A Shocking New Development

Emma Anderson

Background:

Ringbone is a degenerative disease that effects the pastern and coffin joints of a horse. This

disease usually strikes high performance horses and those horses that are under high amounts of stress. It can end a horse’s career and life if too severe. Most horses in these circumstances are middle aged, but there are cases showing up in younger horses. Horses diagnosed with ringbone are usually sold or put out to pasture because they are not viable competitors anymore. David Frisbie, DMV, once said in an article in response about ringbone “I don’t know that there’s an ultimate cure or prevention, if you will. My feeling is if we start, treating some of these horses earlier when we have only slight to mild problems, we may be able to slow down the progression…” Treatments that were used before the new therapy, that semi helped alleviate the pain and added stress, were shoeing, nerve blocks, bute shots (drug shots), and keeping horses on supervised exercise and soft ground. Ringbone is not curable presently but there is a new treatment that shows the promise of being highly effective in reducing the complications that are caused by ringbone.

Purpose:

Is a new treatment for ringbone worth researching? Is ESWT a viable treatment?

Evidence:

Extracorporeal shock wave treatment or ESWT has shown improvement in relieving pain and

stress towards the areas affected along with disintegration of mineral deposits then stimulating

osteogenesis (the growing of healthy bone) and increasing blood flow. The areas effected by ringbone

usually have a limited blood supply, so by increasing blood supply by using ESWT can shorten healing time by allowing more nutrients and remodeling the affected tissues. A horse that heals without the help of ESWT can take up to six months to heal while the use of ESWT can speed up the recovery time to four weeks or less.

Mineral deposits are gathering and ‘growing’ on the  middle phalanx or top of hoof causing the horse to  become lame and in pain.  Amador Veterinary Services, DCM, LimDCM

The way shock waves stimulate healing is unknown. Shock waves increase cellular membrane permeability, division, and increase stimulation in cytokine production by bone marrow. ESWT has been used in humans for thirty years to help with nonsurgical treatments, and urolithiasis. Just recently has shock wave treatments been tested on horses. When shock waves are applied to the bone at appropriate energy and pulse, it can stimulate osteogenesis. In addition, shock waves do not damage soft tissue and do not leave any visible signs of the procedure on the body of a horse. Along with this scientist speculate that the extracorporeal shock wave treatment strengthens soft tissues, decreases bone swelling, alters bone pressure, and causes the central nervous

system to read pain signals differently.

    In the beginning very few people had access to the shock wave treatment. As time has increased

more and more people have donated to the program and there have been improvements made in

equipment and methods used. Scott McClure, DVM, PhD, of Iowa State University stated that, “the

number of users has just skyrocketed in the last year or two. When I first came to Iowa State two years ago, we were the only people offering ESWT between here and Chicago. Now it's in Omaha, Des Moines and every other major city.” Along with this scientist have learned that it not only numbs the pain but heals the diseased area. I have found that there has been one item of concern with the use of extracorporeal shock wave treatment. People in the industry have noticed that because of the analgesic effect associated with ESWT some horses are being put back to work before they have fully healed. On the show circuit and race track there is a required seven days with drawl period. The solution to this problem is to repeat the radiology exam to determine when the bone has healed.

After diagnosing ringbone, a treatment program is designed. The ESWT depth, which can be up

to four inches inside the horse, is determined. As is the number of waves to use. The amount of

treatments is determined by the severity of the disease. Although word of mouth helps to get more

veterinarians to use ESWT, research backs up the claim.

Conclusion:

While there has been a caution put out there for the extracorporeal shock wave treatment, the

benefits in this advancement have shown that it was worth putting the time and money into the

technology. Quicker recuperating and healing times for the horses involved also help to show theimportance of ESWT being used. While some clients still use the older techniques whether it be from being cheaper or ‘what they have always done’, using the new advancement shows faster and easier positive results in the end. The effects from ESWT are all good, increasing blood flow, lowering stress applied to the wounded area, remodeling the bone, etc., all help the horse to get back to feeling 100 percent. That being the end goal.