Evidence-Based Medicine (EBM) in horses involves the systematic use of current, peer-reviewed research and clinical expertise to make informed decisions about equine healthcare. EBM aims to integrate the best available scientific data with practical knowledge to optimize treatment outcomes for horses. This approach includes the assessment and application of research findings to guide clinical practices, diagnostic procedures, and therapeutic interventions. By utilizing evidence-based methodologies, veterinarians and equine health professionals can improve the accuracy of diagnoses and the effectiveness of treatments. This page compiles a collection of peer-reviewed research studies and scholarly articles that explore the principles, application, and impact of Evidence-Based Medicine in the field of equine health.
O'Connor A, Totton SC, Hernandez M, Meyers E, Meyers K, Abreu HM, Spofford N, Morrison J.Barriers to accessing veterinary care can be challenging for companion-animal caregivers and may lead to preventable health conditions or even death of pets. Objective: We conducted a scoping review to: 1) catalog the definitions of access to veterinary care (A2VC) used by researchers, 2) identify risk factors for and consequences of A2VC, and 3) map the risk factors onto dimensions of access to care (affordability, availability, accessibility, accommodation, acceptability). Methods: Primary research on companion animals not involved in commercial enterprises (e.g., horse racing) examining con...
Furtado T, Perkins E, Archer DC.Research on the outcomes of veterinary treatments in dogs, cats and horses has important benefits for these animals and their owners. However, this information is not always available, and the evidence base is often lower-quality than in human medicine. To identify ways to improve the generation of evidence, we investigated the views of veterinary professionals about research involving companion animal patients and their owners. This qualitative study used semi-structured interviews with veterinary surgeons and registered veterinary nurses working in UK companion animal clinical practice. Inte...
Citarella G, Heitzmann V, Ranninger E, Bettschart-Wolfensberger R.This systematic review aimed to identify the evidence concerning the analgesic efficacy of non-steroidal anti-inflammatory drugs to treat abdominal pain in horses, and to establish whether one non-steroidal anti-inflammatory drug could provide better analgesia compared to others. This systematic review was conducted following the "Systematic Review Protocol for Animal Intervention Studies". Research published between 1985 and the end of May 2023 was searched, using three databases, namely, PubMed, Embase, and Scopus, using the words equine OR horse AND colic OR abdominal pain AND non-steroidal...
Cantatore F, Pagliara E, Marcatili M, Bertuglia A.Obtaining a healthy wound environment that is conductive to healing in horses can be challenging. Negative-pressure wound therapy (NPWT) has been employed in humans to enhance wound healing for decades. The existing evidence for the effectiveness of NPWT remains uncertain in equine medicine. The aim of this review is to investigate NPWT applications and benefits in horses. A scoping review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (PubMed, Web of Science-Thompson Reuters, and Wiley...
Barton CK, Goodrich LR.The use of radiofrequency energy (RFE) has become increasingly popular in equine orthopedic surgery in recent years, particularly for the debridement of cartilage lesions and soft tissue resection. However, despite considerable advancements in the technology, the safety and efficacy of RFE have continued to be questioned. While studies investigating the use of RFE for chondroplasty in the equine population are lacking, there is an abundance of research studies in the human literature assessing its effect on healthy chondrocytes, and researchers are seeking to develop guidelines to minimize col...
Offer KS, Dixon CE, Sutton DGM.The sarcoid is the most common equine cutaneous neoplasm. Evidence-based treatment of this condition is often lacking, and selection of treatment modality based on clinical experience or anecdotal evidence. Objective: To assess the quality of the currently available best evidence regarding the treatment of the equine sarcoid. Methods: Systematic review. Methods: In compliance with PRISMA guidelines, literature searches were performed in PUBMED, Web of Science, CAB Abstracts, EMBASE (Ovid) and Scopus in April 2021. Included papers were required to describe an interventional study examining sarc...
Adair S.This article serves as an introduction into integrative case management as it applies to the horse's mental health, pain management, and tissue healing. The integrative philosophy pertains to the combination of conventional Western medicine and complementary and alternative therapies to provide the best patient care possible using currently available evidence. The goal is to improve the health of the patient in a more holistic manner.
