buyer beware: not all shock wave therapy is created equal

ya’ll can probably tell that auto is still lame. i’m not the most prodigious blogger, but i would have been shouting from the rooftops if we had received the all clear for rehab. but no, that was not the case.

it’s not all bad. he’s definitely showing improvement, and dare i say there seems to be a light at the end of the tunnel. in any event, he needed a follow-up from his follow-up, and i was suspicious he had some ulcers going on, so i called a different, highly recommended vet for an exam/second opinion.

at our april follow-up, auto saw the doc who diagnosed his suspensory strain in early march. he was given a cortisone injection in the ligament to “speed the healing.” he had sprung both his front shoes, so the doc was concerned that was a complicating factor. he prescribed shoeing and two weeks of walking under saddle (on soft ground. that seems really weird to me) before recheck. i wasn’t feeling all that confident in his instructions, but with the bare feet complicating things, i didn’t want to argue.

so, last friday auto got his shoes tapped back on. i saddled him up first thing saturday morning, excited to have my ass back in his saddle. well, that excitement quickly faded. he was as angry and reactive to my leg as he had been before: head straight up, ears pinned, wide eyes. i was deflated. we walked for a bit more, with very few/only absolutely necessary asks to yield to my leg, and i untacked him. i felt pretty confident i was dealing with ulcers (and kicking myself for not putting two and two together sooner), and palpated his ulcer points. DING DING DING. i immediately hit the internet for a plan of action, and decided i wanted a new vet. (more about the ulcers/treatment/rant about how this is related in another post.)

the doc came out on thursday, confirmed ulcers immediately and moved on to the suspensory. he proposed a shock wave session, and likely a second one in two weeks. i explained that auto had SWT when he was first diagnosed–not to avoid the present SWT session, but just as point of fact. the doc said, “great, i’m sure it helped, but let me give you a bit of info about different kinds of SWT.”

he brought out his machine, set it up, and explained that it is an extracorporeal shock wave therapy (ESWT) machine, rather than a radial SWT machine, which he believes is a less effective type of SWT for deep tissue injury. i had no idea there might be different types of SWT! i wrongly figured that shock wave is shock wave.

of course the SWT at the original diagnosing vet was radial. shit. the suspensory ligament runs nearly through the center of the leg. it is not at a superficial depth. thus the RSWT probably did diddly squat.

“Radial shockwaves are well suited for indications near the surface. Radial is indispensable for smoothing the muscles before or after focused shock wave treatment. For the therapy of deep local pain points, chronic insertion tendinitis and deeper trigger points, the application of focused [extracorporeal] shockwaves seems to be favorable.

VersaTron depth chart.  the doc used a VersaTron on auto.

VersaTron depth chart.
the doc used a VersaTron on auto.

so the new doc administered the session (no anesthesia, which really pleased me), and even let me feel the shock. when he finished up with auto he turned the machine down as low as it would go and held it to my arm. HOLY COW! and auto received 7 times the intensity and 1000 pulses. no wonder they usually sedate the horses. (don’t worry, auto wasn’t in pain, and handled his session like the champ that he is!).

doc told me that he once treated a 5/5 lame show horse with one session. when he returned in 14 days to do session two, the horse was .5-1/5 on the lameness scale. with the second session, the horse was sound. auto at this visit rated .5/5, so i feel hopeful, even though that is just anecdotal evidence. with one to two sessions of ESWT, his new nimble supreme supplement, his ulcer treatment, and feed changes, i am optimistic that he is on the mend.

i also feel angry that i didn’t know any better at his first session and that we’ve likely lost ten weeks of work to my lack of education. so, buyer beware. not all SWT is created equal. since it has become such a common and effective treatment modality for lameness, i urge you to know which type of SWT is right for your horse!


5 thoughts on “buyer beware: not all shock wave therapy is created equal

  1. thanks for sharing this info! i am so very sorry that you had to learn all about it in the way that you did… and it’s super crappy (shady?) the way things worked out with your earlier vet – but hopefully things are headed in the right direction now! good luck!

    Liked by 1 person

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