Kentucky Horse Racing Commission Committee Examines Shockwave Rules

by | 11.21.2014 | 12:25pm

The Kentucky Horse Racing Commission's Welfare and Safety Committee scrutinized the state's rules on shockwave therapy on Thursday afternoon with a fact-finding session designed to help regulators prevent abuse of the practice. The treatment, which consists of sending short, high pressure pulses to select areas of the body, has been shown to aid healing for horses and humans but comes with a temporary pain relief that is problematic for regulators.

Committee members Ned Bonnie and Dr. Foster Northrop, together with Dr. Mary Scollay, the commission's equine medical director, and commission executive director John Ward posted questions about the treatment to Dr. Scott McClure of Iowa State University. McClure is recognized as one of the preeminent researchers in the field of shockwave therapy as it relates to horses and attended the meeting to help the commission understand the finer points of shockwave and concerns for its regulation.

Kentucky currently requires veterinarians to report shockwave treatment to officials within 24 hours after administration and prohibits horses from running within 10 days of receiving treatment. That rule may be edited in the near future, pending further consultation within the commission.

Here are a few of the highlights from Thursday's session:

  • There are three phases to a horse's comfort level after shockwave treatment. McClure outlined a three-phase process that follows shockwave treatment for horses: initial pain relief, which lasts somewhere between two and three days after being shockwaved; a return to roughly the original pain level; then, roughly two weeks after the treatment, an improvement in pain due to healing. McClure said to his knowledge, there are no ailments for which shockwave is used that would benefit from high-intensity work before this healing window, so the horse really should be taking it easy into the healing phase. It is also possible horsemen, unaware that the healing process takes time to begin, could bring the horse back too fast after seeing an initial improvement in soundness.
  • That initial period of pain relief could be enough to get certain fractures through a vet exam. There is however, an important distinction between pain relief (analgesia) and a local anesthesia, McClure said. His research does indicate that a horse will demonstrate a greater comfort level after shockwave treatment for a bone problem, but studies do not suggest that the area is numbed. This would explain Northrop's experience that after a treatment, a horse will still react if the area is tested with forceps—it has feeling, but is less painful.
  • Though shockwave can treat both bone issues and soft tissue, most concern for abuse of the therapy might reasonably center around bone issues. McClure said he is not aware of any known pain-relieving affects of shockwave in soft tissue injuries. Northrop pointed out that the average bowed tendon or suspensory injury is not painful to the point of lameness at the stage shockwave therapy would be used, anyway…so there's little incentive for trainers to order shockwave in those cases for any reason other than healing.
  • It is possible for a layman to acquire a shockwave machine, and some have done so. Veterinarians do not need to have their machinery registered with the state. Northrop noted that reputable retailers will only sell machines to licensed clinicians, but non-reputable ones may not check for a license. The group was unclear whether the FDA was tasked with tracking usage of shockwave machines for animal use. Attempts to get shockwave machines out of trainers' hands would likely require an agreement with the state medical board to track machines, though that group usually does not handle veterinary instruments.
  • Shockwave could be used inappropriately, but its impact on general injury rates should be taken in context. “I am in no way going to say there's not illicit use. I'm not stupid,” said McClure. “It's obviously occurring to some degree. However, when we look at the injury rates over the last 15 years … I do not believe that the data indicates that things have gotten worse as a result of shockwave therapy.”
  • Eliminating inappropriate use is impossible; restricting it will be a challenge. Scollay pointed out the commission was getting very few reports of shockwave treatment each year, leading her to suspect it is underreported. She suggested rewording the shockwave rule to mandate horsemen report the intent to shockwave 24 hours before the treatment takes place; this way, they are running the risk of a violation if an inspector observes the treatment going on and there is no form on file for it.Another challenge is the movement of horses—as it stands in Kentucky, the commission only has jurisdiction at licensed facilities. Once a horse goes to the farm, a private training center, or even a parking lot, all bets are off.Northrop believes that hiring more investigators is the solution.“It all comes down to feet on the ground,” he said. “And if you're worried about [horses] leaving the grounds, the only way is to follow them. At some point, there's not enough regulations. At some point, the bad guys are going to beat any system you devise.”

    Scollay suggested microchipping horses to better track their movement in and out of tracks would be tremendously helpful with this issue and might be more generally desirable than a tattoo for identification, which security personnel may be unable to read anyway.

    Bonnie, meanwhile, would like to see both the statute and the regulations expand the commission's reach—perhaps to horses who are entered in an upcoming race regardless of location or to licensed individuals regardless of location.

    “We're looking at a mobile enemy,” said Bonnie. “And I want to write a rule that takes us to the edge of the state of Kentucky because that's what we need to do in order to stop cheaters.”

 

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