Manual Equine Back Pathology: Diagnosis and Treatment

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E-mail deze pagina. Engels Druk: 1 april Hardcover pagina's Alle productspecificaties. Productbeschrijving An invaluable reference dedicated to the equine back, providing comprehensive coverage by international specialists. Equine Back Pathology: Diagnosis and Treatment is the first book to explore conditions and problems of the horses back and pelvis, which are often difficult to diagnose and treat.

The importance of the horse's back to their function and athletic ability cannot be underestimated. There has been considerable progress in recent years in understanding back problems in the horse, and this book brings together the most recent research. Toon meer Toon minder. Recensie s This textbook appears to fill a unique niche in veterinary medicine because I am not aware of other textbooks with similar content.

The textbook is well organized and clearly written. One outstanding feature of this textbook is the illustrations, with beautiful diagrams and photographs of diagnostic images and horses with specific conditions. Vet Med Today, 15 June The textbook is well organized and clearly written.

Equine Neck And Back Pathology: Diagnosis And Treatment 2nd Ed

The figures are representative of points made in the text. The price is reasonable when considering the high quality of this publication. Vet Med Today, August There is no other single source of this much information on the equine back. It is well worth the investment to have available in one book the vast array of information this provides. Doody's, April This textbook appears to fill a unique niche in veterinary medicine because I am not aware of other textbooks with similar content. JAVMA, June Overall, for the equine clinician this is an extremely useful, clear and concise book, which should be available in all equine practices.

It fulfils my original hopes by clarifying and giving structure to the examination and thought processes involved, and providing a resource of all relevant information in one place. The Bulletin of the Royal College of Pathologists, July It should prove to be an excellent reference for any practitioner when they get the inevitable call to examine a horse with back pain. Veterinary Times, October Betrokkenen Auteur Frances M. The major limitation is that the two surveys have been addressed to different groups of veterinarians, sampling different population of horses.

Respondents represented a varied group of veterinarians with different experience, working in different clinical setting.

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It would have been interesting to restrict the interview to the same respondents to the previous survey to define the evolution in their approach over 10 years. However, the authors felt it would have been more appropriate to increase the number and the variability of the veterinary surgeons participating at the second study, including also veterinarians working in first opinion practices.

Due to this major limitation, the second aim of the study was not achieved. Furthermore, in the casework of the interviewed veterinarians included a lower number of lameness investigations compared to , when the majority of the enrolled clinicians were performing 50— investigation a month. This reflects a different caseload of horses sampled in our study; partly it could be the effect of the diffuse economic recession or the results of the sampling technique. Although a random method of selection of the study sample would have been more appropriate, it was impossible to select our sample in such way.

The equine population considered in the surveys was not represented by a heterogeneous group of horses, with an highest prevalence for sport horses competing in equestrian disciplines and for a population of hospital attenders' competition horses; therefore, the results of the study cannot be generalized to the whole equine population.

Axial skeletal problems are one of most common injuries in horses performing equestrian disciplines [ 5 , 6 ]. The estimated prevalence of back problems in literature varies from 0. The breed of horses served by the veterinary practice and the expertise of the operator evaluating back-pain could have influenced the extreme variability in this range, as demonstrated by a previous studies [ 5 , 8 , 9 ]. Training intensity and the specific sport discipline may increase the risk of such specific injuries [ 5 , 6 , 10 ]; however, the present study has not the purpose of drawing conclusions on the prevalence of back-pain syndrome in different equestrian specialties.

As reported in literature and confirmed in the current study, clinical signs of back-pain are various and poor specific [ 1 — 4 , 8 , 11 ]. Usually clients of horses affected by the syndrome reported a reduction in performance and behavioral issues. Interestingly, this data reflects an increase attention to the horse's ethogram by the clients, in accordance with the current veterinary literature [ 12 , 13 ].

Nowadays, changes in behavior are considered one of the main manifestations of back-pain by equine specialists [ 1 — 4 , 8 , 9 , 14 ]. In spite of this fact, the veterinarians are still reluctant to correlate clinical signs of back-pain with a primary spinal pathology and back disorders were considered as main source of pain only in the minority of cases. The association between lameness and back problems in horses is frequently discussed among equine practitioners [ 1 — 4 , 9 , 14 — 18 ]. Chronic subclinical lameness may have an impact on spinal biomechanics and kinematics [ 1 — 4 , 14 — 16 ], and on the other hand lameness could be secondary to spinal dysfunction [ 14 , 15 ].

The role of epaxial muscles in the spinal stabilization and stiffen has been analyzed in several studies in the last decade [ 2 , 3 , 20 , 21 ] and secondary atrophy of longissimus dorsi and multifidus muscles has been described in horses suffering from pain localized to thoracolumbar region [ 9 , 20 , 22 , 23 ]. Therefore, in respondents' experience, the evaluation of the muscular system could be highly suggestive of spinal pathology.

For the same reason, the subjective evaluation of the back flexibility and the subjective evaluation of animal response to digital pressure over the paraspinal muscles remained the clinical tests more commonly performed in practice, perceived as highly useful by veterinarians. However, the assessment of the response to these tests to date is still based on the subjective evaluation rather than on objectively algometric data, even in presence of multiple studies reporting the effectiveness of mechanical nociceptive thresholds [ 17 , 24 ].

