StallSide Podcast

An Equestrian Veterinarian’s Perspective on Equine Pain with Dr. Chris Newton

Episode Summary

Dr. Chris Newton, known for treating spinal nerve pain and developing rehabilitation techniques based on classical dressage training, joins Dr. Peter Morresey and Dr. Bart Barber to discuss the intersection of horsemanship and veterinary care. Together, they explore how keen observation, advanced treatment methods, and rehabilitation techniques can improve a horse’s response to pain. Tune in for a conversation that blends cutting-edge veterinary science with the timeless art of dressage.

Episode Transcription

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Today's episode of the Stoll Side Podcast is brought to you by Rudin-Riddle Veterinary Pharmacy.


 

00:00:04.679 - 00:00:04.990

- Bart,


 

00:00:04.990 - 00:00:06.040

how are you doing today?


 

00:00:06.040 - 00:00:06.320

- Oh,


 

00:00:06.320 - 00:00:07.399

I'm better today.


 

00:00:07.399 - 00:00:08.839

It's good to have you back in the room.


 

00:00:08.839 - 00:00:09.060

- Yeah,


 

00:00:09.060 - 00:00:12.439

they actually gave me the keys to the asylum and I let myself out.


 

00:00:12.439 - 00:00:13.039

- Well,


 

00:00:13.039 - 00:00:15.359

glad we captured you and brought you back in.


 

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- Yeah,


 

00:00:15.650 - 00:00:16.960

you want to see what I left behind.


 

00:00:16.960 - 00:00:17.120

So,


 

00:00:17.120 - 00:00:18.600

interesting guest on the show tonight.


 

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- Very interesting.


 

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You know,


 

00:00:20.530 - 00:00:23.510

a veterinarian that came along about the same time that I did,


 

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been with us a long time,


 

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but takes a very different approach to veterinary medicine and I'm interested to talk to him.


 

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- Yeah,


 

00:00:31.080 - 00:00:34.039

and when I first dealt with Chris,


 

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he was sort of like in mixed practice,


 

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He did a lot of broodmare work and he had done some sportable stuff on the side,


 

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but his practice sort of shifted and his location shifted and he's sort of full-time into that now.


 

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And he has a very interesting approach to pain in horses and how to manage that.


 

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- He does,


 

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and a lot of what he does as a veterinarian is his observations as a horseman.


 

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So,


 

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he's got a very different approach.


 

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- Yeah,


 

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that's true.


 

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And there has been a lot of work on that just recently and how horses respond to pain and how that may be responsible for some of the performance limitations that we see in display.


 

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So,


 

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on Stool's side this episode,


 

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we're talking to Dr.


 

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Chris Newton from Rudin-Riddle Equine Hospital about his approach to the painful horse,


 

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how it may affect their performance and what therapeutics he applies to them to get the best out of them.


 

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(audience applauds) Chris,


 

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welcome to Stool's side.


 

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- Hello,


 

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good evening.


 

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- All right,


 

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thanks for taking your time out of your day to be with us.


 

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Appreciate it.


 

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- Absolutely.


 

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It was a quick drive up here from Florida to do such.


 

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- Yeah,


 

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okay.


 

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Hey,


 

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Chris,


 

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tell us a bit about yourself.


 

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- Let's see.


 

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I am probably one of the few local grower-uppers in the group.


 

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I was not born in Lexington,


 

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I was born in New York City,


 

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but moved to Lexington when I was five years old.


 

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And my parents had absolutely nothing to do with horses.


 

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My dad bought a farm as a real estate investment and I talked them into buying my first pony for $100 and always wanted to be a cowboy,


 

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then went to the 1978 World Championships,


 

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which was at the horse park,


 

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and became an avid eventing fan and full equestrian addict,


 

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basically at that stage of the game,


 

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from which I competed professionally quite a bit and then decided I needed to find a way to make money when I started a family.


 

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So I went to vet school and had worked for Rood & Riddle,


 

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basically from the time of its inception.


 

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The founders,


 

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Dr.


 

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Rood,


 

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Dr.


 

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Riddle,


 

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Dr.


 

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Emberson,


 

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all came out and treated colics and looked at emergencies and lacerations on my horses at the farm in the very beginning days and really inspired me at that point in time to become educated and join a practice of exceptional individuals,


 

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which I did in 2000.


