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Category: Equine Health

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10/13/2025
ecallenEquine Health

Shock Wave Therapy for Horses: Clinical Evidence for Lameness and Injury Treatment

Eighty-one percent of chronically lame horses unresponsive to conventional navicular treatment improved with shock wave therapy—and stayed sound beyond 12 months. 

That’s Dr. McClure’s peer-reviewed research, one of several studies Dr. Kim Keeton shared in her recent Zomedica webinar on equine shock wave therapy using PulseVet technology. Dr. Keeton brings 20 years of equine veterinary experience and 15+ years using PulseVet shock wave technology to her integrative practice outside Athens, Georgia. 

Why Electrohydraulic Technology Matters in Equine Shock Wave Therapy

PulseVet shock wave therapy deposits acoustic energy where tissue density changes—tendon-to-bone attachments, joint capsules, bone interfaces—triggering cytokine release that increases blood flow, stimulates neovascularization, and returns chronic conditions to an acute healing phase. 

The focal zone comparison: 

  • PulseVet’s electrohydraulic system: 140,000 mm³ tissue affected per pulse 
  • Electromagnetic devices: 61,000 mm³ 
  • Piezoelectric (linear trode): 2,476 mm³ 

Translation: You cover more tissue with fewer pulses. That means 1-3 treatments every 2-3 weeks instead of 4-8 weekly sessions required by piezoelectric systems. 

Dr. Keeton’s clinical pearl: “If you can see it on ultrasound, you can treat it with PulseVet shock wave therapy. Both use sound energy.” 

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Shock Wave Therapy for Navicular Syndrome: 81% Improvement Rate

Dr. McClure’s study enrolled chronically lame horses that had already failed conventional treatment. These weren’t mild cases.  

Protocol: 2,000 pulses—1,000 through the frog, 1,000 through heel bulbs at E6 energy 

Results: 81% showed decreased lameness with no relapse beyond 12 months. 

Practice implication: You can offer clients a non-invasive alternative to neurectomy for one of equine medicine’s most frustrating chronic conditions. Zero complications reported across the study population. 

Tendon Injuries: Quality Matters More Than Speed

A 10-horse study (each horse serving as its own control) with collagenase-induced tendonitis demonstrated what Dr. Keeton calls the critical factor: PulseVet shock wave therapy improved the quality of tendon repair, not just healing speed. 

For performance horses, that quality differential determines reinjury risk. Suspensory ligament studies backed this up with measurable improvements in fiber alignment scores and echogenicity on ultrasound. 

Standard protocol: Three treatments at 3-week intervals.  

This makes equine shock wave therapy particularly valuable for sport horses where quality of repair determines return to competition. 

Osteoarthritis: Better Than Adequan in Head-to-Head Study

The 2009 carpal OA study compared three groups: placebo, polysulfated glycosaminoglycans (standard Adequan protocol: 7 doses over 28 days), and PulseVet shock wave therapy. 

Horses treated with PulseVet therapy showed significantly greater lameness improvement than both other groups. 

An earlier hock study (74 horses with tarsometatarsal and distal intertarsal OA) delivered 80% improvement rates: 

  • 38% improved one lameness grade 
  • 42% improved two grades 
  • Single treatment of 1,000-2,000 pulses 
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Back Pain: 89% Success Rate, 3-5 Day Return to Work

“Rest does not help a chronic sore back heal,” Dr. Keeton stated bluntly, drawing the parallel to veterinarians’ own back pain experience. 

A 74-horse retrospective on PulseVet shock wave therapy for kissing spines and dorsal articular process inflammation showed 89% positive outcomes, with 60% maintaining improvement for 4-6 months. 

Why this matters mid-season: Horses rest just 2 days post-treatment, return gradually over 3-5 days. Your performance horse clients don’t lose weeks of competition preparation. 

Protocol: 2,000 pulses, single treatment using 35mm trode (midline for spinous processes) and 80mm trode (oblique angle for deeper dorsal articular processes) 

Wounds: When Everything Else Fails

Dr. Keeton presented “Doodlebug,” a 5-year-old Quarter Horse mare with biopsy-confirmed habronemiasis persisting over one year despite multiple surgical debridements, ivermectin, moxidectin, corticosteroids, and topical treatments. 

Dr. Hugh Worsham (Cumming, Georgia) administered two PulseVet shock wave treatments three days apart—just 500 pulses with the 5mm trode at lowest energy. 

The summer sore completely healed. 

Another case: a 6-month-old miniature horse with dog attack wounds, suspected clostridial infection, progressive necrosis, and copious purulent discharge. Three PulseVet shock wave treatments (days 5, 8, and 11 post-attack) produced substantial healing by day 32. 

