S2 E3: Why ruling out pain in horses is hard with Dr Lisa Walter

How many people do you know who’ve had some kind of pain or illness that the human medical professionals have not been able to get to the bottom of or provide relief from? Or where it’s taken some time and robust investigations, often driven by the person or their family to figure out what’s going on?I know quite a few & have experienced this myself, and this is with the diagnostics available to human medicine.Almost daily I see equine-owning humans asking for training help online with a horse that’s body language and behaviour is indicating likely pain. Sometimes this body language from the horse is fairly explicit and other times it’s more subtle. Some of the lovely humans asking for help have sought some veterinary intervention, but it can happen that their initial vet hasn’t been able to find anything wrong.If you listened to Episode 8 in Season 1 of An Equine Conversation, Julia’s story with her horse Maddy, you’ll know that Maddy was exhibiting behaviour that indicated something was wrong and that Julia had to push past initial vet suggestions to get to the point of an actual diagnosis for what was wrong, and then how to treat and manage what was going on for him. It took some time and probing and pushing to figure it out.And here’s the thing. Pain in horses is not always possible to rule out or resolve. It’s not a matter of just saying there’s nothing wrong – because there can be and the science and diagnostic equipment just isn’t there yet to figure absolutely everything out – but, the science, the technology and the research are making progress and there’s so much more available to us than 20 years ago.I wanted to talk to an Equine Veterinarian about why it’s challenging to rule out pain in horses and what we can and should do about it as owners, so I asked my friend, Dr Lisa Walter, Equine Vet in South Australia, if she would join me for a chat. I always love speaking with Lisa as she has so much knowledge and a constant curiosity about how the horses body works – which has led her to working on a PhD in Sacroilliac dysfunction. I’m so pleased to bring this conversation to you and hope it helps expand your knowledge, awareness, understanding and ability to pursue niggles about any pain you are suspect of with your equines. Dr Lisa Walter:Lisa Walter is a veterinarian, researcher and educator with an interest in subtle lameness in sport horses, including the early identification and management of performance horses exhibiting low grade lameness, and locomotory dysfunctions. She completed her veterinary research training and veterinary degree at the University of Melbourne (1998, 2000) and has completed training in traditional Chinese medicine and acupuncture with the International Veterinary Acupuncture Society.Her research includes the validation of a radiographic measurement technique used to identify early indicators of shinsoreness in Thoroughbred racehorses, clinical identification and management of sacroiliac dysfunction, and the effectiveness of different therapeutic modalities for musculoskeletal dysfunction in horses.Lisa is based in Australia and has worked as a veterinarian in Australia and England in first opinion and referral equine practices. She currently runs her own integrative sport horse practice in the Adelaide Hills integrating veterinary medicine, acupuncture, physical therapy and therapeutic exercise to manage locomotory dysfunction in sport horses. She is a sessional lecturer for undergraduate and postgraduate veterinary courses across several universities, and is completing a PhD in sacroiliac dysfunction in horses at the University of Adelaide.Outside of work, Lisa is a horse-owning tragic. She has trained and ridden horses across various disciplines including, showing, stockwork, eventing and showjumping. She loves working with the “project” horse and has an understanding and empathy for the challenges and rewards that this can bring. In this episode we discuss:2:26 - episode introduction4:56 - introducing Dr Lisa Walter6:41 - Lisa’s start & where she’s at now with her work and Equine Veterinary interests9:16 - what brought Lisa to working on a PhD in sacroiliac dysfunction12:08 - why is it so difficult to rule out pain in horses & the challenge of identifying indicators of pain in our horses16:14 - the challenge of the Veterinary community of diagnosing more subtle conditions & the evolution of diagnostic/imaging equipment to better help diagnosis & having a non-verbal patient18:00 - diagnostic imaging technology for equines21:59 - Equine Veterinary Specialists25:20 - why should we continue to try and rule out pain in our horses & not just a ‘naughty pony’29:31 - the ‘cold backed’ horse30:19 - pain versus dysfunction & the challenge for Veterinary medicine of understanding ‘normal variation’ with the developing imaging equipment34:15 - how can individual owners contribute to further research in equine medicine?37:00 - the evolution of physiological issues - awareness, diagnosis & changes in the equine population & equine management39:55 - accessing Equine Specialists43:56 - top tips for listeners - if you’re suspect your horse might be experiencing pain45:51 - Vets who’ve done additional training in other physical modalities & the importance of having a trusted team of practitioners48:46 - if you think there’s a problem - there generally is - trust your instinct Link from this episode:In this episode, Lisa mentions Dr Sue Dyson’s work on the ridden horse pain ethogram. If you haven’t yet watched already, check out:‘The 24 Behaviors of the Ridden Horse in Pain: Shifting the Paradigm of How We See Lameness’ on YouTube to learn some about this research. Our links mentioned this episode:  Sign-up to our email listAbbey's Run Equestrian websiteAbbey's Run Equestrian on Facebook Thank you to Matthew Bliss for podcast production & consultation. You can find out more about podcast support on offer via: Blissery.FM or email [email protected]