A desire to provide superior quality care encouraged veterinarian Meghan Qualls to integrate eastern medicine into her conventional practice.

Whatever is best for the horse is what should be done. That’s the mantra by which equine veterinarian and Eastern medicine practitioner Meghan Qualls, DVM, lives. Combining modern veterinary medicine with equine acupuncture, herbs, chiropractic treatment, laser therapy and pulsated electromagnetic field therapy (PEMF), Qualls helps the horses she treats move more freely and think more clearly. Her mobile practice in Weatherford, Texas, is part of a growing, nationwide trend amongst veterinarians and is known as integrative medicine. Qualls and practitioners like her have built reputations for treating pain, lameness, reproductive issues and skin problems as well as the physical and behavioral issues that may be the result of anxiety or stress, using both Eastern and Western medicine.

“Sometimes integrated medicine is exactly what the horse needs, but sometimes it’s complementary, meaning that it needs to be used in conjunction with traditional medicine. There are also times when it’s not what the horse needs,” Qualls said. “The person who is best at that specialty, for example a lameness surgeon or an internal medicine specialist, is who should be looking at that horse if that’s what’s needed.”

Qualls’ client list includes barrel horses that have gone to the National Finals Rodeo, cutters and reiners that have made finals in major aged events, as well as racehorses, jumpers and backyard pets. Sometimes an owner will call her in a last-ditch attempt to get help for their horse, while others will want to try traditional Chinese medicines first.

“The people who want to use integrated medicine before they go to the lameness guys and internal medicine guys are usually regular customers or people who’ve either had acupuncture work on themselves or have a friend who recommended they try it,” Qualls said. “The last-resort stuff is usually the most fun though, because Western medicine won’t have worked for the horse.”

Like many people, Qualls wasn’t always open to the idea of alternative medicines. In her youth, she’d seen some backyard practitioners who were less than impressive. After graduating vet school, she was still skeptical until she had the opportunity to work with a veterinarian whose specialties were chiropractic treatment and acupuncture.

“There was a horse in the ICU that couldn’t urinate, and no one could work out why,” Qualls said. “He put the needles in, hooked up the electrodes and the horse dropped and urinated. That started to open my eyes. After that, there were too many examples of it working for them all to be coincidences. Horses are extremely honest, there’s no placebo effect with them, so I knew that what he was doing was making them better and I knew in my core that’s what I was going to do.”

That realization led Qualls to undertake further study at the Chi Institute of Traditional Chinese Veterinary Medicine in Florida—a school that only accepts veterinarians. She then studied chiropractic treatment at Options for Animals in Kansas.

“The way the Eastern practitioners look at their horses is the same as Western practitioners, but just in a different language so to speak—they have a different approach,” Qualls said. “I believe by using both of them we get the best of both worlds and can better treat the horse.”

Overall Health and Well Being

A happy, healthy horse is one whose nervous system, endocrine system and immune systems are working effectively.

The nervous system transmits information from the brain to the body, and from the body to the brain. If a message in either direction is interrupted, then it may not be received or it may be corrupted. This can be likened to talking on a cell phone with one bar of service. An example of an interruption in the nervous system would be the feet not being able to tell the brain where they are, or the brain not being able to tell the feet what to do. This could be the result of malformation of the cervical vertebra known as wobbler syndrome, trauma to the vertebra from falling, a viral infection such as herpes or rhinopneumonitis or an infection from a protozoa such as Equine Protozoal Myeloencephalitis (EPM).

The immune system is the body’s defense mechanism against infections and illnesses. An under-stimulated immune system may not be able to fight off viruses and bacteria effectively. An overactive immune system may make the body kill its own healthy cells as happens with the autoimmune skin disorder Pemphigus foliaceus.

The endocrine system is the network of glands that produce and excrete hormones that are responsible for regulating growth, reproduction and mood. Problems in the endocrine system include Pituitary pars intermedia dysfunction (PPID), which is known as Cushing’s syndrome, Equine metabolic syndrome and insulin resistance.

