Veterinarians use complementary therapies alongside conventional care to ease pain, aid recovery, and support performanceVeterinarians use acupuncture to treat conditions such as back and neck pain, nerve pain, and anhidrosis (nonsweating). | Emilee Hall Grover Photo Courtesy Dr. Laura WodzinskiMore and more, veterinarians have incorporated complementary therapiessuch as acupuncture, chiropractic, and electroacupunctureinto equine care. With these modalities they aim to address chronic conditions, such as headshaking and pain, and support health and performance in competitive and recreational horses. Owners can work with their veterinarians to determine whether these approaches are appropriate for their animals.Vets who use these modalities say they can complement conventional treatments and, in some cases, improve comfort and performance when other options fall short.Why the Rise in These Therapies?Sarah Senn, DVM, a general practitioner at Littleton Equine Medical Center, in Colorado, graduated from vet school in 2015 and earned her chiropractic certification four years later. With a strong emphasis on performance horse medicine, Senn says she considers integrative therapies a profound tool in her work. I think over the past 10 years, integrative therapies have been widely accepted, she notes. Increasingly, veterinarians are being trained in these modalities and incorporating them into their practices. I feel that its quite mainstream now to have at least oneif not morepractitioners in a practice who are able to offer these services.Sara Wefel, DVM, Dipl. ABVP (equine specialty), associate professor in the Department of Veterinary Population Medicine at the University of Minnesotas College of Veterinary Medicine, in Long Lake, says she believes the industrys savviness contributes to the popularity of integrative therapies. Primarily a part of the universitys ambulatory service, she has training and certification in acupuncture and spinal manipulation.Expanding the Practice ToolkitEarly in her career, Katie Seabaugh, DVM, MS, Dipl. ACVS and ACVSMR, now an associate professor at Colorado State Universitys College of Veterinary Medicine & Biomedical Sciences, in Fort Collins, managed the care of equestrian team horses at the University of Georgia and was first introduced to acupuncture and spinal manipulation therapies, which horse owners frequently requested.Upon returning to Colorado, Seabaugh sought acupuncture (Medical Acupuncture for Veterinarians) and chiropractic (Veterinary Chiropractic) certification. I went into it to learn so that I could communicate with my clients better, she says. I started to embrace it and utilize it. The therapies are integrative, but also holistic.Expanding Treatment OptionsWefel says complementary therapies such as acupuncture and chiropractic offer a flexible approach to address a wide range of equine conditions. Veterinarians can use these noninvasive modalities alone or in conjunction with conventional medicine to address musculoskeletal issues, chronic pain, and other problems, she says.Every horse has something that weve got to manage, she says. It might be mild arthritis. You might have back pain. I really see their value in taking care of some of our older patients. There are a lot of ways we can add to their conventional therapy. A good example would be something like anhidrosiswhen horses dont sweat. Acupuncture can be hugely helpful in restoring some of that function and improving the horses care and quality of life.Dr. Sara Wefel says she believes training in both conventional and integrative care helps vets find approaches to best suit each patient. | Courtesy Dr. Sara WefelWefel uses both traditional acupuncture and electroacupuncture to address pain and soft tissue injuries. Ill use it for pain relief in a horse struggling with back or neck pain, she adds. I also find it useful with traumatic injury when a horse may not only have a soft tissue injury but also nerve pain. Ive treated horses with an unknown diagnosis, but we know some have a nervous system component. In (muscle twitching) cases when pain control involves the nervous system, I think the electroacupuncture can really be helpful.Understanding The ScienceAs complementary approaches have gained more acceptance in clinical settings, scientists have validated therapies such as acupuncture and chiropractic.For example, researchers studied the use of electroacupuncture to manage horses dealing with headshaking. Scientists believe this devastating neurological condition stems from dysfunction of the trigeminal nerve in the face. Affected horses experience tingling or burning pain in the muzzle, causing the headshaking episodes, which have long been a source of frustration and anxiety for owners and veterinarians alike.Bettina Dunkel, DVM, PhD, Dipl. ACVIM, Dipl. ECEIM, ACVECC, FHEA, MRCVS, is a professor of equine medicine and emergency and critical care at the Royal Veterinary Colleges Hawkshead campus, in Hertfordshire, U.K. She