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

Flemish equine veterinarians' perceptions on the use of and client communication about complementary and alternative veterinary medicine

BACKGROUND

Complementary and alternative veterinary medicine (CAVM) is increasingly popular in horses. As CAVM usage could have risks, client-veterinarian communication about CAVM is crucial.

OBJECTIVES

Evaluating equine veterinarians' attitude towards CAVM, their CAVM usage and veterinarian-client communication about CAVM.

STUDY DESIGN

Cross-sectional study.

METHOD

A telephone survey was conducted among equine veterinarians providing ambulatory care on a daily or weekly basis. The first section of the survey included questions about the veterinarians' attitude towards CAVM and their CAVM usage. The second section focused on veterinary-client communication about CAVM.

RESULTS

When herbs are included as CAVM modality, 83% of the participants applied CAVM. Nighty-eight percent had already communicated with horse owners about CAVM and 81% agreed to be open to talk about CAVM. However, 95% agreed that sometimes CAVM usage takes place without disclosure to the veterinarian. The majority of participants communicated about CAVM on a weekly (40%) or daily (22%) basis, most often in person during consultations (99%) or via phone (32%). The median percentage of conversations about CAVM initiated by the owner was 50% (range 50%-80%). When the veterinarian initiated the conversation, this was usually by mentioning it as a treatment option, mostly in addition to conventional treatments. Some participants directly asked about CAVM use in the information-gathering phase.

MAIN LIMITATIONS

A convenience sample was used due to lack of data on the number of equine veterinarians in Flanders. Potential favourability bias with higher participation of veterinarians interested in CAVM.

CONCLUSION

Equine veterinarians generally had a positive attitude towards CAVM use, although this depended on the specific modality. Veterinarian-client communication about CAVM occurs frequently in ambulatory care. An open dialogue with horse owners about CAVM is important to provide information about CAVM and thus enable them to make informed decisions concerning CAVM usage, together with their veterinarian.

Equestrian-Related Musculoskeletal Injuries Presenting to a Chiropractic Practice: A Retrospective Chart Review of 19 Patients

Objective

The purpose of this study was to describe the types of equestrian-related musculoskeletal injuries and their management.

Methods

We retrospectively reviewed the charts of 19 patients who presented with injuries from equestrian activities at a chiropractic practice from December 2000 to December 2020. Deidentified data were extracted from the charts and summarized.

Results

Of the 19 patients, 42.3% presented with acute trauma, 38.5% had overuse injuries, and 19.2% had chronic injuries as a result of previous trauma. We found that 90% of overuse injuries and 18.2% of acute injuries led to chronic conditions that needed ongoing management.

Conclusion

From this sample of patients, there was a high percentage of overuse and chronic injuries for patients who participated in equestrian activities.

A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Electrotherapy

Electrotherapy modalities are currently used in the treatment of animals, but the evidence base supporting their use has not yet been systematically reviewed. Cochrane guidelines, as adapted by the Swedish Agency for Health Technology Assessment and Assessment of Social Services, were followed for this systematic review. A literature search regarding all currently known electrotherapy modalities applied to horses, dogs, and cats was conducted for the years 1980-2020 using three databases: CABI, PubMed, and Web of Science Core Collection. Of the 5385 references found, 41 articles were included in the review: 13 papers on pulsed electromagnetic field therapy (PEMFT), 7 on neural electrical muscle stimulation (NEMS), 5 on transcutaneous electrical nerve stimulation (TENS), 4 on static magnets, 3 on interference, 2 each on percutaneous electrical neural stimulation (PENS), bioelectricity, and diathermy, and 1 each on micro-pulsed stimulation, capacitive coupled electrical stimulation, and microwave therapy. The literature per modality was limited in quantity (mean 3.7 papers). Half of the articles were assessed to have a high risk of bias (20 high, 7 moderate, and 14 low). The existing literature used a spectrum of indications and treatment parameters, which makes comparisons and drawing conclusions to support the use of these modalities in clinical practice challenging. The current scientific evidence is not sufficient to support the clinical effects of electrotherapies for any clinical indication in horses, dogs or cats. The selected suggestive results warrant further high-quality research on PEMFT, NEMS, TENS, and PENS.

