Lesson 2
Therapies and
Treatment Modalities for Lameness
Lower Leg
Therapies
Cold
therapy
- To treat
acute injuries (first 24 to 48 hours)
1.
Ice boots or pack (30 – 45 minutes on and off)
2.
Cold water therapy (hose or cold water wraps (derby or polo bandage soaked in
ice water and applied directly on lower leg for up to 30 minutes at a time)
3.
Ice-o-Gel or Mineral Ice or alcohol applied directly to lower limb and cooled
by evaporation.
Heat
therapy
– Used to
treat chronic injuries or injuries more than 48 hours old.
1. Warm water turbulator
2.
Furacin sweats – Furacin or
other liniments used under a standing bandage or plastic wrap and standing bandage
to produce a sweating of the lower limbs. (increases
circulation and therefore healing)
3.
Other Braces and Tighteners (liniments
used to increase heat to the area of chronic injury. (Usually contain
ingredients like alcohol, acetone, phenol, menthol, camphor, methylsalicilate, turpentine, glycerin, and thymol.
4.
Capsaisin containing products. Be careful using under a bandage, as it can
get hot.
Anti-inflammatory
products used with or without bandages
1. DMSO . (Dimethyl
sulfoxide) Very effective , penetrates skin to deep
structures to cause anti-inflammatory effect. Sometimes mixed
with Furacin or cortisone – Excellent topical
anti-inflammatory. Comes as gel or liquid. Is absorbed through the skin into the systemic circulation.
2. Antiphlogisine – Numotizine and other osmotic type agents {pull swelling
(edema) out of the lower leg} and also anti-inflammatory. Can be used under
bandage or just applied on the leg as a thick mud or paste to dry and perform
its action. (Denver mud and other Mud products on the market)
Massage
Therapy
– used
mostly over the heavy muscles of the body, but rubbing down or turbulating or hosing a sore area on the lower leg is a
form of massage therapy.
Magnets
and electromagnetic therapy
– These treatments have shown the ability to speed up the healing process,
especially the electromagnetic approach.
Laser
Therapy--
This mode of
therapy has been available for the past 15 or so years and is effective as an
anti-inflammatory and pain relief therapy for acute and chronic limb problems.
Shock
Wave Therapy-
This is a
fairly recent mode of therapy that is gaining in popularity. It appears to be
effective in the treatment of bucked shins, navicular disease, and a few other
lower limb inflammatory problems. The extracoporeal
(shock wave) units have become portable and affordable, so more and more
veterinarians have access to these units.
Blistering
and firing
– A form of counter irritation (to produce an increase in blood supply to an
area of the limb which is lacking good blood supply in order to promote healing
in this area). Done a
lot less than in the old days. Using mild blistering agents on small
areas like chronic splints may be appropriate. Most consider this form of
therapy to be outdated and many consider it inhumane.
Non steroidal
anti-inflammatory drugs (NSAID’S)
and
other products available through your veterinarian
1.
Phenylbutazone “ BUTE”
– Injection--IV ONLY—10cc is 2grams, normal adult dose. It is very caustic if
you get it out of the vein. Will swell and may slough out.
Also
available for oral use in pills, paste and powder form. Tablets come as 1 gram
tablets. It is very bitter and the paste
form may be easier to administer. Can cause stomach ulcers
and/or diarrhea if over used. Used mostly for musculoskeletal pain and
lameness, and also is very effective in reducing fever.
2.
Firocoxib – available in paste form: Equioxx (The small animal
product – Previcox is not labeled for horse use and
it is illegal for veterinarians to prescribe it for horses). Targets
pain and inflammation.
3.
Banamine (flunixin) Injection and paste forms.
10cc is normal adult dose given iv. Not as caustic as bute. Works better than bute for colic pain. More
expensive than bute.
4.
Ketophen (ketoprofen)
10cc is the usual injectable dose IV. Also not as caustic as bute. Can be
given safely IM. Fewer side effects than bute. More
expensive than bute.
5.
Arquel (meclofenamic
acid)–
comes as granules to put in feed. 2 packets is usual dose.
6.
Aspirin – Oral
NSAID’s should be given for the shortest
amount of time as possible to avoid complications, such as ulcers and stress on
the kidneys.
The use of steroids to fight
inflammation and pain is not advised.
Steroids suppress the immune system and the body’s natural healing
processes. Non-steroidal
anti-inflammatories (NSAID’s) do not.
Examples of steroids are prednisone and cortisone.
Natural Products used for Lameness
problems
Hyaluronic acid (Sodium Hyaluronate,
Acid,) Legend, Hylartin V, Hyalovet.
1.
Anti-inflammatory – This is a product which is exactly what is found in normal
joint synovial fluid. It is injected intra-articularly
or intravenously (Legend 4mg.) Thought to normalize an
inflamed joint.
2.
This is an expensive product.
3.
Not really thought of as a curative agent.
Polysulfated glycosaminoglycan (Adequan)
1.
Also thought of as an anti-inflammatory and joint fluid normalizer.
2.
Also an expensive product.
3.
PSGG is a major molecular component of the joint cartilage. Thought
to help restore damaged cartilage to normal healthy cartilage.
4.
Used most commonly as a series of intramuscular injections .
Rarely injected into joints anymore.
Oral joint Nutraceuticals
1.
Most have as the active ingredients either condroitin
sulfate, and/or glucosamine sulfate and/or glucosamine HCL (similar to the
injectable adequan)
2.
The better products have both ingredients in high concentrations.
3.
Examples of products on the market are Corta-Flex,
GLC-5500, Cosequin. There
are many others on the market.
4.
Oral medications formulated as powder, granule or liquid feed additives.
5.
Some nutritionists and researchers question if oral joint supplements survive
the acid in the stomach and reach the intended target. Recording improvement and observation is the
only way to determine if a product is working.
Often trying a different product, if the first one does not work, will
show results.
6.
These products are not nearly as expensive as the injectables.
7.
Oral joint supplements are not regulated, so the ingredients stated on the
label may be in question. Always use
products from a reputable company.
Oral
Hoof Health products
1.
Look for main ingredients of BIOTIN, METHIONINE, AND ZINC, all building blocks
for hoof health and normal hoof growth. Other amino acids and vitamins and minerals
may be found in these products, but these 3 main ingredients are essential.
2.
Nitric acid oral products. Seem to increase the blood supply to the lower
extremity, specially the hoof.
3.
Isoxuprine – a prescription oral tablet used to
increase circulation to the lower extremities. Helpful in lamititis, navicular disease, etc.