Landa L, Trojan V, Demlova R, Jurica J, Hrib R.In connection with the use of cannabinoids for therapeutic purposes in human medicine, there is increased attention for their use in veterinary medicine, particularly by the owners of companion animals and horses. Therefore, veterinarians are expected to face this interest and have the corresponding knowledge on these substances. Presently, it is not possible to use medical marijuana (in terms of the dried cannabis flowers) for veterinary purposes in many countries, but there is increasing evidence that isolated cannabinoids also have beneficial effects (namely cannabidiol - CBD)...
Potvin-Bélanger A, Vincent C, Freeman A, Flamand VH.The aim was to document the effects of hippotherapy on the 12 life habits of children with various disabilities. A systematic review using PRISMA guidelines was conducted to identify relevant studies. Five databases were consulted. Inclusion criteria were: 2-to-18 years old; therapy provided by a PT, OT or SLP/SLT; variables relevant to life habits as defined by the Human Development Model - Disability Creation Process. Quality was analyzed using a quantitative studies critical review form developed by the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Level...
Clarke EJ, Gillen A, Turlo A, Peffers MJ.Horses are used in a variety of equestrian disciplines predisposing them to musculoskeletal injury or disease including osteoarthritis and tendinopathy. As a result, a number of preventative measures are used within equine medicine and husbandry, ranging from therapeutic shoeing to the use of nutraceuticals. Despite their popularity and routine use evidence base and clinical outcomes are variable, bringing into question the efficacy of these prophylactic measures. In recent years a small number of studies have been performed examining the effect of specific strategies in order to quantify the ...
Nieforth LO, Schwichtenberg AJ, O'Haire ME.In the last five years, the literature on animal-assisted intervention (AAI) for Autism Spectrum Disorder (ASD) has doubled in size from 42 studies prior to 2015 to 85 studies (cumulative total assessed in 2020). Horses remain the most commonly researched animal for AAI, followed by dogs. The most commonly researched outcome was social interaction, across 21 studies. Though the quantity of studies has increased, issues with methodological rigor remain. Results highlight the need for a continued focus on methodological rigor as well as refining the structure of animal-assisted interventions, ad...
Gozalo-Marcilla M, Ringer SK.Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords "recovery anaesthesia horse", entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 "narrative reviews/expert opinions", 16 "retrospective outcome studies", 5 "surveys", 59 "premedication/sedation and induction drugs", 27...
Lawson A, Pinchbeck G.When planning to conduct research, thorough consideration of the study design is essential to enable valid results and purposeful conclusions. A good study design will provide a strong basis for robust conclusions that can contribute to the evidence base. Conversely, a poor study design may unintentionally lead to invalid conclusions with inappropriate claims of the clinical importance. The purpose of this article is to review important aspects of observational study design, with an emphasis on observational clinical research. The value of an observational study can be manifold and the benefit...
Guindos-Sanchez L, Lucena-Anton D, Moral-Munoz JA, Salazar A, Carmona-Barrientos I.Cerebral palsy (CP) is a permanent disorder of the posture and movement, which can result in impairments of gross motor function, among others. Hippotherapy (HPT) is an emerging intervention to promote motor recovery in patients with neurological disorders, providing a smooth, precise, rhythmic, and repetitive pattern of movement to the patient. The main objective of this systematic review and meta-analysis of randomized controlled clinical trials was to analyze the effectiveness of HPT interventions on gross motor function in subjects with CP. The following databases were searched in May 2019...
Kinnison T, Cardwell JM.Inflammatory airway disease (IAD) is a commonly diagnosed but variably defined syndrome of equine lower airway inflammation. The most recent American College of Veterinary Internal Medicine (ACVIM) consensus statement, informed by research evidence, recommends a case definition based on clinical signs (poor performance or occasional coughing of at least 3 weeks duration), increased endoscopically-visible tracheal mucus, and bronchoalveolar lavage cytology, and proposes that the condition should be termed 'mild-moderate equine asthma' (mEA). In British Thoroughbred racehorses, research to date ...