The mechanism behind equine shock wave therapy for wounds: Increased blood flow enhances antibiotic penetration. Biofilm disruption tackles resistant infections. Cytokine release (VEGF, TGF-β, PCNA) drives neovascularization. 

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Exercise-Induced Pulmonary Hemorrhage: Treating EIPH with Shock Wave Therapy

Dr. Beau Whitaker’s barrel racing study represents what Dr. Keeton called “one of the most exciting things coming out of PulseVet shock wave therapy”—treating exercise-induced pulmonary hemorrhage. 

Study: 21 barrel racers (13 had bled at their last race, 9 competed on Lasix) 

Results: 

  • Average BAL score dropped 1.5 grades 
  • 76% improved one grade minimum 
  • 47% improved two grades 

The insight: All horses had underlying equine asthma. The theory suggests asthma causes EIPH—PulseVet shock wave therapy addresses root pathology, not just symptoms. 

Research on PulseVet therapy for equine asthma is being extended through a Clinical Registry for Equine Asthma. 

Learn More About the Clinical Registry for Equine Asthma

Amplifying Your Orthobiologic Protocols

If you’re already using regenerative medicine in your equine practice, PulseVet shock wave therapy enhances results: 

PRP study findings: Shock wave application increased growth factor expression by 33-46% (TGF-β) and 190-219% (PDGF-ββ) compared to controls. 

Stem cell research: 500 pulses at low energy doesn’t damage mesenchymal stem cell proliferation or differentiation. Day-3 post-treatment showed increased ALPL indicating osteogenic effects potentially beneficial for fracture healing. 

Treatment Duration Reality

Dr. Keeton addressed the chronic condition question directly: Effects typically last 4-12 months before potential retreatment. This makes PulseVet shock wave therapy appropriate for long-term management, not just acute intervention. 

Why Major Equine Organizations Choose PulseVet Technology

PulseVet shock wave therapy serves as official ESWT for AQHA, NCHA, NRCHA, World Equestrian Center, US Equestrian, USEA, and USEF. That endorsement reflects 20 years of clinical research backing the technology. 

Two decades of equine shock wave therapy research show consistent findings: no serious complications, measurable improvement rates across multiple conditions, and fewer treatments required than alternative systems.  

*Dr. Keeton is an employee of  Zomedica Inc. and was paid for her webinar presentation. Watch the webinar here. 

© 2025 Zomedica Inc. All rights reserved. PulseVet is a registered trademark of Zomedica Inc. 

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08/08/2025
ecallenEquine Health

Groundbreaking Use of Shock Wave Therapy for Equine Pulmonary Conditions

Electrohydraulic shock wave therapy has long been a cornerstone of treating equine soft tissue injuries and managing chronic pain. Now a recent breakthrough may change how veterinarians approach complex respiratory issues in performance horses. Thanks to the pioneering work of Dr. Beau Whitaker, this established modality is now being explored for its potential in managing Exercise Induced Pulmonary Hemorrhage (EIPH) and Equine Asthma. 

The Evolution of Shock wave Therapy in Horses

Shock wave therapy isn’t new to the equine world. For over 20 years, it has been a standard of care for soft tissue rehabilitation and pain management. Backed by a strong foundation of clinical research, electrohydraulic shock wave therapy has helped countless horses return to peak performance.  

Challenging the Old Norms

 Historically, shock wave therapy was considered unsuitable for air-filled structures like the lungs. However, that narrative began to shift in 2022–2023, when Dr. Whitaker launched a study investigating its use in treating EIPH. 

Supported by an unpublished study from the University of Cordoba and clinical applications by Dr. Martin Allen on Standardbred racetracks, Dr. Whitaker’s research challenged longstanding assumptions about safety and efficacy in pulmonary applications. 

Investigating Shock Wave for EIPH Treatment

Dr. Whitaker’s study focused on barrel racing horses with recent EIPH episodes. The criteria included: 

These horses received targeted shock wave therapy to the lungs, and outcomes were measured 2–4 weeks post-treatment, after their next competitive run. 

Results That Rival Traditional Treatment

The results were striking: 

  • 76% of horses improved by at least 1 grade on their BAL score 
  • 47% improved by 2 or more grades 

By comparison, only 68% of horses treated with Lasix (furosemide), the traditional pharmacologic intervention for EIPH, showed a similar improvement of 1 grade or more. 

These results suggest that shock wave therapy may offer a promising, drug-free alternative or complement to Lasix in EIPH management.  

Uncovering a Link Between EIPH and Asthma

In reviewing the cases, Dr. Whitaker noted a surprising trend: every horse in the study also had concurrent asthma. This discovery raised an important question — was the improvement due to the treatment of EIPH, or was shock wave therapy addressing the underlying asthma instead? 