The number of clinical tests used in was lower compared with , suggesting that the veterinarians have selected more specific methods to detect back-pain over or that less time is dedicated to the static evaluation of the horse. Denoix, personal communication while diagnostic analgesia of the back has been previously criticized because the infiltration of local anesthetic could affect the spinal function even in clinically sound horses [ 25 ].

On the other hand, clinicians are routinely employing several different methods for detecting back disorders, even though the clinical value attributed to them is poor to moderate. Concerning diagnostic modalities, over the last decade radiography and ultrasonography became more popular investigating the back region and the general perception is that they are highly effective diagnostic methods.

Radiography is considered useful in detecting osteoarticular lesions in the thoracolumbar region [ 3 , 22 ] but it has limitations due to the superimposition of the pelvis [ 3 , 23 ]. For further investigation of the lumbar and pelvic region scintigraphy could be required [ 3 , 22 , 26 ]. Nevertheless, its use is still limited due to financial constraints.

Ultrasonography is routinely employed by practitioners in the diagnosis and treatment of back disorders [ 27 — 29 ], however in both surveys the employment of ultrasonography was lower than radiography. In first instance, veterinarians are probably accustomed to use radiography more often than ultrasonography to identify back lesions and, as consequence, they have possibly still less experience in the interpretation of ultrasound images compared with radiographs.

Our data show that thermography is not routinely employed in equine practice, even if one clinical study reported that is a not invasive and auxiliary method to identify lesions in the thoracolumbar region [ 30 ]. This result could be justified by the high variability of measurements due to the influence of environmental conditions [ 3 , 31 ]. Although several therapeutic modalities are available, depending on the primary pathology and its severity [ 3 , 19 , 32 — 35 ], little objective information is present in literature on the current usage of different therapeutic modalities within equine practice.

From the results of the last survey, it is possible to conclude that the veterinarians participating in our study preferred local medications, in contrast with what emerged in the previous questionnaire. Conclusions cannot be drawn due to the strong limitations of the study. However, the increased awareness of the advantages of local medications, together with the diffusion of US-guided techniques could explain this difference.

Although there is limited evidence of its effectiveness [ 32 , 33 ], mesotherapy was perceived as a therapy with good efficacy between respondents to our last survey. The topical administration was the prevailing route for drugs administration in the ' survey because perceived as more effective. The two surveys confirmed that corticosteroids are the main drug family used by the interviewed veterinarians to treat back disorders. Interestingly, the use of a distillate of powdered of pitchered plant Sarracenia purpurin as an analgesic agent is still widespread, although its efficacy with regard to horses is not documented in literature [ 33 ].

Instead, the use of systemic NSAID in the treatment of spinal pathologies seemed to decrease over the last decade because the limited clinical value encountered in comparison to the ' questionnaire. Interestingly, the use of systemic bisphosphonates has tripled comparing data between our two questionnaires, even if the majority of veterinarians considered them of limited clinical value.

Controlled clinical trials have been published on bisphosphonates' effect in back-pain over the last 10 years [ 33 , 39 ] and this could have influenced the use by practitioners during such period.


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Further researches such as clinical trials are necessary to justify their use in horses before thinking a considerable diffusion in practice. Manual therapies have been applied to horses treating musculoskeletal diseases [ 7 , 35 , 40 , 41 ]. Osteopathic manipulations [ 21 ], kinesiotherapy and acupuncture [ 42 ] are perceived as good auxiliary treatments by our respondents. Despite the efficacy of extracorporeal shock wave therapy relieving deep muscular pain at the level of the back has been demonstrated [ 43 ] our study suggests its perceived efficacy by equine clinician is still moderate.

A similar trend is registered for diathermy and ozonotherapy. The present study did not report surgical management of dorsal spinous processes impingement [ 44 — 47 ] despite three different studies from United Kingdom described encouraging results and therefore it effectiveness should perhaps be investigated in future [ 47 — 49 ]. The limited number of respondents by United Kingdom could be the main reason of this discrepancy between our data and the literature.

In conclusion, the present study gives an insight into the current perception of different clinicians working in different settings regarding horse back-pain, but it was not able to highlights the change in the veterinarians approach in the diagnosis and management of this condition over the last decade. Equine practitioners are conscious of the limitations related to the clinical tests and imaging techniques available for detecting back disorders.

Achieving the correct diagnosis is still challenging, because of the restricted accessibility of this area and the variability of the pain manifestations. As a consequence, the advised treatment is often empirical and focus to improve the comfort of the horse instead of treating the origin of the problem. A multimodal approach is often required to manage this condition. In the absence of an objective method to assess pain in practice and consolidated protocols to treat back-pain problems, this study could be considered just as a starting point.

Futures studies should be designed in order to rigorously collect follow-up from veterinarians in order to verify whether the common perception on several treatments is actually confirmed in clinical setting. The value gained interviewing the treating veterinarians instead of the owners is that the physicians should be able to assess the improvement more objectively, without being influenced by the client satisfaction. BR and AB conceived and designed the study. JV and AB contributed in an equal manner preparing surveys and to the acquisition of data.

