Extracorporeal shock wave therapy in equine and canine practice.

Overview

• This research article explains how extracorporeal shock wave therapy (ESWT) works and provides treatment guidelines for its use in horses and dogs.
• It focuses on how shock wave therapy aids in healing tendon and ligament injuries, osteoarthritis, and nonunion fractures in veterinary practice.

Mechanism of Action of Shock Wave Therapy

• Shock wave therapy uses high-energy acoustic waves delivered externally to the affected tissues.
• These shock waves create controlled microtrauma at the cellular level, which stimulates a healing response.
• The microtrauma triggers cells to release anti-inflammatory cytokines and growth factors.
• These biochemical signals promote tissue repair and regeneration in the targeted areas.
• The most pronounced biological effects occur at interfaces where different tissue types meet, such as the juncture between bone and soft tissue.
• Such sites are often involved in enthesopathy, a condition affecting tendon or ligament attachments to bone, making them ideal targets for ESWT.

Types of Shock Wave Therapy Devices

• Four main types of shock wave generation methods exist:
• Electrohydraulic
• Piezoelectric
• Pneumatic
• Electromagnetic
• The article specifically discusses in detail the electrohydraulic and piezoelectric methods because they are most widely used in veterinary medicine.
• Both deliver precise energy to focused tissue depths and can be adjusted for energy levels and pulse frequency.

Treatment Considerations and Guidelines

• The dose delivered to the patient depends on:
• The depth setting of the shock waves
• The energy level selected
• The number of pulses administered during treatment
• Highest energy and biological impact occurs at tissue interfaces, so targeting these areas enhances therapeutic effect.
• Due to the mechanism involving inflammation and healing, anti-inflammatory drugs and cryotherapy should be avoided near the time of treatment as they may blunt the therapeutic response.
• Shock wave therapy has potent pain-relieving effects in the first 48 hours post-treatment, but rest is recommended to prevent further injury due to the temporary masking of pain.
• Owners should be informed about rules and regulations regarding the use of shock wave therapy in competition animals to ensure compliance.

Clinical Applications in Veterinary Medicine

• Shock wave therapy is effective and accessible in managing common equine and canine musculoskeletal conditions.
• Primary indications include:
• Tendon and ligament injuries
• Osteoarthritis
• Nonunion fractures (fractures that fail to heal normally)
• The therapy can reduce inflammation, promote tissue regeneration, and provide analgesia, improving recovery outcomes.