In part one of this three-part series we featured Dr. Scott Hie, a doctor of chiropractic, who gave us the lowdown on his work. In part two we featured Sidonia McIntyre, RMT, CEMT, CCF, who is the owner/head instructor of the School of Equine Massage and Rehabilitation Therapies. In our final instalment we feature Dr. Kathryn Surasky, DVM, an associate veterinarian at McKee Pownall Equine Services, who has been part of their team since 2008. She is certified in acupuncture and veterinary spinal manipulative therapy (chiropractics).
HC: What does acupuncture work achieve in horses?
KS: There are multiple ways in which acupuncture work can aid a horse. There are two main theories, or mindsets, regarding acupuncture – one is traditional Chinese medicine (TCM) and the other is a more “science-based” approach. Traditional acupuncture focuses on restoring the balance of the body – yin and yang. Traditionally, working with the horse’s qi (pronounce chee), or energy, and restoring normal flow of this qi, restores normal function. Those professionals who are taught through the more scientific-based courses focus on stimulating specific nerves and receptors to treat specific conditions in the body.
Both systems use an acupuncture point system based on meridians – lines over the surface of the body with points on them. In my practice, besides treating conditions, I also use acupuncture to monitor my athletic patients over time. I have found that we are able to identify problems or weaknesses, ideally before they become clinically significant, by monitoring the horse overtime.
HC: How can you assess where the problem issues are in a horse before treatment?
KS: As in any typical appointment, evaluation of the horse starts with a thorough history. Knowing as much relevant information as possible is invaluable – such as when the issue was first noticed, progression of the issue, any change in the horse’s routine, any response to therapies, what the horse does for a living and goals as to what the horse should be doing for a living are some examples of this important info.
I typically then like to evaluate the horse in a quiet location (such as a grooming stall or cross-tie area) and evaluate the horse from afar looking for symmetry between sides (muscle development, limb swellings, etc). I then will run my hands over the horse essentially feeling along the meridians for any areas of tension, pain, heat. I usually follow this up by using a capped needle to “scan” the horse over these meridians as well to watch for any flinching or reaction to certain spots. Often then I will also pick up and palpate the limbs evaluating for pain, inflammation, swelling, etc.
Depending on the case and how familiar I am with the patient, we may need to watch the horse move – either under saddle, in hand, or on the lunge. Dynamic flexion tests may or may not be used to evaluate for any possible limb pain. Then all these pieces of the puzzle are arranged and a treatment plan is formed.
During an acupuncture treatment, there are horses that may resent the needles being placed, however once in, the vast majority of horses relax and seem to thoroughly enjoy their treatment.
HC: What are the most common issues you see?
KS: Being focused on sport horse work in my job, so I mainly see horses for performance issues. This can range from lack of performance to something more specific like a sore back or resistance in the bridle. Finding discomfort through these evaluations of the meridians does not necessarily mean there is an underlying problem, as these are athletes and like their human counterparts they can suffer from stiffness or mild muscle discomfort from the athletic demands they are asked to perform.
HC: What outcome should an owner expect after one or a few treatments?
KS: Outcomes are based on what condition or problem is being addressed. Certain situations are chronic conditions that acupuncture can help minimize discomfort and aid in improving performance, but if the underlying issue cannot be resolved, then the patient will continue to need further acupuncture treatments. Issues such as joint arthritis and conformational flaws would be examples. These conditions are managed over time, not cured. The horse would also continue to need treatments to help with back pain, for example, from ill-fitting tack, until the tack situation can be rectified. If the situation is a muscle spasm, one acupuncture treatment can likely be curative.
HC: How many treatments are necessary to correct an issue? I assume it varies, depending on severity, but should horses be in a program? Monthly? Quarterly? Or just when there’s an issue?
KS: The number of treatments required does vary with the underlying condition and the demands being placed on the horse. It can also vary with the type of acupuncture performed. This can range from dry needles (acupuncture needles only) to electrical stimulation acupuncture (wires are attached to needles and a small electrical current is applied which helps stimulate the point more robustly) to aquapucnture (a small volume of sterile liquid eg. Vitamin B12 is injected into certain acupuncture points). It is not uncommon for a horse to need 2-3 treatments in the first 1-3 weeks and then often this interval can be prolonged to suit the horse’s condition/athletic demands. Some horses are only seen when there is a concern.
HC: How does a horse owner know when acupuncture is needed vs injections or massage or chiropractic?
KS: Knowing what treatment modality will be most effective is not always easy and clear-cut. I definitely feel it’s an advantage that I am also a DVM so I am able to evaluate the horse from a variety of ways and can offer a variety of treatments from acupuncture, veterinary spinal manipulative therapy, or more traditional veterinary treatments such as joint injections or medications. Factors that often need to be considered are the plans for the horse (for example, a lot of joint injections would require that the horse not show for a period of time to allow for drug withdrawals, while acupuncture does not) and also determining what the individual horse responds to the best. Body work can often help prolong the interval between more invasive veterinary work.