Multimodal therapy for treatment of equine back pain: a report of 15 cases.

Back pain and diseases of the spine are considered significant problems in equine sports and veterinary medicine. This article reports a multimodal approach to the treatment of equine back pain using ozonized platelet rich plasma (PRP), dynamic mobilization exercises, and therapeutic shoeing in 15 horses involved in the vaquejada discipline. Fifteen American Quarter Horses of both sexes engaged in vaquejada in the state of Rio Grande do Norte, Brazil, with a mean age of 8.61 ? 1.73 years were examined at a training center for lower performance diagnostics or back pain. A complete clinical examination was performed on all horses at rest to determine the general conformation and alterations in posture, symmetry, and curvature of the spine. The horses were examined while walking and trotting in straight lines and circles to determine the presence of lameness and/or gait asymmetry. Spinal abnormalities on clinical examination were classified on a scale of 0 to 5 based on the following parameters: degree of response to pain from back palpation, hypertonicity of the back muscles, stiffness of the thoracolumbar joint, and physical dysfunction. After physical examination, ultrasound was performed to identify the cause of the thoracolumbar pain. The therapeutic protocol consisted of the intralesional application of ozonized PRP combined with therapeutic ultrasound, dynamic mobilization exercises, and therapeutic shoeing. All treated animals returned to sports activities at a higher level of performance than at the beginning of the treatment. Six months after treatment, telephone contact was made with the owner or trainer to determine if the back pain had relapsed. None of the animals relapsed during this period, and they participated in vaquejada normally.