WRANGLING ON THE RANGE #177
ALTERNATIVE THERAPIES
HORSE AND RIDER - DECEMBER 2011
Steps to Success
Learn how to make the most of chiropractic, acupuncture, and
massage therapy in your horse's management plan.
BY BARB CRABBE, DVM
THE HORSE, AN ACCIDENT VICTIM, WAS BARELY ABLE TO STAND IN HIS
Paddock, and when we asked him to move, he'd bear no weight on
the leg at all. He was sweating, with a heart rate of 100,
meaning his pain was severe and unrelenting. Even worse, the
accident had happened seven days ago, and instead of calling a
veterinarian, the owners had opted to call a local "chiropractor"
who'd performed an adjustment and recommended four grams of bute
a day for the following week until the horse could be seen again.
The adjuster owned a gas station in town, and had learned to
"crack backs" from his next-door neighbor.
Sadly, the adjustment did nothing for the fractured tibia seen on
radiographs, and even if it could've been repaired, it was too
late by the time the owners finally decided to call their vet.
The horse was also in severe kidney failure, most likely due to
toxic doses of bute.
This is a frightening example of an alternative-therapy choice
gone bad, and similar episodes happen way too frequently. Yet
acupuncture, chiropractic, and equine massage therapy can be
valuable parts of your horse's management plan when used
appropriately by a qualified practitioner. In our practice, we
work closely with a variety of therapists who help us manage
chronic back pain in hard-working performance horses, keep our
older horses comfortable in their retirement, or provide relief
from compensatory pain following a severe injury.
The key is knowing when to use these modalities, and who to call
for help.
I'll outline seven key steps to follow that'll help you make the
most of alternative therapies in your horse's management plan.
I'll also explain basic information on acupuncture, chiropractic,
and massage, outlining what they are, when to use them, and how
to choose a qualified practitioner who'll help your horse and do
no harm.
7 Steps for Success
Before you call that alternative-therapist number passed along to
you by a friend of a friend, protect your horse by following
these steps.
Step 1: Diagnose
First and foremost, if your horse has a musculoskeletal problem,
you'll be most successful getting him back to work if you know
what's wrong - and more often than not this should begin with
your veterinarian, who can do a lameness work - up in pursuit of
a specific diagnosis.
Why is this so important? Because an injury like a torn
suspensory ligament or broken bone is generally best identified
and managed using conventional medical treatments. And in some
cases, such as a neck or pelvic fracture, it's downright
dangerous for a horse to have certain manipulations performed.
Does that mean alternative therapies should be avoided altogether
in these cases? Absolutely not. They can be extremely valuable
for pain management and to address compensatory issues. In some
cases, they can even contribute to the healing process. It just
means they should be applied with care-which requires an accurate
diagnosis from the start.
Step 2: Choose Wisely
A key element to success is to choose your practitioner
carefully. A properly trained chiropractor, acupuncturist, or
body worker will refer you to your veterinarian when it's
appropriate, and won't apply therapy until an underlying problem
is diagnosed and treated. Begin by seeking a practitioner who's
certified, ideally through one of the organizations listed later
in this article.
These organizations all boast rigorous education and testing
procedures, meaning a practitioner with one of these
certifications is guaranteed to have received a certain amount of
training and to have demonstrated a level of knowledge and
competence with which you can feel comfortable. If your therapist
claims to be "certified" but not through one of the organizations
listed, ask questions before you allow him or her to work on your
horse.
A wide variety of training programs exist, and some programs are
better than others. Many issue their own "certificates" when the
course is completed, but a piece of paper doesn't necessarily
equal valid certification.
If this is what you discover, ask some specific questions about
the amount of training your chosen therapist has really had. Be
aware of a non-veterinarian therapist who recommends prescription
medications without consulting with your vet. This can often be a
red flag that the therapist is unclear about where the boundary
between him or her and the veterinarian should lie - which could
not only mean trouble if medications are misused, but also raises
a concern about whether he or she will appropriately involve the
veterinarian for other aspects of your horse's care.
Step 3: Involve Your Vet
Your veterinarian should remain an important part of your horse's
management plan-even when you turn to alternative therapies that
are outside his or her direct expertise. In fact, your vet
usually will be familiar with most or all of the individuals
offering alternative therapies in your area, and can probably
direct you to the most competent person who's most likely to help
your horse.
In our practice, we have close working relationships with a
number of alternative therapists in our area. We chose to develop
these relationships because the individuals are well trained,
know when it's not safe or appropriate to work on a horse with a
specific problem, and maintain open channels of communication
regarding horses in our care.
