Two Multicenter Surveys on Equine Back-Pain 10 Years a Part

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. The aim of the study was to assess the evolution in the veterinarian approach to diagnose and treat back-pain over a 10 years period. To investigate this topic, two surveys were addressed to equine veterinarians working in practice throughout Europe 10 years apart (2006 and 2016). The answers were organized in an Excel dataset and analyzed. There were 47 respondents in 2006 and 168 in 2016, from 8 European Countries. The main reasons for examining horses with back-pain were poor performance (76%), behavioral issues (68%), and lameness (50%). When assessing back pain, 97% of respondents applied careful digital pressure over paravertebral muscles, 90% of them used digital back mobilization, and 69% was detecting areas of localized heat. The use of diagnostic analgesia to confirm the source of pain was rarely employed. Radiography and ultrasonography were the most frequent diagnostic imaging modalities used to investigate the causes of back-pain in both surveys. Obtaining a definitive diagnosis in horses with back-pain is considered challenging due to the reduced accessibility of the area and the variability in the pain manifestations. Corticosteroids injections were used for local treatments by 80% of respondents in 2006 and 92% in 2016. Recently, ultrasonography has been extensively used during the injections of the vertebral articular facets and sacroiliac joints region. The use of complementary therapies was restricted to a low percentage of respondents in the first survey (20%) but it increased over the decade. In 2016, a wider percentage of respondents considered osteopathy (40%), kinesiotherapy (29%), and acupuncture (22%) when treating back disorders compared to 2006. The structural differences of the two surveys did not enable a direct data comparison. Based on the results of this surveys, however, veterinarians should be sensitized to the back-pain problems and seek to integrate findings from clinical research studies in their daily practice.

Long‐term outcome and effect of diagnostic analgesia in horses undergoing interspinous ligament desmotomy for overriding dorsal spinous processes

“…Few horses in the study population were reported to have pain on palpation of the dorsum. Hyperalgesia of the dorsum has been described as a clinical sign of thoracolumbar pain in the horse and has been documented in one report describing a study with experimentally induced pain of the DSP . It is possible that, with more owners and trainers reporting clinical signs, pain on palpation was not reported as frequently because owners and trainers are less likely than veterinarians to palpate the dorsum.…”

“…Eighteen horses met inclusion criteria, with a median age of 9 years (range, [3][4][5][6][7][8][9][10][11][12][13][14]. Breeds represented included seven warmbloods and warmblood crosses, seven thoroughbreds, two Irish sport horses, one draft cross breed, and one Appaloosa.…”

“…Diagnostic analgesia with subsequent resolution of clinical signs is considered to be the most definitive method of identifying horses with pain attributable to thoracolumbar disease . Despite this, a recent article describing a multicenter survey of European veterinary practitioners performed in 2016 reported that 61% of respondents “never” used diagnostic analgesia for diagnosis of thoracolumbar pain …”

“…5,7,8,11 Despite this, a recent article describing a multicenter survey of European veterinary practitioners performed in 2016 reported that 61% of respondents "never" used diagnostic analgesia for diagnosis of thoracolumbar pain. 12 After a diagnosis has been achieved, both medical and surgical management of ORDSP are employed. Conservative management consists of one or a combination of therapies, including but not limited to regional injection of anti-inflammatory or analgesic medications, extracorporeal shockwave therapy, and physiotherapy.…”

“…Conservative management consists of one or a combination of therapies, including but not limited to regional injection of anti-inflammatory or analgesic medications, extracorporeal shockwave therapy, and physiotherapy. 7,[11][12][13][14][15][16][17][18] Surgical management is undertaken when the severity of disease is considered marked or the horse is unresponsive to medical management. 5,11,[19][20][21][22][23] Minimally invasive, standing surgical approaches such as interspinous ligament desmotomy (ISLD) have recently come into favor, with a reported success rate of 91%-95% in two studies.…”