Back problems in horses are a very hot item. More and more we hear about horses being difficult to ride or not being able to perform certain exercises. Lingehoeve Diergeneeskunde has been focusing on back problems and their management for years.
What are the clinical signs?
They can vary from being difficult in turns to real resistance that is translated in bucking or fleeing. Other ways of communicating pain is pushing away the back, not wanting to lower the neck or resisting to go backwards. A horse can communicate pain in a variety of ways. It is very hard for the rider to distinguish real pain from finding it hard to perform on a certain level. It is often very difficult to know how much pain there is involved. Character also plays a big part in this matter.
How can we examine back problems?
Clinical examination: This examination always forms the basis of any further examination of back problems. This examination gives us an overview of the limitations of the horse. Because back pain can be translated by the horse into lameness problems, a thorough lameness examination is performed regularly. If necessary even a ridden examination is performed. Lingehoeve Diergeneeskunde has excellent facilities to see these horses ridden in the large indoor arena.
Radiological examination: Everybody knows the disease kissing spines as a cause of back problems however it is a common mistake to forget about all the other diseases which can appear in the back of the horse such as spondylosis and arthrosis of the facet joints. It is impossible to properly document these conditions with mobile equipment. Lingehoeve Diergeneeskunde possesses the best equipment at the clinic to image the complete back of the horse.
Ultrasonographic examination: Most back pain in caused by pain in the soft tissue such as ligaments, joints, muscles and joint capsules. These structures cannot be imaged be radiographs but by ultrasound. Even small changes on the bone surface and facet joints in the lumbar area are better imaged by ultrasound. One of the causes of back pain are changes in the SI joints, ultrasound is used for these structures as well. Therefore ultrasound is often necessary to do a complete examination of the back.
Scintigraphic examination: This technique is most commonly used to assess the activity in bone. This technique has the ability to show problems in the bones in a very early stage of disease (before any radiological change is visible). It is an excellent technique to screen the horse, locate the pain, determine the location of the problem(s) and examine the gravity of the condition. With this technique it becomes more clear which course of treatment to take and the expected result.
What are the therapeutic possibilities for back problems?
Once we know where the pain is located and what the cause is of this pain there is a large range of treatment possibilities. Besides oral medication (painkillers and supplements) local injections can be given. In back problems mesotherapy can be very useful. Systemic medication in form of biphosphonates (Tildren, Osphos) can help in supporting problems in the bones (found in the radiographic or scintigraphic examination). In addition to the treatment given by the veterinarian it is also very useful to submit the horse to physiotherapy, chiropractor or osteopathy. All these therapeutic options must be combined with the right training of the horse.
In summary it is very important to find the exact location and cause of the back pain. In order to properly and successfully treat these horse a multidisciplinary approach is necessary.