The result? When we all work as a team rather than as solo
artists, your horse is more likely to get better.
Step 4: Be Prepared
Once you've decided on a therapy and selected a qualified
practitioner, it's important to be prepared for your appointment.
The therapist is likely to request a full medical history,
including information from your veterinarian about chronic
conditions or recent treatments. He or she generally will perform
some kind of exam on your horse, and decide on a treatment plan
according to his condition.
If the therapist detects any type of lameness, heat, or swelling
on the body, or sign of a systemic illness, chances are he or she
will recommend your horse be seen by your regular veterinarian
prior to administering treatment. Don't be frustrated if this
happens. Instead, see it as a good sign that the person you've
selected is conscientious and well trained.
As with any visit for medical care, make sure your horse is in
the barn, clean and dry, and ready for your appointment. Also
have any medication information or other medical history at your
fingertips.
Step 5: Tell the Truth
Have you ever paused when filling out that medical history form,
wondering whether that nighttime glass of wine really qualifies
as "drinks alcohol"? Yes...it does. And if you don't answer
truthfully, it could have a significant impact on your health
care.
The same holds true for your horse. If your acupuncturist,
chiropractor, or massage therapist asks you about the type and
intensity of work your horse does, about previous lameness or
medical problems, or even whether you were able to follow
suggestions for after-care, it's important to be accurate with
your answers. Not only will it help your therapist devise the
best treatment plan, it'll also let him or her know whether
treatments are being effective.
After all, if your massage therapist recommends a specific
stretching exercise for your horse and you don't do it... it's
hard to know whether the treatment plan is working.
Step 6: Follow Recommendations
As with any form of treatment, if you want the best results you
should follow the recommendations of the doctor or therapist
who's helping you. If the acupuncturist tells you to give your
horse a day off following treatment, give him a day off. And if
the body worker suggests a follow-up exam and treatment in two
weeks, make the appointment before he or she leaves your farm.
Just as you can't expect your horse to recover from a disease if
you don't administer medications recommended by your
veterinarian, it's unlikely you'll see the benefits of treatment
if you don't follow the protocol outlined by your acupuncturist,
chiropractor, or massage therapist.
Step 7: Be Realistic
If you want a miracle from alternative therapies, you're likely
to be disappointed. Medications can't completely cure every
instance of every disease, and likewise, alternative therapies
won't fix every problem. If your horse has severe chronic
laminitis and Cushing's disease, for example, acupuncture may
help relieve his pain, but it's not likely to cure his disease.
And if your horse has hock arthritis, your massage therapist may
help relieve muscle spasms in his back and hindquarters to
increase his comfort, but the horse is still likely to experience
some amount of chronic lameness.
But if you follow all of the steps outlined above and have
realistic expectations, the following alternative therapies can
make a valuable contribution to your horse's overall good health.
Acupuncture
What it is:
Acupuncture is a procedure in which tiny needles are inserted at
specific locations of the body for therapeutic purposes. This
procedure was originally developed by the ancient Chinese, who
believed that these anatomic locations were portals in the skin.
Through these portals, the ancient acupuncturist could access
meridians, or energy channels, that communicated with internal
organs.
Experiment-based research has since shown us that these points
are actually anatomic locations particularly rich in nerve
endings and/or blood vessels. When needles are placed in these
locations, neurotransmitters and other local factors are
released, starting cascades that ultimately lead to body-wide
therapeutic effects. An acupuncture treatment involves placement
of needles into the points appropriate for your horse's specific
problems.
When to use it:
Acupuncture is a very effective treatment option to help minimize
performance-related muscular soreness or to manage compensatory
soreness secondary to other injuries. It's especially likely to
be recommended as a first line of treatment for your horse if he
suffers from back pain.
Many people don't realize that acupuncture can also be a useful
therapy for problems beyond the musculoskeletal system. For
example, a mare with decreased fertility may be having difficulty
clearing fluid from her uterus. Acupuncture can help lead to
smooth muscle contractions of the uterus, thereby helping the
mare clean herself out.
Or, if your horse has allergy problems (hives, skin rashes, or a
chronic cough), acupuncture, in combination with medical therapy,
can help control symptoms and improve his response to other
medications. Acupuncture may even be used to relieve jaw pain
following a dental procedure, or to help quiet intestinal spasms
that occur during an acute colic.
Who does it?
