Effects of Low-Level Laser Therapy and Chiropractic Care on Back Pain in Quarter Horses.

Low-level laser therapy has been used clinically to treat musculoskeletal pain; however, there is limited evidence available to support its use in treating back pain in horses. The objective of this study was to evaluate the clinical effectiveness of low-level laser therapy and chiropractic care in treating thoracolumbar pain in competitive western performance horses. The subjects included 61 Quarter Horses actively involved in national western performance competitions judged to have back pain. A randomized, clinical trial was conducted by assigning affected horses to either laser therapy, chiropractic, or combined laser and chiropractic treatment groups. Outcome parameters included a visual analog scale (VAS) of perceived back pain and dysfunction and detailed spinal examinations evaluating pain, muscle tone, and stiffness. Mechanical nociceptive thresholds were measured along the dorsal trunk and values were compared before and after treatment. Repeated measures with post-hoc analysis were used to assess treatment group differences. Low-level laser therapy, as applied in this study, produced significant reductions in back pain, epaxial muscle hypertonicity, and trunk stiffness. Combined laser therapy and chiropractic care produced similar reductions, with additional significant decreases in the severity of epaxial muscle hypertonicity and trunk stiffness. Chiropractic treatment by itself did not produce any significant changes in back pain, muscle hypertonicity, or trunk stiffness; however, there were improvements in trunk and pelvic flexion reflexes. The combination of laser therapy and chiropractic care seemed to provide additive effects in treating back pain and trunk stiffness that were not present with chiropractic treatment alone. The results of this study support the concept that a multimodal approach of laser therapy and chiropractic care is beneficial in treating back pain in horses involved in active competition.

Chiropractic abnormalities of the lumbar spine significantly associated with urinary incontinence and retention in dogs.

OBJECTIVES: To retrospectively summarise chiropractic findings in dogs presented in a veterinary practice with urinary incontinence and urinary retention over a 6-year period, and compare these to non-urinary patients presented during the same time period. METHODS: Twenty-two cases were included in the study. They all first underwent a standard clinical examination to rule out or treat other possible causes of their urinary problems. They then underwent chiropractic examination and hypomobility findings were recorded using Gonstead listings. Odds ratios (ORs) were calculated for the occurrence of chiropractic findings in urinary versus non-urinary patients for each vertebra in the lumbar, sacral and ilial regions. RESULTS: All patients had chiropractic findings in the lumbar region that differed from non-urinary patients. The urinary patients were significantly more likely to have chiropractic findings in L3 (OR=4 · 81; 95%CI: 2 · 02 to 11 · 44; P = 0 · 0004), L4 (OR=6 · 85; 95%CI: 2 · 63 to 17 · 84; P = 0 · 0001) and L5 (OR=3 · 98; 95%CI: 1 · 64 to 9 · 69; P = 0 · 0023). In addition, urinary patients were significantly less likely to have chiropractic findings associated with the ilium (OR=0 · 26; 95%CI: 0 · 11 to 0 · 66; P = 0 · 0043). CLINICAL SIGNIFICANCE: This is the first report of an association between chiropractic findings in the lumbar vertebrae and urinary incontinence and retention in dogs.

Successful management of acute-onset torticollis in a giraffe (Giraffa camelopardalis reticulata).

A 2-yr-old male reticulated giraffe (Giraffa camelopardalis reticulata) presented with severe midcervical segmental torticollis upon arrival as an incoming shipment. Despite initial medical management, the giraffe developed marked neck sensitivity, focal muscle spasms, and decreased cervical range of motion. Using operant conditioning to assist patient positioning and tolerance to cervical manipulation, a series of manually applied chiropractic treatments were applied to the affected cervical vertebrae in an effort to restore normal cervical mobility. Laser therapy and cervical range of motion exercises were also used to reduce cervical muscle hypertonicity. The combined application of these nontraditional therapies produced marked clinical improvement. This case highlights the potential benefits of combining traditional medical management with chiropractic treatment and physical therapy techniques for management of severe acute-onset torticollis in a giraffe.

Overview of veterinary chiropractic and its use in pediatric exotic patients.

The scope of this article will be an introduction to veterinary chiropractic and its use in treating pediatric exotic patients. After discussing the general principles of human and veterinary chiropractic, the special considerations of adjusting exotic pediatric patients will be explored.

The use of allied health therapies on competition horses in the North Island of New Zealand.