CF drafts the manuscript. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors would like to thank all equine veterinarians participating to the surveys and Dr. Jonathan Withers for correcting the English. National Center for Biotechnology Information , U. Journal List Front Vet Sci v.

Front Vet Sci. Published online Aug Author information Article notes Copyright and License information Disclaimer. This article was submitted to Veterinary Surgery and Anesthesiology, a section of the journal Frontiers in Veterinary Science. Received May 8; Accepted Jul The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.

No use, distribution or reproduction is permitted which does not comply with these terms. Abstract Despite back-pain being a common cause of poor performance in sport horses, a tailored diagnostic workflow and a consolidated therapeutic approach are currently lacking in equine medicine. Keywords: back-pain, multicentric survey, sports medicine, veterinarians' opinion, equine spine. Introduction Back-pain is a common health problem in the equine population. Questionnaire composition Two cross-sectional surveys were performed.

Diagnosis and Treatment Equine Neck and Back Pathology Textbooks

Data collection and analysis In the survey, invitations to participate to the study were posted directly by the principal investigators using a personal e-mail. Results Excluding the incomplete surveys, 47 responses were received in ; whilst in , respondents could be included in the study. Respondent's characteristics and study caseload In the survey, complete replies were received from 6 European countries 14 each from France and Italy, 6 from both England and Sweden, 4 from Spain, and 3 from Germany.

Table 1 Horses population characteristics examined by and survey respondents in clinical practice. Open in a separate window. Table 2 Clinical tests used by the and survey respondents in order to detect back-pain in horses. Local heat areas 69 25 15 25 15 28 60 13 27 6 13 Local thickening of supraspinous ligament 40 24 64 38 64 38 31 65 12 26 4 9 Neurological examination 32 19 70 18 11 0 0 47 0 0 Oral examination 52 31 89 53 27 16 n.

Paraspinal muscles digital pressure 97 2 1 3 2 46 98 1 2 0 0 Rectal examination 13 8 60 54 32 10 21 31 66 6 13 Ridden exercise evaluation 10 6 70 40 24 39 82 8 18 0 0 Surcingle test 34 20 71 42 64 38 41 87 6 13 0 0. Table 3 Clinical signs considered by respondents in and suggestive of back-pain in horses.

Bad attitude 61 n. Bunny-hopping hindlimb gait 94 56 n. Poor hindlimbs impulsion 71 n. Poor performances 74 42 89 Refuse to jump 67 n. Spasm of longissimus dorsi at palpation 66 n. Subtle hindlimb lameness 82 49 26 55 Unexplained forelimb lameness 67 40 10 Diagnostic imaging techniques Results of both studies were similar, confirming that radiography and ultrasonography were the preferred modalities to image the axial skeleton.

Table 4 Frequencies of imaging modalities used to diagnose spinal pathologies by and survey respondents. Table 5 Primary back pathologies and corresponding frequencies identified in the case-load of horses with back-pain by survey respondents.

Table 6 Therapeutic routes and corresponding frequencies to treat back disorders in horses by survey respondents. Table 7 Perceived efficacy of different therapeutic modalities to treat back-pain in horses by and survey respondents. Table 8 Classes of drugs administered to treat back-pain by and survey respondents. Figure 1. Efficacy of the complementary therapies in treating horse's back disorders. Discussion The current questionnaires are the first international surveys on back-pain management in sport horses. Author contributions BR and AB conceived and designed the study.

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Frontiers | Two Multicenter Surveys on Equine Back-Pain 10 Years a Part | Veterinary Science

Conflict of interest statement The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Acknowledgments The authors would like to thank all equine veterinarians participating to the surveys and Dr. References 1. Cauvin E. Assessment of back pain in horses. Equine Pract. Denoix JM. Spinal biomechanics and functional anatomy. Vet Clin N Am. Thoracolumbar spine. In: Diagnosis and Management of Lameness in the Horse 2nd ed.

Louis, MO: Elsevier Inc; Martin BB. Physical examination of horses with back pain. Identification of risk factors for lameness in dressage horses. Vet J.

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Association of type of sport and performance level with anatomical site of orthopaedic injury diagnosis. Haussler KK. Chiropractic evaluation and management of musculoskeletal disorders. In: Diagnosis and Management of Lameness in the Horse , 2nd ed. Comparison of clinical examinations of back disorders and humans' evaluation of back pain in riding school horses. BMC Vet Res. Jeffcott LB. Disorders of the thoracolumbar spine of the horse - a survey of cases. Equine Vet J. Holmes M, Jeffcott L. Equitation science, rider effects, saddle and back problems in horses: can technology provide the answer?

Dyson S, Murray R. Pain associated with the sacroiliac joint region: a clinical study of 74 horses. Williams J, Tabor G. Rider's impact on equitation. Appl Anim Behav Sci. Development of an ethogram for a pain scoring system in ridden horses and its application to determine the presence of musculoskeletal pain.


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