A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Soft Tissue Mobilization

Simple Summary

Soft tissue mobilization involves different massage and stretching techniques that are commonly used in animals. Despite the frequent use, there is limited knowledge of how the methods affect the animal. Therefore, this study reviews the scientific literature on massage and stretching in cats, dogs, and horses. Three core bibliographic sources were used. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 1189 unique publications screened, 11 met the inclusion criteria and were included in the review, nine on massage and two on stretching. The risk of bias was assessed as high in eight of the studies and moderate in three of the studies. There were large differences in reported treatment effects; two studies assessed as having a moderate risk of bias indicated a decreased heart rate after massage. According to the results, the scientific documentation of massage and stretching is not of sufficient quality to draw clear conclusions about their clinical effect in horses, dogs, and cats.

Abstract

Soft tissue mobilization is frequently used in the treatment of sport and companion animals. There is, however, uncertainty regarding the efficacy and effectiveness of these methods. Therefore, the aim of this systematic literature review was to assess the evidence for clinical effects of massage and stretching in cats, dogs, and horses. A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 1189 unique publications screened, 11 were eligible for inclusion. The risk of bias was assessed as high in eight of the studies and moderate in three of the studies, two of the latter indicating a decreased heart rate after massage. There was considerable heterogeneity in reported treatment effects. Therefore, the scientific evidence is not strong enough to define the clinical efficacy and effectiveness of massage and stretching in sport and companion animals.

A Systematic Review of Complementary and Alternative Veterinary Medicine: "Miscellaneous Therapies"

Simple Summary

Complementary and alternative veterinary medicine (CAVM) is commonly used in animals. However, there is limited knowledge of how the methods affect the animal. Therefore, this study reviews the scientific literature of 24 different CAVM therapies used in cats, dogs, and horses. Three core bibliographic sources were used. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 982 unique publications screened, 42 were eligible for inclusion, representing nine different CAVM therapies, which were aromatherapy, gold therapy, homeopathy, leeches (hirudotherapy), mesotherapy, mud, neural therapy, sound (music) therapy, and vibration therapy. For the other 15 predefined therapies, no study was identified. The risk of bias was assessed as high in 17 studies, moderate to high in 10, moderate in 10, low to moderate in four, and low in one study. In those studies where the risk of bias was low to moderate, there was considerable heterogeneity in reported treatment effects. Therefore, the 24 CAVM therapies do not have scientific documentation of sufficient quality to draw clear conclusions regarding their clinical effect.

Abstract

There is an increasing interest in complementary and alternative veterinary medicine (CAVM). There is, however, an uncertainty of the efficacy of these methods. Therefore, the aim of this systematic literature review is to assess the evidence for clinical efficacy of 24 CAVM therapies used in cats, dogs, and horses. A bibliographic search, restricted to studies in cats, dogs, and horses, was performed on Web of Science Core Collection, CABI, and PubMed. Relevant articles were assessed for scientific quality, and information was extracted on study characteristics, species, type of treatment, indication, and treatment effects. Of 982 unique publications screened, 42 were eligible for inclusion, representing nine different CAVM therapies, which were aromatherapy, gold therapy, homeopathy, leeches (hirudotherapy), mesotherapy, mud, neural therapy, sound (music) therapy, and vibration therapy. For 15 predefined therapies, no study was identified. The risk of bias was assessed as high in 17 studies, moderate to high in 10, moderate in 10, low to moderate in four, and low in one study. In those studies where the risk of bias was low to moderate, there was considerable heterogeneity in reported treatment effects. Therefore, the scientific evidence is not strong enough to define the clinical efficacy of the 24 CAVM therapies.

A Questionnaire Study on the Use of Complementary and Alternative Veterinary Medicine for Horses in Sweden

Complementary or alternative veterinary medicine (CAVM) includes treatment methods with limited scientific evidence. Swedish veterinarians are legally obliged to base treatments and recommendations on science or well-documented experience, but most CAVM methods are not well documented in animals. The aim of this study was to explore the use of CAVM in Swedish horses. Electronic questionnaires were distributed to horse owners, equine veterinary practitioners and CAVM therapists. Of the 204 responding horse owners, 83% contacted a veterinarian first in case of lameness, while 15% contacted a CAVM therapist. For back pain, 52% stated a CAVM therapist as their first contact and 45% a veterinarian. Only 10-15% of the respondents did not use any CAVM method for prevention or after injury. Of the 100 veterinarians who responded, more than half did not use CAVM themselves but 55% did refer to people who offer this service. Of the 124 responding CAVM therapists, 72% recommended their clients to seek veterinary advice when needed, 50% received referrals from a veterinarian, and 25% did not collaborate with a veterinarian. The two most common methods used by the respondents in all three categories were stretching and massage. Most veterinarians and therapists were not content with the current lack of CAVM regulation.

