The Equine Surgery group is excited to offer extracorporeal shockwave therapy (ESWT) as part of our comprehensive diagnostic and therapeutic services. ESWT is a noninvasive treatment modality that uses focused, high-pressure sound waves to stimulate healing of wounds and musculoskeletal injuries.
The specific mechanism of action in ESWT is unknown, although research suggests that upregulation of growth factors in the treated tissue may play a role. Other responses to ESWT reported in the scientific literature include local stem cell recruitment, stimulation of new bone growth, and neovascularization.
Short-term analgesia is a well-recognized effect of treatment, reported in both naturally occurring injuries and experimentally induced osteoarthritis in the horse. While ESWT is not appropriate for every injury, clinical applications in horses include treatment of tendon and ligament injuries, kissing spines, back pain, navicular disease, and osteoarthritis.
The University of Illinois has a focused, electrohydraulic shockwave unit manufactured by Pulsevet. This VersaTron system is the only electrohydraulic equipment specifically designed for equine use and is considered to be state-of-the-art in this field. Interchangeable probes allow focused penetration of the pressure waves from 5 mm to 110 mm depth, depending on the location of the injury being treated.
Typical treatments consist of 1,000 to 1,500 pulses per site and take only a few minutes to perform. One to three treatments (10 to 14 days apart) are recommended based on the type and location of the injury. Many insurance companies will cover up to three ESWT treatments.
Depending on the horse, light sedation may be administered for the treatment, but no specific aftercare, such as bandaging, is required. ESWT can be used in combination with other treatment modalities, including the use of biologic therapies (e.g., platelet-rich plasma therapy, stem cell therapy), and rest and rehabilitation protocols, which can often be shortened with the addition of shockwave.
Clients have become increasingly aware of ESWT over the past few years, with extensive coverage in the lay press and online horse owner forums advocating its use for both therapeutic applications and “tune-ups” of horses in training. However, use of ESWT prior to competition is restricted, primarily due to concern over its analgesic effects, which are thought to last at least 48 to 72 hours after treatment. Current prohibitions on treatment vary by jurisdiction, and range from 3 to 10 days prior to competition. These regulations are subject to change, and clients should be advised to consult with the appropriate governing body before scheduling an ESWT treatment for a horse in active competition.
The current cost of each ESWT treatment is approximately $300, which includes sedation and a brief exam. Additional diagnostics, such as a complete lameness exam or imaging, and therapeutics are not included in this price.
If you have any questions regarding ESWT at the University of Illinois, or would like to consult with a clinician about a case that might benefit from ESWT, please contact us at (217) 333-2001.
—Annette McCoy, DVM, PhD, DACVS