notes how practitioners saw early signs of potential benefit from using percutaneous electrical nerve stimulation (PENS) to treat headshaking. Still, only 50-57% of horses treated showed improvement in clinical signs. Additionally, the equipment proved to be cost-prohibitive, and she says horses balked at the procedure.Because they saw promising results with electroacupuncture in smaller studies, Dunkel and her team of researchers sought to retrospectively investigate the effectiveness of the procedure in 42 horses across the U.K.In one study, researchers found 64% of headshaking horses improved with electroacupuncture, and 33% became symptom-free. | Courtesy Boltons Park Farm, Hertfordshire, U.K. We saw an improvement in 64% of horses, and 33% of horses were symptom-free, she says. Electroacupuncture proved to be as effective as PENS, but the advantage is that it utilizes a small, handheld device that fits into the palm of your hand. Rather than using expensive electrodes, it uses very cheap electroacupuncture needles.The veterinarian inserts an acupuncture needle over the exit point of the trigeminal nerve and places another needle in the shoulder region to form what is essentially an electric circuit on both sides of the face. The machine delivers electrical impulses, starting at a low frequency and escalating until the horse shows signs of intolerance.Read more about the research behind these therapies at TheHorse.com/198248.Combining Conventional and Complementary ApproachesWefel says she believes a background in both conventional and integrative therapies enables veterinarians to find approaches that best suit the equine patient.On the large animal side, especially the equine side, we have so many faculty members who have a background and training in integrative therapies, she says, such as anesthesiologists with acupuncture training. Students are really getting exposure to how you can apply these modalities in a bunch of different services and in different ways.Integrative therapies offer an added benefit to healing in critical care and, again, nerve pain cases, says Wefel.Nerve pain can be notoriously hard to get under control, she explains, and acupuncture serves as a noninvasive option. Were not giving them systemic things that could contribute to gastric ulcers. We can be really targeted if we know the area thats affected. We can treat the nervous system. Say we have a critical care patient, and surgery isnt an option. Were giving the horse all the conventional medications, but we can add in some of these other therapies for pain relief.Senn concurs, offering an example of how she might treat a performance horse with chronic back pain. Our traditional approach would be to do a thorough musculoskeletal exam and, likely, imaging of the area, including radiographs, ultrasound, things like that, she says. Depending on the diagnosis, we can determine whether chiropractic or acupuncture would be a suitable complement to any other treatments necessary for the back. And then we can couple those to make the horse more comfortable.Treating the Whole HorseSeabaugh stresses that if owners believe their horses need a specific therapy, they need to trust their vets to be able to sort through what tools they have to help and explain why theyre selecting them.Most of these modalities are expensive to invest in , she says. We cant have them all. Trust your veterinarian because they are going to make the choice theyre most comfortable with, that they feel is best for your horses injury, one that is the most feasible.Wefel notes that a holistic approach not only supports the horses health but also builds trust. She stresses that while she loves the other services she provides, integrative therapy appointments force her to slow down her pace and her mind.When I approach a horse with simple tools and my hands and my time, horses really open up, she says. Its amazing the difference. Some horses are very stoic and closed off. When you find an area of muscle tension and youre treating it, horses see you on a different level. Its a significant achievement to establish a connection with our patients. In the event of something routine or an emergency, they have a stronger relationship with you and a stronger trust in you. Thats the name of the game. Its a huge, huge trust builder for our patients.Senn says she hopes the research catches up with clinical practice and agrees with Wefel that integrative therapy appointments can be meaningful. These appointments are lovely because the horses feel good and end up learning that they get an endorphin release. Its a nice appointment to have on both the horse side and the practitioner side.This article is from the Winter 2025 issue ofThe Horse: Your Guide to Equine Health Care. We at The Horse work to provide you with the latest and most reliable news and information on equine health, care, management, and welfare through our magazine and TheHorse.com. 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