Horse owners' attitudes towards and motivators for using complementary and alternative veterinary medicine

BACKGROUND

Complementary and alternative veterinary medicine (CAVM) is becoming increasingly popular in horses.

METHODS

Online, cross-sectional survey in 1532 horse owners. Attitude towards CAVM, subjective norms, perceived behavioural control and intention for future CAVM use were measured based on the theory of planned behaviour. Structural equation modelling was performed to characterize factors influencing intention to use CAVM.

RESULTS

Past use of CAVM, predominantly manual therapies and herbal supplements, was reported by 72.5% of all participants. Frequently reported indications were improving horse's well-being, illness which did not resolve after conventional treatment and chronic illness. The attitude towards CAVM was positive with a median (interquartile range) score of 6 of 7 (4.75-7.00). Predictors for past CAVM use were higher owner age, alternative medicine self-use and higher education (non-university). The strongest predictor of future CAVM usage was perceived behavioural control and perceived CAVM efficacy, as well as positive attitude towards and perceived knowledge about CAVM. The veterinarian was reported as a source of information about CAVM by 86.4% of all participants.

CONCLUSIONS

Horse owners showed a high intention to use CAVM with the owners' perceived behavioural control and perceived CAVM efficacy as the strongest predictor. Veterinarian-client communication is important to inform horse owners correctly.

Commercial equine production in New Zealand. 3. The racing and sport industries

The present review examines the commercial production of racing and sport horses in New Zealand, describing the size and scope of the industries, the management and feeding, and the training and wastage of race (Thoroughbred and Standardbred) and sport horses. The number of horses per head of population in New Zealand (30/1000 people) is high by international standards and the main equine industries generate ~2% of national gross domestic product. In New Zealand the Thoroughbred breeding and racing industry dominates organised equestrian activity (economically and numerically). Furthermore, this Thoroughbred bias has an influence on equestrian culture and may explain, in part, the high proportion of Thoroughbred sport horses registered for eventing in New Zealand, which is in contrast to other international sport-horse populations. An understanding of the production, management and structure of the racing and sport industries in New Zealand is paramount to ensure the health and welfare of the equine athlete and the continuing success of the industries.

Nontraditional Therapies (Traditional Chinese Veterinary Medicine and Chiropractic) in Exotic Animals

The nontraditional therapies of Traditional Chinese Veterinary Medicine and chiropractic care are adjunct treatments that can be used in conjunction with more conventional therapies to treat a variety of medical conditions. Nontraditional therapies do not need to be alternatives to Western medicine but, instead, can be used simultaneously. Exotic animal practitioners should have a basic understanding of nontraditional therapies for both client education and patient referral because they can enhance the quality of life, longevity, and positive outcomes for various cases across multiple taxa.

Complementary and alternative medicine for the management of orthopaedic problems in Swiss Warmblood horses

It appears that complementary and alternative medicine (CAM) is used increasingly often in horses for the assessment and treatment of suspected orthopaedic problems, especially back problems. The aim of this study was to determine the frequency of CAM use for the management of orthopaedic problems in a defined population of Swiss Warmblood horses. A total of 239 owners and caretakers of horses from a pre-defined database were called by a veterinarian to participate in the survey. A standardized questionnaire was designed to determine, for each orthopaedic case, where the localization of the problem was (limb or back) and if conventional medicine or CAM was used for consultation and treatment. When CAM was employed, the CAM discipline and administrator (veterinarian or alternative therapist) was defined. A total of 222 cases in 170 horses with orthopaedic problems were identified. Sixty-two horses were identified with a back problem, 96 horses with a lameness involving one or more limbs and 12 horses with a combined back problem and lameness. CAM was used commonly in this population (73.9%, 164 of 222) for both diagnostic workup and treatment of suspected orthopaedic problems, but was rarely administered by a veterinarian (12%, 27 of 222). In general, if a back problem was suspected by the owner, CAM was more frequently applied for diagnosis and treatment than in cases where a lameness was suspected; (91.9%, 68 of 74) vs. (64.9%, 96 of 148) (P < 0.001), respectively. Osteopathy was the most frequently applied CAM discipline. CAM was frequently used for diagnostic and therapeutic purposes in Swiss Warmblood horses with suspected orthopaedic problems. CAM practitioners were consulted predominantly if a back problem was suspected, and the majority of CAM practitioners were not veterinarians.