Alternative Treatments

To treat the whole horse, the horse’s symptoms, ailment and compensatory issues need to be treated. A compensatory issue is one that arises due to the original issue. For example, if the horse has a hoof issue it may place its hoof on the ground at a different angle to what it usually does in an attempt to alleviate pain in the hoof. The different angle could cause injury or pain in the knee or shoulder. Qualls uses a variety of proven methods and tools to treat primary and secondary pain and issues.

Chiropractic Treatment

The structure and function of the joints directly effects the nervous system and the muscles. Chiropractic work on a horse helps ensure that all of the joints are moving appropriately. The common terminology that a joint or bone is ‘out’ is incorrect. Preferable terminology is that the joint is not motioning properly—it is either moving too much or not enough.

Joints can become misaligned due to trauma, a misstep in training or competition, repetitive use, ligament laxity, overuse and exhaustion. When joint motion is changed, nerve impingements can also occur. The inflammation that accompanies an impingement can cause the messages that are sent to and from the brain to be conveyed incorrectly.

When a joint isn’t moving properly, the body will compensate by tensing the muscles around it. Constant tensing will create a trigger point. A trigger point is an area where the muscle has become tight.

A body that is moving appropriately requires fewer drugs, for example joint injections, which can be detrimental to the long-term health of the cartilage associated with that joint.

Adjustments are made by applying the pressure to the correct point, at the correct angle with the correct force.

Equine Acupuncture

Eastern medicine called PEMF.
PEMF is being used to treat the back and the shoulders. Photo by Bridget Kirkwood.

Acupuncture is the stimulation of acupuncture points with a needle. An acupuncture point is an area that is dense in pre-nerve endings and mass cells. It stimulates the nervous system, the endocrine system and the immune system. Acupuncture can be used to deactivate trigger points, which are referred to as ashi points—an area that is tender.

Equine acupuncture is used to both prevent and treat disease. Mass cells contain histamine, and when an acupuncture point is stimulated, histamine is released. The body’s reaction to acupuncture can be likened to its reaction to a bug bite.

“When you get bit by a bug, histamine gets released. You’d get redness, increased blood flow, and signals are sent to the brain saying, ‘this area of the body needs help,’” Qualls said. “In Chinese medicine, acupuncture is used to relieve stagnation. When you think of stagnation, think of an old man in an old car on the highway that you’re sitting behind. In order to get the Chi flowing, you simply take the old man and old car away.”

Different branches of acupuncture can be used including:

  • Acupressure—stimulation of the points with pressure
  • Electro-acupuncture—electrodes are hooked up to the acupuncture needles, causing a contract- and-release sensation in the surrounding area.
  • Aquapuncture—B12 is injected into the acupuncture points
  • Hemoacupuncture—blood is drained from an area that has extreme excess heat
  • Moxa—the burning of an herb over the acupuncture points. It is especially useful for horses in extreme pain that do not want those acupuncture points to be touched. It relaxes the body and relaxes the mind, enabling further treatment.

PEMF

PEMF is often referred to by the brand name Magnawave. It combines magnets and an electrical field to increase bloodflow and oxygenation. This increases the permeability of the cells, which enables toxins to be released. PEMF is Food & Drug Administration (FDA) approved for use for non-healing bone wounds, muscle wounds, urinary incontinence and depression.

Herbal Therapy

Herbal therapy can be used in place of some Western medicines, or it can be used to complement them. Prescribing herbs is similar to prescribing medicines—the appropriate herb and the appropriate dosage are required, and the more accurate the diagnosis, the more effective the herb will be.

“The Chinese believe using herbs is like stimulating the acupuncture points daily,” Qualls said. “They are good for ongoing management of the horse and for balancing the horse.”

Balancing the horse refers to helping the horse’s body and mind work in harmony. This can be done by decreasing its pain and stress.

“For example, if a horse doesn’t sweat, then it’s parasympathetic nervous system isn’t working appropriately so you’re going to use acupuncture and herbs to stimulate it,” Qualls said. “To balance a non-sweater, you’ll increase the parasympathetic nervous system, which enables the horse’s body to relax and decrease the sympathetic nervous system, which prepares the horse’s body for intense activity.”