Buczinski S, Ferraro S, Vandeweerd JM.Evidence-based medicine (EBM) is used in various areas including veterinary medicine. The assessment of the quality of systematic review and meta-analyses (SR-MA) despite their importance in the EBM process is uncommonly performed in veterinary medicine due to the absence of specific dedicated tools. The main objective of this observational study was to examine the extent and nature of SR-MA that can be available online to an equine or bovine veterinarian. Secondary objectives included: (1) to determine if A MeaSurement Tool to Assess systematic Reviews (AMSTAR) tool can be used for equine and...
Muir WW, Ueyama Y, Noel-Morgan J, Kilborne A, Page J.To evaluate the quality of the veterinary literature investigating IV fluid therapy in dogs, cats, horses, and cattle. Methods: Systematic review. Methods: The preferred reporting of items for systematic review and meta-analysis protocols (PRISMA-P) was employed for systematic review of all relevant IV fluid therapy manuscripts published from January 1969 through December 2016 in the Commonwealth Agricultural Bureaux International (CABI) database. Independent grading systems used to evaluate manuscripts included the updated CONsolidated Standards of Reporting Trials 2012 checklist, risk of bia...
Stanley SD, Moffitt K, Wiebe V.Equine practitioners should follow these recommendations when using compounded medications: (1) the decision must be veterinary driven, based on a valid veterinarian-client-patient relationship and on evidence-based medicine; (2) compliance with the Animal Medicinal Drug Use Clarification Act of 1994; and (3) use limited to (a) horses for which no other method or route of drug delivery is practical; (b) those drugs for which safety, efficacy, and stability have been demonstrated; or (c) disease conditions for which a quantifiable response to therapy or drug concentration can be monitored.
Tsantefski M, Briggs L, Griffiths J, Tidyman A.Children exposed to problematic parental substance use (PPSU) often face a number of deleterious developmental outcomes, yet these children are less likely to become known to child protection and welfare services. Although there is a growing evidence base for equine-assisted therapy (EAT) as an effective treatment modality for atypically developing children and adolescents, scant research has explored the benefit of EAT for children exposed to PPSU. The current study is the first to explore the benefit of EAT for children exposed to PPSU in Victoria, Australia. Five 12-week EAT programmes were...
McElhone RL, Meakin GE, French JC, Alexander T, Morgan RM.A study was designed to investigate the effects of external variables, including blood type, flooring surface, footwear tread depth and blood dryness, on the appearance of blood-based footwear marks, with particular reference to simulating a specific casework scenario. Results showed that footwear marks left in human blood tended to be of greater quality than those in equine blood, highlighting a potential issue in applying data generated with equine blood to human bloodstains in casework. Footwear tread effects were also dependent on blood type, but the type of flooring surface did not affect...
Goff L.Physiotherapy assessment of the equine athlete is carried out by qualified physiotherapists, who use a functional approach to the assessment of the horse. Observation, clinical reasoning, good palpation skills and implementation of outcome measures are skills used by these professionals in their assessment of the horse. Equine physiotherapists attempt, where possible, to use an evidence-based approach to the assessment of the equine athlete.
Wilkinson JE, Frost H.This commentary considers the vexed question of whether or not we should be spending time and resources on using multifaceted interventions to undertake implementation of evidence in healthcare. A review of systematic reviews has suggested that simple interventions may be just as effective as those taking a multifaceted approach. Taking cognisance of the Promoting Action on Research Implementation in Health Services (PARIHS) framework this commentary takes account of the evidence, context and facilitation factors in undertaking implementation. It concludes that a 'horses for courses' approach ...
Sullivan SL, Whittem T, Morley PS, Hinchcliff KW.Furosemide is the most commonly used medication for exercise-induced pulmonary haemorrhage (EIPH); however, critical evaluation of the strength of evidence for efficacy of furosemide is lacking and is warranted so that evidence-based treatment decisions can be made. Objective: To evaluate the efficacy of furosemide to reduce the severity or frequency of detection of EIPH in Thoroughbred and Standardbred racehorses. Methods: Systematic review with meta-analyses. Methods: Primary studies were identified via searches of electronic databases, relevant texts and reference lists of published article...
Anestis MD, Anestis JC, Zawilinski LL, Hopkins TA, Lilienfeld SO.Equine-related treatments (ERT) for mental disorders are becoming increasingly popular for a variety of diagnoses; however, they have been subjected only to limited systematic investigation. Objective: To examine the quality of and results from peer-reviewed research on ERT for mental disorders and related outcomes. Methods: Peer-reviewed studies (k = 14) examining treatments for mental disorders or closely related outcomes were identified from databases and article reference sections. Results: All studies were compromised by a substantial number of threats to validity, calling into question t...