Three primary programs are recognized for acupuncture training,
and each has a slightly different
emphasis. All three require that students be licensed
veterinarians, with the exception that third- and fourth-year
veterinary students and veterinary technicians can participate in
some courses. The practitioner you select should be able to
provide credentials from one of the three.
The Chi Institute (tcvm.com) focuses on traditional Chinese
medicine with the underlying belief that needles are a way to
unblock energy channels within the body. To become a certified
veterinary acupuncturist with the Chi Institute, a veterinarian
must complete approximately 130 hours of course work (four
sessions of approximately three and a half days each); pass a
written and practical exam; submit a case report; and log an
additional 30 hours of internship, either by shadowing a CVA
practitioner in the field or enrolling in advanced courses.
The Colorado-based Medical Acupuncture for Veterinarians course
(colovma.org) is at the other end of the spectrum. This course
emphasizes Western medical acupuncture based on neuroanatomy and
physiology-a more scientific-based approach. Similar to the Chi
Institute's requirements, certification through this program
requires veterinarians to complete 140 hours of course work (four
sessions of 35 hours each), and pass both a clinical and
practical exam.
Finally, the philosophy of the International Veterinary
Acupuncture Society (ivas.org) lies somewhere in the middle. One
stated goal of this organization is to integrate traditional
Chinese medicine and Western veterinary science. For
certification, the WAS program requires approximately 160 hours
of course work, a written and practical exam, a case report, and
a 40-hour internship with an IVAScertified practitioner.
Chiropractic
What it is:
Chiropractic involves manipulation of the bones to restore proper
alignment of the vertebrae or other joints when they've been
disrupted. The bones of the spine and joints should be maintained
in a specific alignment, and any change in that alignment is
called a subluxation. Subluxation can impact nerves, muscles, and
joints in the surrounding area, which can cause pain and
discomfort. A subluxation may even have an effect on other organs
in the body due to the disruption of nerve supply and blood flow.
When to use it:
Chiropractic adjustment can be particularly useful for horses
with back pain, especially when the condition is accompanied by
visible asymmetry such as a horse that travels crooked, carries
its tail to one side, or has a consistent headtilt. Stiffness and
training issues unassociated with apparent lameness often will
respond well to chiropractic therapy. The well-trained
chiropractor will examine your horse carefully to identify any
subluxations, and then will make necessary adjustments.
Who does it?
The American Veterinary Chiropractic Association (refer to ani
malchiropractic.org or avcadoctors .corn) is the most widely
recognized group that certifies chiropractic practitioners in the
U.S. To be AVCA-certified, a practitioner must be a licensed
veterinarian or chiropractor. He or she is required to attend a
program from one of five approved schools. The training involves
approximately 220 hours of course work covering a range of topics
from basic anatomy and physiology to specific adjustment
techniques.
Veterinarians are required to take special courses covering
chiropractic theory and techniques, while chiropractors are
required to take additional coursework on basic veterinary
medicine. Following this training, candidates must pass both a
written and clinical examination. Recertification is required
every three years, and requires 30 credit hours of continuing
education.
Massage/Body Work
What it is:
Massage therapy or body work involves hands-on manipulation of
muscles to help improve circulation, relieve muscle spasms, and
increase range of motion. Practicing therapists use not only
massage techniques, but also stretches or other exercises in
their work.
When to use it:
Massage therapy can be beneficial for your horse in a wide
variety of situations. Like acupuncture, it'll help minimize
performance-related muscular soreness, and can be especially
useful for managing compensatory soreness secondary to other
illnesses or injuries. If your horse has back pain, massage
therapy is likely to be a valuable part of his management plan.
Massage therapists often use acupuncture points as trigger points
in their work.
Who does it? Consumer beware:
Unlike acupuncture and chiropractic, massagetherapy training
programs don't require participants to be veterinarians. In
addition, a large number of programs offer "certificates" for
coursework completion, making it more difficult to determine
which therapists are truly qualified to work on your horse.
Training offered ranges from weekend courses to extensive
programs that educate students in anatomy, physiology, and
biomechanics, as well as basic and advanced massage techniques.
Although there's no single certification shared by most massage
therapists, the International Equine Body Workers Association
(iebwa.com) is one to look for. To become an IEBWA member, a
practitioner must complete at least 150 hours of coursework from
a recognized school, submit case studies, and complete an
externship as well as pass a practical hands-on test. To maintain
this certification, members are required to have 16 hours of
continuing education each year and carry professional liability
insurance.
Visit HorseandRider.com this month for a sampling of machinebased
alternative therapies.
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