Homestead Veterinary Hospital

May 2006

Homestead Veterinary Hospital conducted a survey in April 2006 of clients whose horses had been treated with shock wave therapy in the past 15 months. By late May, more than half the surveys were filled out and sent back. Of those who responded, 67 percent showed significant improvement, with a majority of those horses returning to complete soundness.

The positive results were
on par with national statistics
and confirmed how useful the
treatment is for many types
of injuries. In the largest U.S.
study conducted so far,
71 percent of the horses
resumed full work six months
after treatment, and those
patients were chosen much
more selectively. Homestead
has been trying shock wave
on a broad range of injuries.

Dr. Mark Cassells is one of a growing list of veterinarians who have become big fans of the treatment. “It’s a noninvasive procedure that can’t hurt horses,” Cassells says. “It should be at the top of the list of things to try before more invasive procedures.”

The device emits shock wave impulses that are transmitted in a radial fashion into the targeted area. The shock waves make the tissue behave as if it has just been injured, which activates a healing response from the body, as if the body is being taken back to the time of the injury. In chronic injuries, the body has reached the point of ignoring the damaged area.

Equine physiotherapist shares experiences

Homestead’s success stories don’t surprise Trish Quirion-Henrion, an equine physiotherapist who pursuaded Dr. Don Walsh to investigate shock wave therapy a few years ago. Henrion is a resident of LaGrange, Ky., and longtime friend who breeds and races thoroughbreds, while also riding dressage. A tireless commuter, Henrion works as an equine physiotherapist every other week for the New England Equine Medical and Surgical Center in Dover, N.H.

The hospital (formerly the Rochester Equine Clinic) has been using shock wave therapy since 2001 after Henrion attended a meeting of the American Association of Equine Practitioners and talked to a veterinarian presenting a paper based on a major study on shock wave therapy, Dr. Joseph Boening.

“I was so impressed with the possibilities,” she says of the treatment, adding that the hospital became one of several centers to take part in a clinical trial for a year. “We ended up buying a machine because we believed in it so much,” she said. New England Equine has continued studies and presented its findings at meetings of the World Equine Veterinary Association as well as other groups.

Henrion’s main area of study has been shock wave’s effect on suspensory ligament injuries. “We have found it to be unbelievably helpful,” she says.

Cassells notes that many vets inject soft tissue injuries repeatedly with A-cell and steroids, invasive procedures with risks, when those same injuries could be treated with shock wave therapy with no risks and perhaps bigger benefits.

Henrion agrees that the treatment is safe. “We have yet to see any adverse affects; we have yet to see a down side,” she says.

Shock wave uses Shock wave therapy can be used for a number of large animal injuries: any ligamentous injury, particularly those where the ligament attaches to the bone; certain bone conditions; sesmoid fractures, bucked shins; stress fractures and navicular disease. It also can be used for pain control, such as with chronic back pain, and for tissue healing.

On small animals, it can be used for hip dysplasia and knee and shoulder injuries. One manufacturer of the equipment, EMS America, says that demand from equine practices is high, but the company is really seeing a surge in need from small animal practices.

European counterparts are leading the trend

The United States apparently has been slow to catch up to its European counterparts in using the therapy.

“Shock wave was used much more extensively in Europe before we got on the bus,” Henrion says, especially for human treatments. The FDA currently is conducting trials for certain human uses.

The treatment takes five to 10 minutes to complete. The horse remains standing and requires mild sedation in order to remain still. The area to be treated is shaved, and 2,000 impulses are administered. The treatments are given 10 to 14 days apart, and a minimum of three treatments is recommended.

When asked to compare the cost of treatment on the East Coast to that offered by Homestead, Henrion said it was obvious that Homestead’s No. 1 priority was getting the patients treated. The cost in St. Louis is considerably less.

Henrion talked about a horse — a 17-hand older thoroughbred crossbred named Grover — who had been lame for a year with a high suspensory injury, in which the ligament was partially torn away from the bone. The horse was given five shock wave treatments and improved markedly. A year later, he was back to fox hunting. Henrion said that example proves that age does not seem to have any indication of how a horse will respond, nor do old injuries. The procedure can help many seemingly lost cases.