McMichael M, Goggs R, Smith S, Wagg C, Warman S, Wiinberg B.To systematically examine the evidence on system comparability between the thromboelastography and the rotational thromboelastometry viscoelastic point-of-care instruments and to identify knowledge gaps. Methods: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Methods: Academic and referral veterinary medical centers. Results: Medline via PubMed, CAB abstracts, and Google Scholar were searched. A total of 8 rele...
Vandeweerd JM, Coisnon C, Clegg P, Cambier C, Pierson A, Hontoir F, Saegerman C, Gustin P, Buczinski S.Various treatments of osteoarthritis (OA) have been described, including use of nutraceuticals. Objective: To review systematically the literature about the effects of nutraceuticals on clinical signs of pain or abnormal locomotion in horses, dogs, and cats, and to discuss methodological aspects of trials and systematic reviews. Methods: A systematic search of controlled trials evaluating the impact of nutraceuticals on OA in horses, dogs, and cats was performed, using Medline, CAB Abstracts, and Google Scholar. Scientific evidence was evaluated by means of criteria proposed by the Food and Dr...
Taylor PM, Pascoe PJ, Mama KR.This chapter begins by providing an overview of current philosophies relevant to equine pain management. Objective and subjective techniques for assessing pain and the limitations of these are then described in depth. The conclusion emphasizes the need for an evidence based approach to managing pain in the horse and sets the stage for subsequent chapters in this edition.
Anestis MD, Anestis JC, Zawilinski LL, Hopkins TA, Lilienfeld SO.Equine-related treatments (ERT) for mental disorders are becoming increasingly popular for a variety of diagnoses; however, they have been subjected only to limited systematic investigation. Objective: To examine the quality of and results from peer-reviewed research on ERT for mental disorders and related outcomes. Methods: Peer-reviewed studies (k = 14) examining treatments for mental disorders or closely related outcomes were identified from databases and article reference sections. Results: All studies were compromised by a substantial number of threats to validity, calling into question t...
Selby A, Smith-Osborne A.This systematic review examines the empirical literature in an emerging body of evidence for the effectiveness of biopsychosocial interventions involving equines across populations with chronic illness or health challenges. Methods: Selected quantitative studies published in peer-reviewed journals were reviewed for inclusion; the gray literature and white papers were also explored. Population, Intervention, Comparison, and Outcome (PICO) criteria and Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) were applied to all studies. Fourteen full reports meeting a priori inc...
Kinnison T, Cardwell JM.Inflammatory airway disease (IAD) is a commonly diagnosed but variably defined syndrome of equine lower airway inflammation. The most recent American College of Veterinary Internal Medicine (ACVIM) consensus statement, informed by research evidence, recommends a case definition based on clinical signs (poor performance or occasional coughing of at least 3 weeks duration), increased endoscopically-visible tracheal mucus, and bronchoalveolar lavage cytology, and proposes that the condition should be termed 'mild-moderate equine asthma' (mEA). In British Thoroughbred racehorses, research to date ...
Guindos-Sanchez L, Lucena-Anton D, Moral-Munoz JA, Salazar A, Carmona-Barrientos I.Cerebral palsy (CP) is a permanent disorder of the posture and movement, which can result in impairments of gross motor function, among others. Hippotherapy (HPT) is an emerging intervention to promote motor recovery in patients with neurological disorders, providing a smooth, precise, rhythmic, and repetitive pattern of movement to the patient. The main objective of this systematic review and meta-analysis of randomized controlled clinical trials was to analyze the effectiveness of HPT interventions on gross motor function in subjects with CP. The following databases were searched in May 2019...
Muir WW, Ueyama Y, Noel-Morgan J, Kilborne A, Page J.To evaluate the quality of the veterinary literature investigating IV fluid therapy in dogs, cats, horses, and cattle. Methods: Systematic review. Methods: The preferred reporting of items for systematic review and meta-analysis protocols (PRISMA-P) was employed for systematic review of all relevant IV fluid therapy manuscripts published from January 1969 through December 2016 in the Commonwealth Agricultural Bureaux International (CABI) database. Independent grading systems used to evaluate manuscripts included the updated CONsolidated Standards of Reporting Trials 2012 checklist, risk of bia...
