Back Pain in Horses Table Topic (AAEP 2011)

Back pain in the horse, said Kent Allen, DVM, "is one of the last great frontiers." During a Table Topics discussion at the 2011 American Association of Equine Practitioners convention, held Nov.18-22 in San Antonio, Texas, Allen, owner and practitioner at Virginia Equine Imaging near Middleburg, called back pain a condition that is "underdiagnosed in the performance horse."

Co-moderator, Philippe Benoit, DVM, a private practitioner at Clinique Equine des Bréviaires in Les Bréviaires, France, added that a veterinarian needs "to get a good history" from the owner in order to diagnose equine back problems. Both clinicians stressed the importance of a precise diagnosis for back pain since the back is a complex region that has muscles, joints, ligaments, and nerves.

Benoit asked the audience how many examine the horse under tack during a lameness exam. Allen remarked that a significant difference in movement under tack versus in hand or on the longeline can be "a significant indicator of back problems."

The majority of back problems, said Benoit, are 50-60% bony in nature but are always combined with soft tissue damage. Treatment can't ignore muscle spasm around the problem area. The most important part of therapy is to restore motion, Benoit said. Allen remarked that the more acute lesions tend to be soft tissue while the more chronic pain is likely to be of bony origin.

Benoit, Allen, and the veterinary audience discussed diagnostic techniques including radiographs (X rays), ultrasound, nuclear scintigraphy (bone scans), thermography, and diagnostic nerve blocks. They emphasized the importance of good history and thorough examination.

Both clinicians pointed out that the condition known as "kissing spines" is present from birth. The lesions will change and remodel, but the condition starts at relatively the same grade in all affected horses. They noted that the problem often appears to be acquired in nature because young horses not yet in training have not yet experienced the associated pain brought on by work.

Regarding back pain therapy, Allen remarked that "any time there are this many treatment (methods available), it means that nothing works consistently." He defined the ideal treatment as one that "addresses bone and soft tissue, lasts 4-6 months, and is cheap." Benoit commented that in treating back injury, a practitioner is not only treating inflammation, but also pain. You have to restore motion, Benoit said. No matter what, treatment needs to break the pain/spasm cycle.

Any successful therapy will involve the rehabilitation of the back. Rest alone does the horse no favors, they said. The session closed with a reminder of the need for a re-evaluation process. Practitioners should see horses back within four to six weeks then within three to four months after that.

This session was moderated by Kent Allen, DVM, owner and practitioner at Virginia Equine Imaging near Middleburg, and Philippe Benoit, DVM, a private practitioner at Clinique Equine des Bréviaires in Les Bréviaires, France.

About the Author

Christy Corp-Minamiji, DVM

Christy Corp-Minamiji, DVM, practices large animal medicine in Northern California, with particular interests in equine wound management and geriatric equine care. She and her husband have three children, and she writes fiction and creative nonfiction in her spare time.

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