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  Discussion on Trochanteric Bursitis & Acupuncture
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Posted on Thursday, Jan 25, 2001 - 3:16 pm:

I have a 5-year old standardbred trotter who has a problem with the right hind leg. Although the horse has an old bone-spur in the hock, he shows no sign of tenderness there. Instead he does show tenderness on the whorlbone. He also pulls to the right when trotting at speed. And he seems a little short-gaited with the right back leg when trotting. After many tests, we believe he has Trocanteric bursitis or some other muscular problem up around the whorlbone. We rested him for 5 weeks, brought him back and he showed no change.

From all we have heard and read, this condition may be career-ending, even though he seems robust and healthy in every other way.

We've decided to try acupuncture to deal with this. Has anyone else ever tried this with success? How often is best to use acupuncture therapy? Weekly? 3 times a week?

Any information would be appreciated.

Posted on Tuesday, Jan 30, 2001 - 7:55 am:

Hello Brendan,
In the very few good experiments on other areas of the horses body with accupuncture, technique did not seem to be much of a problem. It seemed almost no matter what you did or how you did it you got a response. I am not sure what this means.

It seems you still have a poorly defined disease process, we always recommend as accurate a diagnosis as is practical before starting treatment.
DrO

Posted on Wednesday, Jan 31, 2001 - 2:35 pm:

Thanks for your response Dr. O. I am Brendan's wife Barbara, the actual owner of the trotter in question, chiming in with some more specific details. Over the last 4 months my trainer has had 3 veterinarians go over this gelding, with x-rays of each joint and diagnostic blocks from the hoof on up. The x-rays show lovely joints - no reduction in cartilage space or bone deterioration. We've injected hyaleuronic acid and Adequan in the ankle and hock joints, and used DMSO as a rub on his hock. We also blocked the "jack cord" as that tendon passes near the old bone spur. Just in case, we blocked and injected his knees too. We even gave him a couple of doses of EPM medicine at the suggestion of one of the vets. Nothing we've tried has relieved the problem, which is actually in his LEFT hind. He does not want to move that leg as far forward during a stride as he does with his right leg.

At this point the vets, all experienced with standardbred racing and who consulted together, conclude that his problem is above the stifle, most likely the muscle/soft tissue in the whirlbone area since he is so tender there. He is having acupuncture once a week, aspirin and MSM daily, and is jogging slowly with no training. He's playing in his stall and fighting to jog faster (he's a fairly fast horse, a prior State Champion in stakes competition) - in short his attitude is not sickly or depressed. I have seriously considered retiring this horse and finding him a nice home. He's a sweet gentle giant and deserves a good life. However the veterinarians believe he can be made right again and return to racing (which he loves). So I am trying to find other ways to help him.

I have contacted Cornell and New Bolton where they have more elaborate diagnostic tools that those available at our track or local clinics. However the cost of the scans and the trucking to get him there is prohibitive. My trainer, who has been in the business for more than 40 years, has suggested using an old horseman's remedy - injectable iodine called McKay's Solution. My question then is: has anyone had experience with a similar problem or success using McKay's iodine?

Thank you for any input! If I can help anyone with harness racing let me know. Barbara

Posted on Thursday, Feb 1, 2001 - 7:30 am:

Hello Barbara,
Whorlbone lameness is a horseman's term for inflammation of the bursa of the greater trochanter. This is a little pocket of synovial fluid that sits adjacent to a projection off the proximal end of the femur, so that puts right next to the hip joint. Because this area is very deep in the musculature and closely associated with the hip joint it is a difficult diagnosis to make and difficult to differentiate from trauma and inflamation of the hip joint including fracture of some of the small bones that make up the socket.

The best bet at a accurate appraisal of this disease is intrasynovisal nerve blocks of the area followed by radiographs. This is a very difficult area to block at least without an experienced ultrasound guided procedure and radiography of the area requires general anesthesia and a large referral institution machine. But other simpler (though no less expensive) tests may reveal problems elsewhere.

If the diagnosis is correct, I do not see how an internal blister like McKay's could possible help this condition other than buying a little more time while the horse recovers from the effects of the treatment. If I was remotely confident in this diagnosis I would be attempting to deposit a little cortisone in the bursa and the hip joint but I only know one man who believes he can do this with any confidence: Dr. William Moyer at Texas A&M. Alternative to this would be more rest and stronger oral antiinflammatories.
DrO
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