Ask the Vet: Complementary Therapies and Rehabilitation

Written by Courtesy of AAEP Answered by, Sara Sammons, DVM, MS, Lavender Equine Rehabilitation & Vet Svcs.

Question: My 15-year-old half Arabian gelding has arthritis in his left hock and a tiny bone chip. I discovered this when he began favoring the leg. What would be the best course of treatment for him? Please advise.

Answer: Thank you for your question. It seems like the hock arthritis and bone chip are bothering your gelding since there is lameness evident, so treatment is likely indicated if you are planning to continue to use him for riding. Some horse owners elect to decrease the horse’s work load to slow the progression of the arthritis even if they also provide treatment.

Unfortunately, there are not usually options that remove the source of pain once arthritis has begun, but instead we attempt to maintain comfort for as long as possible. The arthritis will progress, however. Options for maintenance of comfort can include systemic oral anti-inflammatory drugs such as Phenylbutazone or Previcox or injection of substances (usually steroids) into the affected joint to decrease inflammation and improve comfort temporarily. Both of these treatment options are not without risk.

There are other treatment options used currently including shock wave therapy or injection of biologics into the affected joint. Some horses are good surgery candidates if arthritis is severe and a surgeon believes that the horse is a good candidate for surgical joint fusion. That would, of course, depend on the location of the issue within the hock joints. I have not had much luck prolonging comfort from hock arthritis with acupuncture or chiropractic treatments, though these options certainly help with the secondary muscle and back pain that can develop due to chronic lameness.

Checking with your veterinarian or an equine orthopedic specialist can help you determine which of these options is best for your particular case.

Question: My horse hoof tests sore only in the toe of both back feet. I have had him in back shoes for 18 months with no improvement. My farrier has suggested pads, but I think it’s just covering up the problem. He is stiff and short strides but doesn’t act lame. While standing in the crossties, he parks out slightly behind. I have had his hocks injected two months ago and I have him on Equithrive, but no improvement. He is 17-years-old, on pasture 24/7, and I ride 3-4 times a week. Any thoughts? Would complementary therapy be of help to him? I’m at my wits end.

Answer: Thank you for your question! Because of your description of parking out when standing in the crossties, I wonder about your horse’s back and pelvic comfort. It is difficult to determine if the hind toe sensitivity is the primary issue or, as I suspect actually, an issue with another region causing inappropriate weight-bearing on the toes during exercise. I am very curious if your horse’s pelvis is out of alignment or if he has pain or misalignments in his lower back. I encourage you to contact a veterinary chiropractor (certified by the American Veterinary Chiropractic Association) for an evaluation. You may learn a lot more about your horse’s muscle and joint function than you imagined you could! Most chiropractors also provide you with homework to encourage proper muscle development and promote better range of motion. If chiropractic adjustment and prescribed exercises do not improve your horse over time, nerve blocks with imaging as well as a neurologic evaluation are indicated to be sure you’re not missing something that’s causing this problem.