Equine Field Service: Integrative Equine Sports Medicine

The UCD Veterinary Hospital is constantly striving to optimise clinical outcomes and explore new medical advances for our patients.  As part of this, the Equine Field Service has introduced Integrative Sports Medicine for our equine patients to optimise health and improve performance. The Equine Field Service, which has proven to be a very popular rotation with our final year students, provides a wide variety of diagnostic and treatment procedures, including mobile Digital x-ray and ultrasound; the introduction of Integrative Sports Medicine to the Service, which combines conventional medicine with complementary therapies, will provide a whole patient approach.

Dr. Sinead Devine MVB, Assistant Professor in Equine Clinical Studies, is a clinician with our Equine Field Service and the person responsible for driving this innovative approach.  Sinead worked for 12 years at Peninsula Equine Medical Center, in the heart of Silicon Valley, California, specializing in Sport Horse Medicine and Lameness.  Sport Horse Medicine in the US has embraced this integrative approach for the past decade, especially for competing horses who often suffer from chronic issues, e.g. stiff joints, sore back, stiff neck, which compromise horse welfare and performance. Management of these athletes using acupuncture, chiropractic, laser therapy and massage can help to prevent progression of these issues into breakdown injuries.

As a starting point, all consultations in this area begin with a thorough clinical exam and full work up of the lameness, with imaging as appropriate. A Diagnostic Acupressure Examination can then be performed. Acupuncture has been used to treat various medical conditions in humans for over 3,000 years. Modern research shows that acupuncture point locations are in areas with a high density of free nerve endings, mast cells, small arterioles and lymphatic vessels. Stimulation at acupoints causes release of substance P and histamine, capillaries, mast cells and nerves are involved in the reactions. Needle insertion also stimulates mechanoreceptors; this activation can augment analgesia (pain relief). In our equine patients, acupuncture is used in pain management for musculoskeletal and joint pain for riding horses from ‘happy hackers’ to competitive show jumpers. Most horses tolerate the acupuncture needles (single use sterile needles), and they are not sedated for the assessment or treatment.

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Chiropractic is a manual therapy the goal of which is to ensure smooth, coordinated movement of all spinal segments to optimise spinal joint neuromuscular function. The purpose of the equine chiropractic exam is to assess for reduced range of motion, as opposed to the misconception that there is a ‘rib out’ or any bone is ‘out of place.’ The chiropractic adjustment serves to restore optimal range of motion of the joint, which may subsequently alleviate inflammation in and pressure on surrounding nerves and soft tissue. Horses are also not sedated for this treatment. Follow up massage and stretches by the owner will aid in on-going management of the case and these movements are demonstrated to the owner at the appointment. Cases of ‘cold-backed’ horses often improve with this integrated approach, where anti-inflammatory drugs provide only transient relief.  LASER (Light Amplification by Stimulated Emission Rays) therapy is also used as an adjunct to acupuncture and chiropractic care in the management of cases.  Our Equine Field Service also has the support and back up of the surgeons and internal medicine specialists on site in the UCD Veterinary Hospital and their experience and opinions are just a Facetime consult or realtime phone call away; this innovative approach is very much a team effort.

Our final year Veterinary Medicine students all rotate through the Equine Field Service and they have the opportunity to experience first hand this clinical practise and integrative approach. They also work with our physiotherapist Maria Jose Gomez Sanchez BApS (Physical Therapy) RVN Equine CST MIAPT, as we teach a ‘circle of care’ approach to our cases, with strong communication between the owner, patient, vet and physiotherapist. Students enjoy seeing the results of this integrative approach to cases, as the follow up and continuity of care focuses on the future health of the horse and not on a quick fix mindset.

For further information contact: Dr Sinead Devine | devines@ucd.ie | (01) 716 6000

References:

Haussler, KK.  (2016) ‘Joint Mobilization and Manipulation for the Equine Athlete,’ Veterinary Clinics of North America: Equine Practice, 32(1), pp. 87-101.

Memon, M.A. et al.  (2016) ‘Integrative Veterinary Medical Education and Consensus Guidelines for an Integrative Veterinary Medicine Curriculum within Veterinary Colleges,’ Open Veterinary Journal, 6(1), pp. 44-56.

White, A. et al.  (2009) ‘Western Medical Acupuncture: A Definition,’ Acupuncture in Medicine, 27(1), pp. 33-35.