New Study: Shock Wave Therapy for Equine Asthma

Prompted by this revelation, Dr. Whitaker launched a follow-up study focused exclusively on horses with mild to moderate asthma. These are typically horses whose owners report coughing during rest and exercise. 

Promising Early Results

While data collection is ongoing, early outcomes include: 

  • 55% of horses showed 100% symptom resolution within 2 weeks 
  • 67% experienced at least 90% improvement 

Dr. Whitaker has a paper currently in development to publish these findings. 

New Study: Shock Wave Therapy for Equine Asthma

To support clinical investigation of this innovative approach, Zomedica has sponsored an Equine Asthma Clinical Registry. This global database allows veterinarians to track shock wave treatment results in horses with asthma, contributing to a growing body of evidence and accelerating understanding within the veterinary community. 

Final Thoughts

The potential for shock wave therapy to treat respiratory issues in performance horses is an exciting frontier in equine medicine. With results showing comparable — and in some cases superior — outcomes to traditional treatments like Lasix, this could represent a paradigm shift in how we manage EIPH and asthma in horses. 

As studies expand and the Equine Asthma Clinical Registry gains traction, the equine veterinary community is poised to explore a new and promising era of non-invasive pulmonary treatment. 

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09/02/2024
ecallenEquine Health

Maintaining Comfort in the Performance Horse

By T.J. Barclay, DVM

Just like their human counterparts, equine athletes are prone to experiencing discomfort or injury over the course of their training.  Effectively treating injuries and maximizing the comfort of the horse are essential for the horse to realize its peak potential.  The owner, trainer, veterinarian, farrier, and other supporting personnel each have important roles, and they all must work together as a team to maintain the overall health and fitness of the horse. 

Common Signs of Discomfort in Equine Athletes

Discomfort can manifest itself in many ways.  Some, such as overt lameness, are relatively easy to detect.  Other times, it can be difficult to determine if a behavior is pain related or not.  Problems such as difficulty changing leads, refusal to perform certain maneuvers, girthiness, and bucking can all be induced by musculoskeletal pain. Whenever pain or injury are suspected, the veterinarian’s expertise in managing orthopedic conditions becomes key.  First and foremost, an accurate diagnosis of the problem is critical to formulating an appropriate treatment plan.  A thorough examination in both static and dynamic states, combined with diagnostic analgesia and diagnostic imaging provide the necessary information. 

Choosing the Best Treatment Plan for Equine Athletes

Once a diagnosis is reached, options for treatment are discussed with the owner and a plan is made.  For some conditions, treatment may allow the horse to continue training with no changes.  In other cases, interventions such as rest, rehabilitation, or corrective shoeing may be indicated.  Today, we are fortunate to have a myriad of therapeutic options at our disposal for treatment of orthopedic conditions. Anti–inflammatories, viscosupplements, orthobiologics, chiropractic manipulation, and acupuncture are some of the viable options, and a multi-modal approach often provides the best outcomes. 

PulseVet® Shock Wave Therapy for Equine Recovery

Another modality that has become a mainstay of treating musculoskeletal conditions is extracorporeal shock wave therapy, with PulseVet shock wave being the leading provider in this field.  PulseVet therapy delivers high-energy sound waves focused and directed into injured tissues. These shock waves stimulate the release of a variety of different cytokines that modulate inflammation, increase blood supply, and stimulate bone growth. A typical treatment protocol using PulseVet’s system involves one to three shock wave treatments at approximately two-week intervals. 

PulseVet shock wave therapy is well established in the treatment of soft tissue injuries such as suspensory ligament strains and bowed tendons. These structures are notorious for developing scar tissue that is less elastic than normal tissue and prone to reinjury.  PulseVet shock wave stimulates growth of normal collagen fibrils within the lesion, resulting in a better quality of healing and a more functional structure.  

Other common areas where PulseVet shock wave therapy is beneficial are the neck, back, and sacroiliac regions.  Dorsal spinous process impingement (kissing spines) and osteoarthritis of the dorsal articular processes can often be effectively managed with shock wave therapy, allowing the horse to return to work in a timely manner.  PulseVet technology is also useful in slowing the progression of osteoarthritis in other joints. 

Maximizing Equine Athletic Performance

Maintaining peak performance in the equine athlete is a team effort involving input from multiple areas of expertise. When injuries arise, accurate diagnosis and effective treatment provide the best chances for complete healing and a timely return to work. PulseVet shock wave therapy is often a valuable tool for achieving that goal. As veterinarians, nothing is more satisfying than seeing our patients sound and competing with their owner! 

By incorporating PulseVet shock wave technology into our treatment plans, we can offer our equine athletes cutting-edge care that promotes faster healing and better outcomes. Whether dealing with soft tissue injuries, joint issues, or back problems, PulseVet shock wave provides a non-invasive, effective solution that helps maintain comfort and performance in our equine athletes. 

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