$ENGLISH conditioner Luca Cumani was astounded when Racing Victoria Ltd. (RVL) announced they were investigating Bauer’s second place finish in the Aus$5.65 million Emirates Melbourne Cup on November 4, 2008. He acknowledged the six-year-old horse, who had won the 2008 Geelong Cup in preparation for Australia’s biggest race, had some pain in his hindquarters and underwent shockwave therapy on October 30, 2008. The treatment was recommended by Dr. Rob McInnes, a veterinary surgeon employed by RVL. “Maybe I should have been more familiar with the rules,” said Cumani, in an interview with Sydney Radio. “This kind of therapy is used all over the world and in England cannot be used only on race day. We were following the advice of one of their veterinary surgeons. The horse deserved to finish second.” Australian Rule of Racing 64H, which was introduced in June 2004 and had never been violated previously, states, “A horse that has been subjected to any form of shockwave therapy shall be ineligible to race or take part in any trial in the seven days following such treatment.” RVL discovered the transgression after McInnes submitted his invoice on November 11 and listed the procedure. After conducting a probe, they announced that Bauer’s placing would stand and his connections would retain all purse monies. “We have taken legal advice from a senior Queen’s Counsel who is an expert in this field of the law,” RVL explained in an official statement on December 3. “In essence (though expressed in many different ways) that advice is that in circumstances where the otherwise ineligibility of Bauer was caused as a result of actions taken by a veterinary surgeon specifically assigned by RVL to be responsible for the veterinary care of the visiting horse (and who Mr. Cumani for that very reason was entitled to assume was fully familiar with the Australian Rules of Racing) AR64H can have no application. In these 30 TRAINERMAGAZINE.com ISSUE 12 SHOCKWAVE.qxd:Jerkins feature.qxd 6/4/09 22:47 Page 1 SHOCKWAVE THERAPY for at least four days after ESWT or RSWT treatment,” stated McClure at the 2003 American Association of Equine Practitioners Convention. McClure and his associates conducted another study presented at the 2006 American Association of Equine Practitioners Convention and published in the July 2006 edition of the Journal of the American Veterinary Medical Association that buttressed his former results. He evaluated nine horses with acute forelimb lameness during seven days of shockwave treatment. “There was significant analgesia after ESWT from eight to 48 hours after treatment,” McClure wrote. “Horses should have limited exercise for a minimum of 2 days after shockwave therapy to avoid potential injury caused by a lack of pain perception. For this reason, racing jurisdictions in the United States and the Federation Equestre International have adopted regulations that require a five-toseven day period after treatment before the horse is allowed to perform.” Shockwave therapy in humans and other mammals has been shown to affect nerve endings and blood vessels, which could contribute to the fleeting analgesic affect. In horses, however, not enough research has been completed to ascertain if this is true. In a study presented at the 2006 American Association of Equine Practitioners Convention, Mauro Verna, DVM, now of La Plata University in Argentina, and colleagues from his residency program at the University of Minnesota used non-focused shockwave ISSUE 12 TRAINERMAGAZINE.com 31 Shockwave treatment was introduced to equine medicine in the mid to late 1990s circumstances it is not open to RVL Stewards to apply the Rule.” A shockwave is a high intensity acoustic wave created by a machine which is targeted to a specific location of the body. The waves pass through fluid and soft tissue and affect areas only where there is a tissue change, such as where bone and soft tissue meet. It is still unknown how shockwaves specially stimulate the healing process, but they do reduce inflammation, increase blood flow and promote the creation of new bone. They might also aid in destroying hematomas in tendon lesions, which enables new tendon to be laid down more rapidly. Although the effects of shockwaves from detonated bombs were first noticed during World War II, there was a relatively small amount of interest in using this therapy for human medicine until 1966 in Germany after an experiment with high propensity projectiles. The German Department of Defense financed the research project on shockwaves and in 1971 this mode of treatment was used to splinter kidney stones in humans so they could be passed through the body. The first machines for commercial use were built in the early 1980s and by 1985, had been used for gall bladder stones. Currently, shockwave therapy is the preferred form of treatment for kidney and gall bladder stones, but is also used throughout the world to treat heal spurs and tennis elbow. Scientists are researching whether shockwave can be used to remedy various forms of tendonitis and stress fractures. Shockwave therapy was introduced to equine medicine in the mid to late 1990s for proximal suspensory desmitis and navicular pain. There are two different types of shockwaves: extracorporeal and radial. Radial shockwave therapy (RSWT) is less pressured and therefore, does not penetrate as deeply. “Extracorporeal shock therapy can be a valuable noninvasive mechanism to stimulate healing of some musculoskeletal injuries in horses,” said Dr. Scott McClure, DVM, of Iowa State University in Ames, Iowa. “A major concern of ESWT in horses is the potential for analgesia after therapy.” If analgesia is induced in a horse, it may not experience pain to a varying degree, even to the extent of having no consciousness of pain, and as such could severely increase the amount of damage to the injured area through overuse. Since this increases risk to the horse and his rider, precautions must be taken to ensure the analgesic affect has disappeared once the horse returns to work. “This data indicates a horse should not be subjected to strenuous activities where local analgesia might pre-dispose them to injury “Maybe I should have been more familiar with the rules. This kind of therapy is used all over the world and in England cannot be used only on race day” Luca Cumani SHOCKWAVE.qxd:Jerkins feature.qxd 6/4/09 22:47 Page 2 race days, and control physical treatments on race days, but do not specifically control nonmedical treatments before then. “Our rules must however be seen in the context of UK law (Animal Welfare Act 2006) which both impose a ‘duty of care’ to ensure freedom from injury and suffering,” he continued. “This means both adequate treatment, but also not being able to do something that places a horse at risk of injury. That includes a pain relieving treatment that could mask injury and/or makes the injury worse.” McClure contends that shockwave treatment still has many benefits and its use should be approached cautiously. “There are an array of injuries that could benefit from the use of shockwave therapy,” he said. “We still don’t know everything about it but we should continue to use it, just very carefully.” ■ therapy on the blood vessels in the fore and hind limbs of five ponies. They concluded shockwaves do not alter digital blood vessels in a horse over a short period of time. Like medications, the use of shockwave therapy prior to racing or competing varies widely throughout the world. The Association of Racing Commissioners International Rule 011-015 Section 5a states: “any treated horse shall not be permitted to race for a minimum of 10 days following treatment.” Most racing jurisdictions in the United States, which are controlled by each individual state, have adopted rules not allowing a horse to compete from 5 to 10 days after shockwave treatment. As Cumani mentioned, British Horse Racing Rules permit horses to undergo treatment up until race day. “Our Rules cover medications as VETERINARY 32 TRAINERMAGAZINE.com ISSUE 12 treatments, and prohibit treatments on race day,” explained Dr. Tim Morris, DVM, PhD, Director of Equine Science and Welfare at the British Horse Racing Authority in London. “We also control stable access on$

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(08 April 2009 - Issue 12)

Apr 8 Shockwave Therapy - stimulating the healing process

Apr 8 Backstretch Welfare Programs

Apr 8 Ligament Injuries - how to diagnose and treat them