupuncture, as well as a particular technique of regional anaesthesia, was employed to address the problem. The horse was treated three times and rested for three weeks. Thereafter, it re-started its regular training and continued its highly successful competition programme.
Shoulder lameness in a horse
Aislin is an eighteen-year-old thoroughbred gelding. He was rested for the last three months because of chronic lameness in the right front limb. The lameness did not improve with neither rest, with corrective shoeing, nor following the administration of Equipalazone (a standard anti-inflammatory and pain-killing drug).
When presented for an acupuncture assessment and treatment, the horse was tender in the low neck, shoulder, as well as its upper back - all the sites being located on the right side. Additionally, Aislin showed a definite tenderness on examination of the right front upper suspensory ligaments. The diagnosis of a soft tissue strain was made and appropriate acupuncture points were stimulated.
Only a few tender points around the shoulder were tender on the next visit five days later. A second acupuncture treatment was carried out then.
Subsequently, the horse was found to be sound and the owner started to ride it within a few days. No lameness was noted during the following six months.
Lameness is a common problem in horses. Indeed, it is imperative to establish the correct diagnosis first and to install an appropriate treatment thereafter. Should the cause be related to the hoof, a farrier should be consulted first. Indeed, any saddle problems must be handled accordingly, while any severe and acute lameness accompanied by local heat, deformity (including swelling) and/or infection should be evaluated and treated conventionally as a matter of urgency.
Acupuncture can be particularly useful in cases of soft tissue injuries located around the shoulder and hips. These injuries are usually due to muscle or ligament strain, or due to nerve irritation. Often, a number of muscles or other tissues are involved at the same time and must be treated accordingly.
An unruly horse showing stiffness on the right reign
This Thoroughbred horse was said to be very "hot" and unruly when ridden and jumped during the last few days. Also, he was markedly stiff on the right reign.
It was noted on the initial assessment, that the horse was tender on palpation of the right front upper suspensory ligament spanning from behind the knee down to the fetlock joint.
Apart from that, there was a prominent muscle spasm on the right side of the horse's upper neck and upper back.
Additionally, the horse showed a distinct tenderness in its low back muscles. In total, three acupuncture treatments were necessary to address the problem.
Five weeks later, the horse was performing well and was no longer stiff on the right reign.
Riding difficulties in a dressage horse
A seven-year-old Thoroughbred mare used for dressage was said to canter with her head up when ridden on the right circle. While otherwise sound, this behaviour spoiled her dressage performance and the rider rightly suspected that pain and discomfort may be an underlying cause of this behaviour. A distinct pain on palpation of the following body parts was seen (on the right side only): the temporo-mandibular joint on the head, a small area just behind the ear, most of the neck, lower and middle area of the chest and of the abdominal muscles, as well as the upper back muscles. This rather unusual pain pattern was then treated using seven acupuncture needles: two of them were inserted to the head points, while the remaining five needles were used to stimulate neck acu-points.
The needles were left in place for about ten minutes; they were repeatedly manually stimulated during this period. Only an area of sore muscles in the low neck was detected twenty four hours later when another acupuncture treatment was given. The mare was then sound in performance until eleven months later when she had to be treated for an unrelated hind limb problem.
Restricted shoulder movement & bucking in a show-jumper
An eleven-year-old Thoroughbred was presented with a complaint of bucking when jumped. Additionally, he showed a prominent restriction in the movement in his front limbs.
The initial acupuncture examination revealed muscle spasm and tenderness in the upper as well as lower back. A number of back acu-points were injected with saline/vitamin B solution.
Four days later, the extent of the back-pain was reduced by 70 per cent, while the severity of pain decreased by approximately 50 per cent. Another acupuncture treatment was given and the horse was ridden again shortly thereafter.
On telephonic enquiry seven weeks later, the owner reported that the horse has not been bucking and that it felt much more loose in its shoulders.
Riding problems in an eventer
I have known this talented eventer for the last seven years. The eleven-year-old Thoroughbred has been fit and sound most of the time. Nevertheless, eventing is a demanding equestrian discipline and, occasionally, I have been called to address particular riding problems (the relevant clinical diagnosis is briefly summarised in brackets ( ).
- Resistance on the right reign for the last six months (irritated nerves on the head; an old scar in the withers)
- The horse disunites behind (a hind limb muscle strain)
- Stiff neck (a neck strain: nerves & muscles)
- Left-sided pain and weakness in the low back & croup area (sacro-iliac ligament strain) Lameness in the right front limb (a shoulder muscle strain)
- Uneven on the right front limb in canter (muscle injury in the shoulder and upper back area)
- Sore front limbs (muscle strain secondary to a hoof problem)
- Unsound on the right hind and front limb (an acute muscle and ligament strain).
Generalized body pain in a race horse
This four-year-old temperamental sprinter suffered repeatedly from generalised muscle spasm and pain. When pronounced, the condition significantly affected the horse's racing performance.
In this particular case, the distressing and debilitating condition was related to intensive speed work.
On the initial examination, the horse displayed signs of severe generalised pain when palpated, in particular in the following body regions: low back and hind limb muscles, shoulders as well as the low neck, front upper suspensory ligaments. A mild pain on palpation of the right front heel was detected as well.
The horse was given a series of four acupuncture treatments over a period of two weeks. Ten to sixteen acupuncture points located on the head, neck and trunk were stimulated using stainless steel acupuncture needles ranging in length from 2 to 12 cm. Light work was advised during the time.
The treatment was associated with a progressive decline of the pain; only moderate pain along the front part of the hind quarters was noted before the last acupuncture treatment. The horse's performance improved accordingly.
Understandably, acupuncture might have to be given periodically in predisposed high-performance horses.