Cryotherapy has been used for human athletes over the years to recover from the various injuries they encounter. This procedure is meant to offer a faster recovery for the tissue damages and inflammations following exercises. When cryotherapy was still an emerging medical technique, it was tested on animals, and that was a success. Later this was introduced for animals. Being very athletic and undergoing intensive exercise regularly, horses largely benefit from cold treatments, especially for health issues in the limbs. Almost 50% of the body mass of these magnificent animals comes from muscles. Hence muscle tissue damages are quite common for them.
Cryotherapy is basically applying cold water or ice to an injured area to get a quick recovery. Cold is commonly used on muscles, joints and to treat laminitis which is the inflammation of the laminae that binds the hoof wall to pedal bone in the hoof. When the cold is applied to the area, vasoconstriction results in limiting the blood floor to the targeted area. When the cold is removed, the area gets overcompensated. The blood floor will be suddenly increased. The red blood cells have many oxyhemoglobins, and they will release oxygen to the treated area. White blood cells help to remove any dead tissues in the area through phagocytosis and various immunologic processes. This is how cryotherapy helps fast recovery for injuries.
The traditional cryotherapy methods are done using cold water. Submerging the injured hoof in an ice-cold water container and boots that are specifically designed to circulate cold water while applying pressure on the injured hoof are some traditional cryotherapy procedures to offer relief for laminitis. The therapy is mainly given to performance horses. These traditional procedures are commonly called ‘wet cryotherapy.’ (due to the use of cool water). These procedures have proven to improve the horse’s condition, but there were few drawbacks as well. Some of these drawbacks are being labor intensive and consuming a lot of time. Because horses are very strong and energetic animals, treating and handling them need more human labor and this procedure takes long hours to perform. For example, wet cryotherapy for laminitis should be continued for 24 hours after the resolution of clinical signs to make the cryotherapy effective. There are also anecdotal reports that state cellular, local tissue damage, and softening of the hoof can occur following these cryotherapy procedures. However, considering all these drawbacks, novel cryotherapy procedures are introduced to this field.
The new cold treatments consume minimal labor and less time compared to the traditional measures. Some of the new cold treatments consume only 3 - 5 minutes.
Cryofan CF-04 is one such product now commercially available. This product is mainly developed to treat various muscle injuries in a user-friendly manner. This comes in a compact size, making it easier to move around. Because mobility allows giving care for multiple horses by moving between buildings within a short period. The horses will be sent out for a 10 minute walk before doing cryotherapy. This helps to boost the healing mechanisms. Cryofan CF- 04 works well in the recovery sessions of swollen, stable legs, swellings caused by lesions of tendons, edema (or fluid accumulations in the tissue spaces), and thrombosis (or blood coagulation) that can occur at the end of the intensive training days.
Cryomed equipment is also a new device used to perform cryotherapy more efficiently.
Cold therapy packs have opened gates to pave the road to end many difficulties that were there. This is a dry cooling system. The cooling packs are reusable, so they can offer treatment for many cases when you purchase one. There is a specially designed boot that is used to hold the cooling packs in place. So then, the pressure can be directed to the exact place that needs medical attention. This is an added advantage and a new feature that has successfully solved problems in traditional cryotherapy.
The newest addition to cryotherapy in horses is now being performed for the elite racehorses in Dubai. Here the horse is enclosed in a chamber that allows head and neck to be outside. This is the first-ever whole-body cryotherapy chamber introduced to horse care. The chamber is filled with nitrogen mist. The mist is so cold that it’s almost -140C, and this freezing mist surround the horse to boost its performance. The horses are carefully introduced to this chamber by few familiarizing sessions that last a short time just to make them used to the whole body cryotherapy chambers. The chambers' doors remain unlocked so that the horses can run away if they get panicked. After few familiarizing sessions, horses are undergoing complete treatment. The complete treatment usually takes around seven minutes. This treatment cools their skin to about 3 to 5 degrees.
