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Supported by an unpublished study from the University of Cordoba and clinical applications by Dr.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:
- Normal upper airway anatomy
- Bronchoalveolar lavage (BAL) specimens confirming a bleed within the last 48 hours
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
- 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.