AIM: To obtain data on the use of allied health therapy within competitive equestrian sport in the North Island of New Zealand. METHODS: Data were collected during January 2010 by survey at show jumping and dressage championships in the North Island, and from racing yards in the Central Districts of New Zealand. The survey consisted of 30 open, closed and multiple-choice questions, and was conducted face-to-face, by the same interviewer. Information on the demographics of riders or trainers and horses in each discipline (show jumping, dressage, and Thoroughbred racing), the use of allied health therapy (physiotherapy, chiropractic and equine sports massage) on horses, and knowledge of training and qualifications of the allied health therapists was obtained. Univariable and multivariable logistic regression were used to examine relationships between demographic variables and the use of allied health therapists. RESULTS: In total, 110 riders or trainers participated in the survey. The relative contribution of responses across disciplines was 39/110 (36%), 41/110 (37%) and 30/110 (27%) for show jumping, dressage, and Thoroughbred racing respectively. Allied health therapists were used by 68/110 (62%) respondents to treat their horses. The most common types of allied health therapy used were chiropractic (25/68; 37%) and physiotherapy (16/68; 24%). The main reasons for using allied health therapies were for back pain (22/68; 32%) and lameness (17/68; 25%). Only 5/68 (7%) respondents chose a type of allied health therapy based on veterinary advice, and 49/68 (72%) stated that their veterinarian and allied health therapist did not work together when treating their horses. The final multivariable model for use of allied health therapists included the explanatory variables discipline of the rider or trainer and the number of horses in training per season. CONCLUSIONS AND CLINICAL RELEVANCE: The use of allied health therapies for the treatment of competition and racehorses was widespread. Many riders or trainers perceived allied health therapy to be beneficial, however many therapists and veterinarians do not work together and therefore the integrative treatment approach to rehabilitation is lost.

The effects of chiropractic, massage and phenylbutazone on spinal mechanical nociceptive thresholds in horses without clinical signs.

REASON FOR PERFORMING STUDY: Common methods used to treat back problems in horses need to be assessed objectively. OBJECTIVES: To measure spinal mechanical nociceptive thresholds (MNTs) and evaluate the effects of chiropractic, massage and phenylbutazone, compared with active and inactive control groups. METHODS: Baseline MNTs at 7 sites within the thoracolumbar and sacral regions were measured in 38 healthy mature horses exhibiting no clinical signs of lumbar pain. Horses were assigned to one of 3 treatment groups: instrument-assisted chiropractic treatment, therapeutic massage and phenylbutazone; or 2 control groups: ridden exercise (active control) or routine paddock turnout with no ridden exercise (inactive control). MNT measurements were repeated at 1, 3 and 7 days post treatment. The percentage change from baseline MNT values was calculated within groups. RESULTS: On Day 7, the median MNT had increased by 27, 12 and 8% in the chiropractic, massage and phenylbutazone groups, respectively. MNT changes of <1% were seen within the active and inactive control groups. CONCLUSIONS: Chiropractic treatment and massage therapy increased spinal MNTs within horses not exhibiting signs of lumbar pain. POTENTIAL RELEVANCE: Pressure algometry provides an objective tool to evaluate the effects of commonly used, but currently unproven treatment modalities on spinal MNTs. Future studies need to evaluate combined treatment effects and longer-term MNT changes in horses with documented back pain.

Effect of chiropractic manipulations on the kinematics of back and limbs in horses with clinically diagnosed back problems.

REASON FOR PERFORMING STUDY: Although there is anecdotal evidence of clinical effectiveness of chiropractic in treatment of equine back pain, little scientific work has been reported on the subject. OBJECTIVES: To quantify the effect of chiropractic manipulations on back and limb kinematics in horse locomotion. METHODS: Kinematics of 10 Warmblood horses were measured over ground at walk and trot at their own, preferred speed before, and one hour and 3 weeks after chiropractic treatment that consisted of manipulations of the back, neck and pelvic area. Speed was the same during all measurements for each horse. RESULTS: Chiropractic manipulations resulted in increased flexion-extension range of motion (ROM) (P<0.05) at trot in the vertebral angular segments: T10-T13-T17 (0.3 degrees ) and T13-T17-L1 (0.8 degrees ) one hour after treatment, but decreased ROM after 3 weeks. The angular motion patterns (AMPs) of the same segments showed increased flexion at both gaits one hour after treatment (both angles 0.2 degrees at walk and 0.3 degrees at trot, P<0.05) and 3 weeks after treatment (1.0 degrees and 2.4 degrees at walk and 1.9 degrees and 2.9 degrees at trot, P<0.05). The lumbar (L3 and L5) area showed increased flexion after one hour (both angles 0.3 degrees at walk and 0.4 degrees at trot P<0.05), but increased extension after 3 weeks (1.4 degrees and 1.2 degrees , at trot only, P<0.05). There were no detectable changes in lateral bending AMPs. The inclination of the pelvis was reduced at trot one hour (1.6 degrees ) and 3 weeks (3 degrees ) after treatment (P<0.05). The mean axial rotation of the pelvis was more symmetrical 3 weeks after the treatment at both gaits (P<0.05). There were no changes in limb angles at walk and almost no changes at trot. CONCLUSIONS: The main overall effect of the chiropractic manipulations was a less extended thoracic back, a reduced inclination of the pelvis and improvement of the symmetry of the pelvic motion pattern. POTENTIAL RELEVANCE: Chiropractic manipulations elicit slight but significant changes in thoracolumbar and pelvic kinematics. Some of the changes are likely to be beneficial, but clinical trials with increased numbers of horses and longer follow-up are needed.

Use of complementary veterinary medicine in the geriatric horse.

The use of complementary and alternative veterinary medicine continues to grow within the veterinary community. As more clients seek out complementary and alternative medicine for their own health care, they begin to seek out these forms of therapy for their animals. For the equine practitioner, this includes those clients with geriatric animals. It is hoped that this article provides some insight into what conditions may be helped with CVM (complementary veterinary medicine) and when an equine practitioner may want to consider CVM as a form of therapy for the geriatric horse.