This special limited service is only offered to about 125 elite horses at Zabeel Stables in Dubai. These horses are a part of a multimillion business in this part of the world: horse racing. In the United Arab Emirates, reward prizes for horse races are as high as a couple of million dollars. So the horses are given the best possible medical care and the nutrition to keep them in the optimum body conditions.
The nitrogen mist cryotherapy has so far given positive results for tissue injury. The horses who have undergone this procedure have gained the ability to come back to their premium body condition sooner and have gained the ability to race more often, having fewer intervals between horses. These horses have been able to exercise for longer hours, making them stronger and ready to win the horse races. Cold mist cryotherapy allows horses to recover sooner following races and intensive exercise sessions. When the treatments become unsuccessful, the horses are even being euthanized.
Another major horse health issue that is addressed through cryotherapy is laminitis. Laminitis is the failure of attachment of epidermal laminae from the dermal laminae. Hoof is also a modified form of the integument. After the hard keratinized hoof, the corium is placed. The epidermal laminae are attached to the hoof wall, while the dermal laminae are attached to the distal phalanx. This detachment is mainly caused by inflammation of the laminae. This is a severe disease condition that can be recurrent in horses. As a result of this pain, horses show lameness, which causes a massive loss for the horse owners, especially when it comes to racehorses.
There are various causes for laminitis, but one of the main causes is increased carbohydrate ingestion. Horses could ingest an excessive amount of carbohydrates through overconsumption of concentrates and overindulging in lush pastures. This type of laminitis can be easily prevented through proper nutritional management.
To minimize the susceptibility to the disease, overweight and easy keepers and those with Cushing’s syndrome or equine metabolic syndrome are given special medical attention. When the horses show the primary signs of laminitis, and along with that, as increased blood glucose level is reported, the animals will be given a change in diet. The grass and concentrate food are recommended to replace with low soluble carbohydrates. These are also known as non-structural carbohydrates. Some of the carbohydrates that match to these requirements are hays low in soluble carbohydrates and soaked hay in water to remove carbohydrates. Along with replacing the conventional concentrate food, pasture intake also should be reduced. A feed with high fat and fiber content is recommended in addition to vitamin and mineral supplements.
Other types of laminitis are supporting limb laminitis and laminitis due to diseases associated with sepsis and endotoxemia. Supporting limb diseases come when one limb has undergone an injury, and the parallel leg tries to bear that increased weight. Because of the pain in the injured limb, the animal is reluctant to keep that limb on the floor. Some of the common causes that prevent the use of one limb are radial nerve paralysis and post-operative orthopedic procedures. Sepsis and endotoxemia appear as a result of equine metabolic syndrome.
When the horse owners observe the primary signs of laminitis, they should take medical advice from a veterinarian. The apparent clinical signs of acute laminitis such as the increased temperature of a part of the complete hoof, abnormal posture, hard pulse in digital arteries, and reluctance to move away due to the pain in hooves allow the veterinarian to come up with a quick diagnosis.
Despite the quick medical attention and best treatments, acute laminitis is considered hard to cure. You can not grant a certification until the full recovery. There are drugs administered as NSAIDs, and surgical procedures are also performed to treat the horses with laminitis.
For chronic cases, if the horses fail to improve the condition even after offering proper nutritional management significantly, cryotherapy is done as a treatment. As we discussed earlier, one of the most apparent clinical signs of laminitis is the increased temperature of the hoof. What is done in cryotherapy for laminitis is, cooling the lower limbs and hooves at an intensively cold temperature for a prolonged time.
The traditional wet cryotherapy procedures and the novel inventions of dry cryotherapy were discussed above.
Cryotherapy has proven successful results in treating laminitis for horses at risk. The procedure helps relieve the pain that comes with laminitis and, most importantly, control inflammation in the lamellar tissue for the horses suffering from acute laminitis. There have been researches done on the effectiveness of the commonly performed cryotherapy procedures for laminitic horses. The main outcome that is expected from all the cryotherapy is decreasing enzymatic activity in the lamellar tissue by 50% in every 10C drop in the temperature of the tissue. This is achieved through vasoconstriction in the blood vessels supplied to the treated hoof, hypometabolism, and anti-inflammatory effects.
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