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 bandage or plastic wrap and 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 a 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. Tablets come as 1 gram tablets. 2
tablets for adult horse. Very caustic if you get it
out of the vein. Will swell and may slough out. Tablets are bitter
. Also comes in paste form and powder form. 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.
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.
3.
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.
4.
Arquel (meclofenamic
acid)– comes as granules to put in feed. 2 packets is usual dose.
5.
Aspirin – Oral
*
STEROIDAL ANTI-INFLAMMATORIES INHIBIT THE BODY’S NORMAL HEALING PROCESSES AND
INHIBIT BODY’S NORMAL IMMUNE RESPONSE. NSAID’S DO NOT.
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 intraarticularly 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.
My opinion is these oral products are an effective long term therapy for equine
athletes with chronic joint problems.
6.
These products are not nearly as expensive as the injectables.
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.