McMichael M, Goggs R, Smith S, Wagg C, Warman S, Wiinberg B.To systematically examine the evidence on system comparability between the thromboelastography and the rotational thromboelastometry viscoelastic point-of-care instruments and to identify knowledge gaps. Methods: Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Methods: Academic and referral veterinary medical centers. Results: Medline via PubMed, CAB abstracts, and Google Scholar were searched. A total of 8 rele...
Kearney CM, Buckley CT, Jenner F, Moissonnier P, Brama PA.Selection of suture material in equine surgery is often based on costs or subjective factors, such as the surgeon's personal experience, rather than objective facts. The amount of objective data available on durability of suture materials with regard to specific equine physiological conditions is limited. Objective: To evaluate the effect of various equine physiological and pathological fluids on the rate of degradation of a number of commonly used suture materials. Methods: In vitro material testing. Methods: Suture materials were exposed in vitro to physiological fluid, followed by biomechan...
Sullivan SL, Whittem T, Morley PS, Hinchcliff KW.Furosemide is the most commonly used medication for exercise-induced pulmonary haemorrhage (EIPH); however, critical evaluation of the strength of evidence for efficacy of furosemide is lacking and is warranted so that evidence-based treatment decisions can be made. Objective: To evaluate the efficacy of furosemide to reduce the severity or frequency of detection of EIPH in Thoroughbred and Standardbred racehorses. Methods: Systematic review with meta-analyses. Methods: Primary studies were identified via searches of electronic databases, relevant texts and reference lists of published article...
Offer KS, Dixon CE, Sutton DGM.The sarcoid is the most common equine cutaneous neoplasm. Evidence-based treatment of this condition is often lacking, and selection of treatment modality based on clinical experience or anecdotal evidence. Objective: To assess the quality of the currently available best evidence regarding the treatment of the equine sarcoid. Methods: Systematic review. Methods: In compliance with PRISMA guidelines, literature searches were performed in PUBMED, Web of Science, CAB Abstracts, EMBASE (Ovid) and Scopus in April 2021. Included papers were required to describe an interventional study examining sarc...
Mair TS, Smith LJ, Sherlock CE.Colic surgery is now performed at many equine hospitals around the world. Despite the tremendous improvements in survival rates over the past 30 years, the morbidity and mortality rates remain relatively high. This fact, coupled with the high cost of treatment, makes it important to apply evidence-based medicine principles to establish the best possible treatment plans and surgical techniques whereby the outcomes can be optimized. Factors affecting survival rates and rates of major complications (incisional complications and postoperative ileus) are discussed. Preoperative assessment and posto...
Gozalo-Marcilla M, Ringer SK.Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords "recovery anaesthesia horse", entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 "narrative reviews/expert opinions", 16 "retrospective outcome studies", 5 "surveys", 59 "premedication/sedation and induction drugs", 27...
Tsantefski M, Briggs L, Griffiths J, Tidyman A.Children exposed to problematic parental substance use (PPSU) often face a number of deleterious developmental outcomes, yet these children are less likely to become known to child protection and welfare services. Although there is a growing evidence base for equine-assisted therapy (EAT) as an effective treatment modality for atypically developing children and adolescents, scant research has explored the benefit of EAT for children exposed to PPSU. The current study is the first to explore the benefit of EAT for children exposed to PPSU in Victoria, Australia. Five 12-week EAT programmes were...
Potvin-Bélanger A, Vincent C, Freeman A, Flamand VH.The aim was to document the effects of hippotherapy on the 12 life habits of children with various disabilities. A systematic review using PRISMA guidelines was conducted to identify relevant studies. Five databases were consulted. Inclusion criteria were: 2-to-18 years old; therapy provided by a PT, OT or SLP/SLT; variables relevant to life habits as defined by the Human Development Model - Disability Creation Process. Quality was analyzed using a quantitative studies critical review form developed by the McMaster University Occupational Therapy Evidence-Based Practice Research Group. Level...
