Adjunctive therapeutic guidance
The guidelines' specific adjunctive therapeutic treatment recommendations include:
Extracorporeal shockwave treatment (ESWT): The AAEP recommends that this form of treatment not be used within five days of competition since the length of therapeutic
(analgesic) effect of ESWT is controversial. Committee chairperson Nathaniel White, DVM, MS, Dipl. ACVS, of Virginia Tech
College of Veterinary Medicine says, "Immediately after shock-wave administration, we're concerned there's some analgesia
that may cover up a painful condition that you wouldn't want to have present in competition or in a place where the horse
might be injured."
Acupuncture and chiropractic therapy: The AAEP recommends these therapies be based on a valid diagnosis and administered by or under the direct supervision of
a licensed veterinarian. "There isn't a lot of information about acupuncture or chiropractic therapy in competition practice,
so we haven't come out with a major recommendation in regard to their use," says White.
Cold therapy: This form of therapy is considered a valid treatment when used for a specific condition. Cold therapy machines that can cool
below 32 F (0 C) should never be used. White acknowledged that cold therapy is a valid treatment. The concern with this therapy
is that the tissue not be subjected to excessive cooling or freezing. "Cold therapy is very beneficial to performance horses
if it isn't abused, producing frostbite," he says.
The task force did not specifically address nutritional supplements. "There's some question about whether various nutritional
supplements used to treat the competitive horse (e.g., oral hyaluronic acid, chondroitin, glucosamine) are absorbed (i.e.,
biologically available) and whether they're doing what they're prescribed for, what the label says they do," says White. "I
don't think there's any harm, as with oral hyaluronic acid, but is it getting to the joints and effective to assist joint
function? I'm not sure anybody knows. To me, it's a matter of whatever is safe for the horse and then buyer-beware, because
we don't have any scientific proof that it's effective."