The use of laser biostimulation in human and animal physiotherapy – a review

Laser biostimulation involves applying a laser beam to the tissue to facilitate healing and regenerative processes. Laser therapy is one of the most important physical methods used in human physiotherapy. In veterinary medicine, laser therapy is a new and so far poorly examined method. The results of studies conducted so far are very promising, yet the positive effect of laser light, especially that of class IV, has yet to be confirmed. This article presents an overview of the available literature on the effect of laser treatment on the human and animal organism.

Associations between yearling exercise and interruptions during race training in Thoroughbred racehorses

OBJECTIVE

To investigate the effect of exercise during yearling sales preparation on the risk of interruptions during training in Thoroughbred racehorses.

ANIMALS

114 Thoroughbred racehorses.

PROCEDURES

Information regarding the daily exercise of yearlings during sales preparation was obtained prospectively from a convenience sample of stud farms. Yearlings were followed to entry into race training, and subsequently, daily training information was recorded until the end of the racing season. Competing-risks survival analysis was used to model time from entry into race training to voluntary training interruption (no known condition or disease identified) and time from entry into race training to involuntary training interruption (due to presence of a condition or disease) occurring before the first trial (practice race for education). Total hand walking time and mechanical walker time accumulated during sales preparation were the main exposures of interest.

RESULTS

82 of 114 (71.9%) horses had an interruption before the first trial; 65 (79%) interruptions were voluntary, and 17 (21%) interruptions were involuntary. Increased total hand walking time was significantly associated with decreased risk of voluntary interruptions, whereas longer cumulative distances at a canter were significantly associated with decreased risk of involuntary interruptions.

CONCLUSIONS AND CLINICAL RELEVANCE

Results identified an association between early exercise during sales preparation and decreased risk of voluntary interruption and increased risk of involuntary interruption during training of 2-year-old Thoroughbred racehorses. Further investigation into the effects of early exercise on racing performance is needed, but results have indicated that there may be an opportunity to modify early exercise programs.

Proactive Management of the Equine Athlete

Simple Summary

The athletic career of a horse is relatively short. Career length can be positively influenced by the trainer and the age at which the horse starts competition. There are opportunities for a team approach of health professionals and changes in management to improve functional/competition life. The ability to improve the tolerance of the tissue to exercise load via the introduction of early exercise, which reflects the horse’s evolutionary cursorial lifestyle, could provide a proactive mechanism to attenuate injury risk.

Abstract

Across many equestrian disciplines the median competition career of a horse is relatively short. One of the major reasons for short career length is musculoskeletal injury and a consistent variable is the trainer effect. There are significant opportunities within equestrian sport for a holistic approach to horse health to attenuate musculoskeletal injury. Proactive integration of care by health professionals could provide a mechanism to attenuate injury risk and the trainer effect. However, the limited data available on current exercise regimens for sport horses restricts interpretation of how management and exercise volume could be modified to reduce injury risk. Early exercise in the juvenile horse (i.e., pre weaning) has a positive effect on stimulating the musculoskeletal system and primes the horse for an athletic career. The early introduction to sport competition has also been identified to have a positive effect on career length. These data indicate that management systems reflecting the cursorial evolution of the horse may aid in attenuating loss from sport due to musculoskeletal injury.

The implementation of biosecurity practices and visitor protocols on non-commercial horse properties in New Zealand

A survey was conducted to investigate biosecurity practices on non-commercial horse properties, to describe the number of visits by horse professionals and any protocols that visitors were required to follow before interacting with resident horses. Data were collected in November 2009 during a cross-sectional study of non-commercial horse properties, in New Zealand, selected using generalised random-tessellated stratified design and a self-administered postal questionnaire. Data were described and the associations between property-level factors and biosecurity practices were analysed using logistic regression analysis. In total there were 791 respondents from non-commercial horse properties, of which 660 (83%) answer at least one question relating to biosecurity practices. Of the respondents, 95% had at least one biosecurity practice for arriving horses. Only 31% of properties isolated horses for more than four days, and few respondents checked for pyrexia or other clinical signs of infectious disease in new horses. Moving horses from a property was associated with the implementation of biosecurity practices and practices specific to the clinical signs of respiratory disease. Overall, 79% of properties had horse professional's visit, but only 33% of respondents reported biosecurity protocols for these visitors. Most properties had some knowledge about newly arriving horses, but the effectiveness of these practices for biosecurity were questionable, as few practices would stop disease spread to resident horses. Horse professionals are likely candidates for disease spread due to contact with horses, limited visitor protocols and the frequency of visits. The development of a plan to improve biosecurity for endemic and exotic disease is recommended.