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Case Study: Manhattan
Basic Information
Name: Manhattan, aka Mani
Breed: Thoroughbred (Chestnut)
Sex: Mare
Weight: 61 lbs.
Age: 19 years old
History
Manhattan was seen by Dr. Browne on 12/2/10. She had a history of off and on lameness in her right front limb for years. She was diagnosed and treated for EPM many years ago, and recently tested positive again. She had acupuncture and chiropractic previously and had responded well, but now the owner feels she wasn’t getting as much relief as initially seen.
Condition / Diagnosis / Findings
Upon examination Mani was Grade 3/5 lame in the right front limb at a trot, she also would extend her neck and head forward. She was hesitant with transitions, and her front limbs tucked slightly under while standing. She had sensitivity at her poll, especially the left side. Mani showed slight restriction of the right shoulder, with mild tenderness. She had moderate to severe muscle tenderness in the muscles of her right shoulder. Mild swelling and trigger points were also found. Chiropractic and acupuncture examinations revealed sensitivity in her cervical and right shoulder regions.
Therapy Goals
Gradual return to normal riding and turnout schedule.
Course of Therapy
Dr. Browne's recommendations based on her findings were to get cervical (neck) and possible right shoulder radiographs. Dr. Grace (GVEC) took radiographs of the elbow, and the findings were normal for a right front limb. The cervical radiographs revealed questionable joint articulation. Ultrasound of the shoulder area was also performed, no scar tissue was seen leading Dr. Grace to conclude this was a newer injury. Based on the radiographs and ultrasound the decision was made to start Laser IV, and to continue with routine chiropractic and acupuncture as needed. Mani was also restricted with her activities- she was turned out solo in a paddock, and lunged lightly instead of being ridden.
Progress Evaluation
Mani began Laser IV treatments on 12/17/10- she received a total of 6 treatments before a recheck was performed on 12/29/10. During this time the owner began to notice improvement after the second treatment. Mani had shown motivation to begin trotting some on her own while on the lunge. By the fourth treatment no muscle spasm or tenderness could be palpated. In addition to the Laser treatments the owner was very good at making sure to use moist heat prior to any exercise.
Progress to Date
Mani has since been gradually reintroduced into her herd and slowly put back to some light work. According to her owner she is doing fantastic and feeling quite good about herself. She received the Laser IV treatments once a week for 2-3 more treatments. The owner is dedicated to maintaining a routine chiropractic schedule. Shockwave therapy and Pulsed Signal Therapy are also being considered if Mani plateaus in her progress.
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