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Mesotherapy is a treatment that stimulates the mesoderm, the middle layer of skin, which will, in turn, relieve a wide variety of symptoms and ailments. The technique was introduced into the United States by veterinarian, Dr. Jean Marie Denoix, for the equine patient at the Veterinary Thoracolumbar Spine Seminar, presented at Virginia Equine Imaging in the spring of 2002.
Mesotherapy is very helpful in treating many causes of chronic neck and/or back pain. It is particularly helpful in stopping the pain-spasm cycle that can be a contributing cause to chronic neck and back pain.
Mesotherapy works based on the theory of the gate control of pain, which takes place in the dorsal horn of the spinal cord. Pain signals are transmitted in specific types of neurons from the periphery in to the spinal cord and subsequently to the brain. Where these peripheral nerves connect with the next neuron in the dorsal horn of the spinal cord the pain signal can be changed or even blocked by signals from other types of neurons that don’t transmit pain signals but instead they transmit pressure or tactile (touch) sensation. Thus these other types of neurons have the ability to act as a gate for pain signals - if the gate is open the pain signals travel further up the spinal cord in to the brain where pain is perceived. If the gate is closed the pain signals are blocked or greatly diminished thus preventing the perception of pain. When we perform mesotherapy we are stimulating these other types of neurons which subsequently close the gate to pain signals in the spinal cord.
The simplest example of the gate theory of pain at work is if you accidentally smash your finger with a hammer you will instinctively grab the injured finger and squeeze it. By squeezing it you are stimulating different receptors in the skin which close the gate thus blocking the pain signals from traveling further in the spinal cord and thus pain perception is blocked or greatly reduced.
Your horse can be ridden prior to the treatment but it is best they not be worked hard. The horse should be done working no less than 1 hour to the appointment so that they are fully cooled out and relaxed at the time of the appointment. Please make sure they are clean and dry (it is preferred they be given a bath prior to the appointment to make sure the skin is as clean as possible to reduce the risk of infection).
Due to the multiple number of needle pokes that mesotherapy enatails moderate sedation is required. The horses treatment area (neck or back) is scrubbed clean with chlorhexidine and rinsed with alcohol.
A multi-injector plate is then used with very short (4-6mm), fine needles to inject fluid into the mesodermal layer of the skin creating small bumps in the skin. We generally administer 5 rows of injections on either side of the horses spine .These bumps typically disappear 24-48 hours after treatment.
There is no standard medications injected in mesotherapy but our protocol typically involves local anesthetic (mepivacane), homeopathic medications (Traumeel and/or Zeel), and Vitamin B-12. Depending on the severity of the pain we may also include a small amount of steroid (dexamethasone).
The horse should ideally be kept in for 24 to 48 hours after the treatment. If that is not possible then they can be turned out with a sheet on to cover the back. If the horse goes out after treatment and rolls, grinding dirt in to the treatment area there is risk of infection.
The horse may be ridden as soon as the bumps have disappeared but preferably the horse has 2-3 days of lunging with return to normal work thereafter. Improvement is often noted 5-7 days after treatment.
The number of treatments required for a horse with chronic back pain is dependent on several factors:
If problems are milder one treatment may provide several months of relief. If the pain is more severe the treatment may need to be repeated in 2-4 weeks. Thereafter preventative or maintenance treatments are generally 2-4 times a year.