Herbal therapy can also be useful for low-grade gastrointestinal ulcers and to help balance highly aggressive mares.

Cold lasers are used in eastern medicine.
The cold laser is treating the Lumbar epaxial muscles. Photo by Bridget Kirkwood.

Cold Lasers

Cold lasers increase oxygenation and blood flow. They can be used to deactivate trigger points and stimulate acupuncture points. Cold lasers are useful in areas that are hard to treat with acupuncture, for example, corneal ulcers. Cold lasers are preferable to hot lasers as they eliminate the risk of thermal damage to the horse’s tissue. When in use, the cold laser gives a cool sensation to the treatment area, however, the area will often feel colder after the treatment is complete.

Assessing and Treating the Horse

An integrated veterinarian inspects the horse in a similar manner as a conventional Western practitioner and takes into consideration why the horse is being brought to them.

“If it’s a non-sweater or has reproductive issues, I’m not going to look at the horse the same way as if it’s got a pain or lameness issue,” Qualls said.

Initially, Qualls does a passive exam to check that the horse is balanced symmetrically left and right. She then does a traditional Chinese exam to evaluate the horse’s tongue color, temperature and pulses.

“I’m looking for an energy change in the pulses, because they’re an indication of what’s going on in the horse internally. I’m feeling for a forceful pulse or a weak pulse—similar to how a person checks the digital pulses for the horse’s feet—are they throbbing, weak or hot?” Qualls said. “The tongue is supposed to be pink, but if it is purplish that’s an indicator of pain and stagnation.”

An acupuncture scan is done next. Using a blunt object, the acupuncture points are lightly stimulated in search of a response. Pain at a point is suggestive of an ailment specific to that point.

If the horse presents a lameness issue, its movement will be evaluated. Each joint is then assessed via motion palpation to check that it is moving appropriately. The horse is also scanned for compensatory/secondary pain.

Using pressure points to identify pain.
Learn how your horse responds to being touched in different areas so that you can gauge an increase or decrease in pain. Photo by Bridget Kirkwood.

“An example of secondary pain could be a horse that has a fetlock or hock issue that is actually being caused by the horse’s stifles or because the pelvis isn’t moving appropriately,” Qualls said. “Similarly, a sore back may be due to a sore pelvis because the horse is carrying itself differently to alleviate the pain in the pelvis. When that arises, we treat both areas of pain.”

Treatment usually involves more than one therapy, for example chiropractic and acupuncture.

“It’s a horse-by-horse, case-by-case basis. What I do today may not be what I do on the same horse later on, because the horse will be at a difference phase of the healing process or they might have something different going on,” Qualls said.

Integrative medicine can help decrease the quantity of drugs administered to a performance horse. This is beneficial to any organs that could be damaged or forced to work harder as a side effect of that drug. For example, pain killers like phenylbutazone affect the stomach and hindgut, and long-term use can cause ulcers, increase the rate of colic, or make the horse go off its feed, which will in turn affect the horse’s athletic ability and psychological outlook. Additionally, once a horse’s pain and physical issues are resolved, they often become more content.

Examples of ailments treated with Chinese medicines:

Anhidrosis: Acupuncture and herbs can be used to treat the symptoms and usually gives fast relief. Often the horse will sweat immediately following treatment.

Reproduction: Acupuncture can stimulate the nerves to the male and female sex organs. Low libido stallions that usually take hours to collect may be ready to collect or serve a mare within minutes of receiving acupuncture.

Male horses can also suffer from a nerve impingement to the urogenital tract, making them unable to urinate even after surgical treatment. Chiropractic work and acupuncture can help the horse drop and achieve a full stream shortly after treatment.

Anovulatory mares (a mare that is not ovulating) can benefit from acupuncture and PEMF to help decrease the production of hormones that may prevent her from cycling. It also strengthens the reproductive tract. Mares that have received treatment have been able to produce viable embryos for collection.

