VET ON CALL

For more dressage articles, videos and news, head over to DressageToday.com. pain in response to a larger stimulus, such as during saddling and mounting. Back Pain in the Horses with back pain may lower their back to avoid contact when the saddle is placed overtop, or turn to bite as the Performance Horse girth is tightened. Negative behaviors An overview of clinical signs, diagnosis and at the mounting block may be a sign of treatment options back pain. The degree of the response can vary widely, and in severe cases can “Recently I’ve noticed that my gelding will hollow his back when I include dramatic avoidance behaviors put on my saddle, and he seems like he is in pain when I groom his such as rearing or bucking. The most topline. Are these signs that my horse has back pain? If so, what can common complaint from an owner I do to address this?” when a horse has a back problem is poor performance. Often a horse with a back Q problem is sound but just not performing as expected. He may be knocking down Indeed, back pain is a to pressure over his back. In some cases, more rails than usual or missing his lead common finding among simple daily activities like being curry changes, or not be able to maintain a athletic horses. combed cause pain, and the horse will steady connection in a frame. Back pain The most easily recog- flinch or lower his back away from the is not exclusive to any one discipline and nized sign of back pain in pressure, or his muscles will become is seen in all types of performance horses. Aa horse is a negative reaction in response more tense. Some horses only show Diagnosis An important step in the Pain and injury can occur at any one of evaluation of back pain the structures within the back. Condi- is careful palpation of tions of the back that can affect perfor- the bony and soft tissues mance of a horse include narrowing of of the back to evaluate the space between the bony projections the response to pressure of successive vertebra in the region under over a specifi c area. the saddle (“kissing spine”), degenerative arthritis, inflammation of the muscles or ligaments, or fractures of the bones in the spine. In many cases, complete diag- nosis is not just limited to one aspect of the back, as these areas are interrelated. Even though most horses with back problems are sound, evaluation still begins with a classic lameness examina- tion, including evaluation of the horse

PAULA DA SILVA/ARND.NL moving at various gaits, possibly with

Christina “Cricket” Russillo, DVM, graduated from the Tufts University School of Veterinary Medicine in 2001. After completing a large animal medicine and surgery internship at Texas A&M, she realized her desire was to work on elite sporthorses. Following 13 years of practice at Fairfield Equine Associates in Newtown, Connecticut, focused on high-level show-jumping and dressage horses, she joined Virginia Equine Imaging in 2015. Russillo relocates to Florida every winter to support her clients and patients. She has competed through Third Level in CRICKET RUSSILLO dressage and in February 2017 she was appointed the U.S. Dressage Team veterinarian. She is also a certified member of the International Society of Equine Locomotor Pathology.

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such as the muscle relaxer methocarba- mol, non-steroidal anti-inflammatories and bisphosphonates, which reduce the activity of the cells which break down bone in response to inflammation. Even surgery can be considered for certain con- ditions. If there is an underlying primary lameness that is contributing to the back pain, then this must be addressed as well. Rehabilitation is also very important for successful management and return to training. Alleviating the pain is the first COURTESY, VIRGINIA EQUINE IMAGING step to restoring normal movement of the The technique of meso- back, but helping the horse redevelop his therapy involves a vet- muscles to avoid ongoing stress on the lig- erinarian injecting a small aments and joints is essential to reduce the amount of medication into recurrence of pain. This can be achieved the horse’s skin to achieve by adjustments in the exercise program, muscle relaxation. for example how a horse is warmed up, or through a short break in training under and without the weight of a rider. One of to develop a complete diagnosis of the saddle to avoid direct pressure on the the tools we commonly use in our practice underlying condition. back while the inflammation subsides. is a weighted surcingle. Even though the Physiotherapy with a functional elec- weight applied is relatively small com- Treatment and Management tric stimulation device which externally pared to the collective weight of tack and Treatment and management protocols stimulates muscle movement is useful to rider, it can elicit a significant avoidance are developed specific to the diagno- reduce spasm and retrain the muscle’s response by the horse (bucking, for ex- sis and can include a combination of normal biomechanical action. Appli- ample) to indicate that there is back pain. therapies. A commonly used modality cation of this therapy should only be Another important step in evaluation is shockwave therapy, in which a high performed by a trained veterinary profes- is careful palpation of the bony and soft energy sound wave is generated outside sional or physiotherapist. tissues of the back, whereby the veterinar- the body and pulsed into the tissues of Practical considerations such as ian slowly and methodically touches the the back to reduce pain. changes in saddle or adjustment of saddle horse’s back and evaluates the response to Targeted injections into the joints fit can also be very important. Once the pressure over a specific area. Contraction and soft tissues of the back are done underlying condition has been addressed, and tension of the musculature (spasm) routinely to manage back pain. A adjunct therapies can facilitate continued in response to palpation of the longis- veterinarian may choose to inject with comfort. These can include acupuncture, simus musculature is a hallmark sign of corticosteroids or regenerative products chiropractic treatments, massage therapy back pain. Some veterinarians employ the like platelet-rich plasma. and regular use of supportive devices like technique of motion palpation, which is The technique of mesotherapy is very cold laser and magnetic blankets. an adaptation of a human chiropractic effective at reducing muscle spasm. In The good news is that following diag- evaluation tool that assesses how well the this procedure, the veterinarian injects a nosis and treatment, the large majority individual segments of the back move in small amount of medication into the skin of horses are able to happily return to response to subtle motion created by the to achieve muscle relaxation. While the work. Ongoing attention and periodic veterinarian. This helps the veterinarian disruption only lasts hours, the resulting management over a horse’s career may assess flexibility, and to know if a horse relief can last months. This is also a less be necessary, but properly supported, is limiting extension or rotation to avoid invasive approach compared to more most horses are able to continue long pain in its spine. Imaging of the back traditional injection therapy. performance careers. through radiographs, ultrasound and Medical management can also include This column has not been approved in some cases a bone scan, is essential systemic administration of medications or endorsed by U.S. Equestrian.

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