Dezutti JE.Patients with eating disorders may have the most complex interdisciplinary treatment plans of any mental illness. Nurses need innovative evidence-based treatment interventions to assist their patients with eating disorders on their road to recovery. Although much has been written about equine-assisted psychotherapy (EAP) and equine-facilitated psychotherapy, the literature has not described a detailed session that can help nurses understand how this experiential treatment works and the impact it can have on the patient. A review of the literature on eating disorders and on the use of equine th...
Stiller L, Depczynski J, Fragar L, Franklin R.Child injury on farms is a significant public health problem. This article describes the evidence and consultation base for development of a national strategy for child safety on farms in Australia. Methods: A data profile describing farm child injury was compiled, with evidence for the effectiveness of solutions being defined and the strength of recommendations determined. Representative working groups played a key role in assessing the evidence and advising on the best ways to communicate prevention messages within the farming community. Results: The main risks identified were drowning; farm...
Nolen-Walston R, Paxson J, Ramey DW.The use of an evidence-based approach allows veterinary clinicians to assess questions that are clinically relevant to the diagnosis and treatment of equine gastrointestinal tract disease. This approach involves formulating a clinical question, searching the literature, and answering the question with the best available evidence, with the results summarized as a clinical "bottom line." This article is organized to reinforce the principle that the cornerstone of evidence-based medicine is the clinical question. Specific questions are further categorized as to topic, with epidemiologic risk fact...
Clegg PD, Pinchbeck GL.Evidence-based medicine (EBM) refers to the conscientious, explicit, and judicious use of current best evidence from research for the care of an individual patient. Central to the adoption of EBM is both producing and identifying the best possible evidence for a particular intervention or therapy. This article identifies and reviews the approaches to producing and identifying the best possible evidence that is necessary for the full acceptance of stem cell therapies in the horse and reviews the approaches that will allow future clinical studies in stem cell therapies to provide the best eviden...
Goff L.Physiotherapy assessment of the equine athlete is carried out by qualified physiotherapists, who use a functional approach to the assessment of the horse. Observation, clinical reasoning, good palpation skills and implementation of outcome measures are skills used by these professionals in their assessment of the horse. Equine physiotherapists attempt, where possible, to use an evidence-based approach to the assessment of the equine athlete.
Wilkinson JE, Frost H.This commentary considers the vexed question of whether or not we should be spending time and resources on using multifaceted interventions to undertake implementation of evidence in healthcare. A review of systematic reviews has suggested that simple interventions may be just as effective as those taking a multifaceted approach. Taking cognisance of the Promoting Action on Research Implementation in Health Services (PARIHS) framework this commentary takes account of the evidence, context and facilitation factors in undertaking implementation. It concludes that a 'horses for courses' approach ...
Clarke EJ, Gillen A, Turlo A, Peffers MJ.Horses are used in a variety of equestrian disciplines predisposing them to musculoskeletal injury or disease including osteoarthritis and tendinopathy. As a result, a number of preventative measures are used within equine medicine and husbandry, ranging from therapeutic shoeing to the use of nutraceuticals. Despite their popularity and routine use evidence base and clinical outcomes are variable, bringing into question the efficacy of these prophylactic measures. In recent years a small number of studies have been performed examining the effect of specific strategies in order to quantify the ...
Richardson DW, Loinaz R.There is an enormous volume of published material about most of the agents used to treat or prevent arthritis in horses. Unfortunately, most of the claims made by nearly all purveyors of arthritis medications in such media are largely unsubstantiated. In addition, the quality of the available information is highly inconsistent, making evidence-based recommendations difficult. This article concentrates on injectable polysulfated glycosaminoglycan, injectable hyaluronan, and the common oral "nutraceuticals".
Shmalberg J, Xie H.Acupuncture exerts diffuse analgesic effects through the release of endogenous opioids and other locally and centrally acting mediators. Successful therapeutic interventions for various musculoskeletal conditions in horses are well documented, and acupuncture may significantly enhance performance. The use of acupuncture is specifically supported in treating nonsurgical gastrointestinal disorders, in which specific techniques can alter motility and contribute to visceral analgesia. This article describes the use of acupuncture and Chinese herbal medicine for equine reproductive management and f...