Facial Nerve Paralysis: Horses that are unable to blink due to trauma or a neurological disease have regained movement and full function of the eyelid after acupuncture treatments.

Upward Fixation of the Patella: When a horse that is locking up in the stifle or unable to bend at the hock when walking forward is taken to a conventional veterinarian, it may receive IRAP, have its ligaments blistered or the joint injected. In some instances, chiropractic care can remove the need for these treatments by returning appropriate movement to the joint. This can occur when the angle of the pelvis to the stifle has been altered due to the normal physical stress of work and competition.

Laminitis: Acupuncture, PEMF and chiropractics have proven to help horses in the acute stage of laminitis, including those whose navicular bone has rotated fully through the hoof and are unable to stand, and those with compensatory issues on their hind end due to shifting their weight onto the hind end in an attempt to relieve pressure on the front feet. This combination of treatments provides pain relief, causes the release of the feel-good endorphins and has enabled the joints to move appropriately again.

Cribbing: Acupuncture has been able to help horses in the early stages of cribbing. In established cribbers, it is less effective.

Self-Diagnosis

Changes to a horse’s performance either in training or competition or a change in its attitude are both indications it may need help. Pain is the easiest symptom for riders and trainers to monitor at home.

While doing basic tasks such as tacking up the horse, brushing or washing it, take note of whether the horse is reacting to that contact. For example, as you run the brush over the back, is it reacting more today than it did yesterday or more than it did last week? You can also run your hand along either side of the spine to feel for soreness.

Other signs that the horse is experiencing pain are crabbiness when the saddle is put on, walking off when you get on, not picking up the correct lead in one direction and reluctance or difficulty to move laterally.

“Putting your hands on your horse is the easiest way to keep a pulse on what’s going on with them. Even if you have someone else who gets them ready and saddles them, put your hands on them,” Qualls said. “Feel for changes like heat in their legs and try to notice any differences in them. A change in attitude is a big indicator for pain.”

Cool and Calm

Just like humans, some horses have a predisposition to become nervous or anxious at or before events. Herbs, massage and acupuncture can all be used to help calm the horse without detracting from their athletic ability.

The Logan Technique is used in Eastern medicine.
The Logan Technique relaxes the horse’s back. Photo by Bridget Kirkwood.

Gold Bead Implantation

Gold Bead Implantation is a Chinese treatment that uses beads, surgical staples or sutures to permanently stimulate an acupuncture point on a horse to calm them. The implant can remain in place for life, however they typically stay in for up to six months.

Logan Technique

Horses that have tight muscles in the back usually have a tense mind. Help the horse relax immediately prior to entering the competitive arena by using the Logan technique. The Logan Technique is ideal for horses with back pain or that are tight in the loins, both of which may manifest behaviorally as bunny hopping and bucking.

The Logan Technique involves massaging the inside of the semimembranosus muscle, which is underneath the tail head by the anus. Rubbing that point relaxes the supraspinous ligament, which runs along the horse’s spine. This relaxes the entire back and mentally relaxes the horse.

Relax the Shoulder

Pain in the shoulder and the girdle/ shoulder sling (the muscles that hold the shoulder onto the horse’s body) can cause the horse to have a shorter stride and make it reluctant to move its front end laterally. Shoulder pain often results from problems lower in the horse’s leg. You can relax the shoulder with the saddle on immediately before entering the competitive arena or working the horse.

To relax the shoulder, locate the acupressure point that is in the middle of the horse’s pectoral muscle and apply pressure. Press hard enough that the horse can feel it, but not so hard that you’d pop a grape. Hold the pressure for 60 seconds. The horse will let you know if it likes this within the first 20 seconds by licking its lips or yawning. Yawning (da chi) releases endorphins—a feel-good hormone. A yawn during or after treatment is an indication that the horse feels better. If the horse does not like this pressure, it may pin its ears, grimace or move away from the pressure. If this occurs, you may be pressing too hard or pressing in the wrong spot.

This article was originally published in the May 2019 issue of Barrel Horse News.

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