Ask the Vet: Alternative Therapy

Answered by Chris Newton, DVM, Rood & Riddle Equine Hospital, Lexington, Ky.

Question: I am an equine sports massage therapist. As such, I do get called on to massage horses rehabbing from injuries not just helping to keep them working well for their jobs. What benefits have you seen from adding in professional equine massage therapy as an adjunctive therapy for horses in rehab? In my experience, I find there is no replacement for hands on therapies.

 Answer: The use of massage therapy has been a common practice in human and equine sports therapy for quite a long time. This modality of therapy is practiced with multiple different techniques or “schools” of practice. There are schools which offer certification, but most states don’t license equine massage therapists and it is to be managed under veterinary guidance.

The application of massage therapy is used to identify and treat soft tissue pain in the body. Through manual palpation and pressure, areas of pain, tightness, and diminished circulation can be identified and massaged. The manual strength of the practitioner is needed to apply the therapy to deeper tissues, so this modality can put a lot of pressure on the masseuse.

There have been quite a few studies done to evaluate the benefits of massage therapy. It has been looked at as a method to diminish injury as a pre exercise treatment or to improve time of healing as a post injury treatment. Unfortunately, few studies have shown significant benefit in either category. However, massage therapy has been shown to provide a short term improvement in discomfort and improved performance immediately following treatment.

If the massage therapist is used as part of the therapeutic team with the veterinarian, farrier, trainer and rider, they can provide additional information to how the body is responding to work and conditioning; and whether there are new or chronic areas of discomfort. The modality can be utilized to improve how the horse feels and performs, and improve it’s outlook towards work as a consequence. Hopefully, both rider and horse can enjoy a good rub down before their next show.

Question: I have a 4-year-old Thoroughbred filly that has a sarcoid or what my vet thinks is a sarcoid. They have no idea how to treat it. I was wondering what is the best method of treatment? She also has mild arthritis and tendonitis in that same leg where the sarcoid is located. Would complementary therapy work for any of these conditions?

 Answer: The equine sarcoid is a skin tumor which is currently thought to come from infection with a bovine papilloma virus. Papilloma viruses are the cause of warts and other types of epithelial skin tumors in multiple species, and they are generally species and region specific. The other type of skin growth in horses, which is associated with a papilloma virus, is milk warts; which young horses generally get around their muzzle. Unlike milk warts, which almost always go away with mild or no treatment, equine sarcoids can be quite difficult to resolve completely.

There are several different approaches to treat equine sarcoids. One of which is to get the horse’s immune system to recognize the virus and then mount an immune response and kill it throughout the body. The other is to kill the cells affected with the virus with surgical, thermal, or chemical methods.

The first method of triggering the immune system to attack the virus is accomplished with immuno stimulating medications. Blood root is the most common of these products and it can be applied topically, injected intralesionally, or given orally. Other non-specific immuno stimulants such as Noni juice have been used in conjunction or separately from the blood root. This method will create an inflammatory response at the site of the sarcoids, which can cause pain and swelling short term but if effective horses will often eliminate all sarcoids on the body not only the one which was treated.

The second method of destroying the virus in the affected region has multiple approaches. Surgical removal has a high rate of recurrence. Cryo therapy has a high rate of reoccurrence and often leaves unsightly scars. Intralesional injection with the chemotherapeutic cisplatin has shown promise and is likely the best form of this method for treatment. This method generally causes less reaction at the site of treatment but will not eliminate other sarcoids in the body and has a higher rate of reoccurrence.

There are multiple ways to treat sarcoids, which means no method is perfect, and each case should be treated as an individual. Complementary therapy will be helpful in managing the arthritis, tendonitis, and improving the immune function of your horse to assist in treating the sarcoid, but is unlikely to cure any of them. Good luck in treating your horse, and I hope you are back in the saddle soon.