 

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I took a year and a half out of school,


 

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went to Charlotte to practice before coming back just because I didn't want to be so insular and only see Lexington and then have been here pretty much since and started out in general,


 

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a combination of general broodmare,


 

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thoroughbred practice,


 

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farm practice with sports medicine.


 

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At that time,


 

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when I came,


 

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Dr.


 

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Rood was excited about starting sport horse stuff and Dr.


 

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Pierce said we'll never have a sport horse client,


 

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probably in the time of this practice,


 

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and we've seen that shift dramatically as we've grown through the years.


 

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- Threw Dr.


 

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Pierce right into the bus today.


 

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Never say never again.


 

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- Exactly.


 

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- Wait for Sean Connery.


 

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- And then I kind of retired from broodmare practice in 2015 and have concentrated just on sport horses and gotten back into competing and eventing pretty heavily myself.


 

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Last year,


 

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I was the Masters Advanced Level and Intermediate Level Champion for the United States in eventing and I'm shooting to break the record at the largest three-day event in the country,


 

00:04:08.879 - 00:04:14.599

the Horse Park this spring in the time span between competitive rides there of 33 years.


 

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- Wow,


 

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ambitious.


 

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- Ambitious,


 

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yeah.


 

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- And that's one thing we know about Chris,


 

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he's ambitious.


 

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I didn't know you were born in New York City,


 

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that's a new fact for me.


 

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So,


 

00:04:24.449 - 00:04:24.860

you know,


 

00:04:24.860 - 00:04:25.879

one of the first,


 

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it wasn't the very first case that I did,


 

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but it was one of the first three or four anyway.


 

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I looked at a horse for your mom,


 

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Nancy.


 

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We got a call here and they sent me out there and I got to know your mom pretty well in that few years when she was still around and it was great.


 

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Your family was a big part of Lexington,


 

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for sure.


 

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- Yeah,


 

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we have,


 

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yeah,


 

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it's been wonderful.


 

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Well,


 

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Lexington's a wonderful area,


 

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that's for certain.


 

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- But yeah,


 

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but you split your practice between Lexington and Ocala,


 

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so tell us a little bit about what your day looks like.


 

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- I try to get up first thing in the morning and ride two horses because you have to ride in order to compete at that level now.


 

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And then I'm practicing,


 

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seeing lamenesses and still do some emergency work.


 

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Eyes and colics,


 

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you don't avoid that for the clients that I have.


 

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I do a lot of body work.


 

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I really,


 

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prior to going to veterinary school,


 

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I felt like horses' bodies,


 

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just like human bodies,


 

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tended to be a primary source of pain.


 

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But at that point in time,


 

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I would have a vet look at a competition horse,


 

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and they'd say,


 

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"Well,


 

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it's sound,


 

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there's not a problem.


 

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"Wouldn't worry about it." But the way they performed,


 

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they were definitely exhibiting pain behaviors in the way that they went.


 

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That was,


 

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at that point in time,


 

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was kind of the advent of equine acupuncture with Dr.


 

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Cain,


 

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and I traveled with him for a while.


 

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And equine chiropractic started to come out,


 

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and I studied that for a while and integrated that into my practice.


 

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Still was doing a lot of joint injections,


 

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and now I've transitioned a lot more towards treating spinal nerve pain and developed a rehabilitational techniques,


 

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which are based off classical dressage training,


 

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more like you would do in physical therapy in humans,


 

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where we exercise horses in manners repetitively to regain strength and range of motion to regions of the body that are not,


 

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they're not utilizing and they're compensating away from.


 

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And the degree of pain that a lot of horses have in their body is shocking to me.


 

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And still,


 

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the identification of that pain by many of us in the equine world,


 

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although growing significantly over the last five years,


 

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is being missed,


 

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I think.


 

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- Well,


 

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let's talk about that just a little bit because you talked about pain behavior,


 

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and I'm guessing that's not the objective pain that we see exhibited in lameness or something like that.


 

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So could you dive us into a little bit further into that,


 

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what you mean by pain behavior?


 

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- Yeah,


 

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so lots of both performance and behavioral problems.


 

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Horses that rear,


 

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I find,


 

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generally have extreme pain at the atlantocipital or the first spinal nerve region.


 

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They don't wanna come through contact.


 

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And horses that are swapping leads as they're working,


 

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horses that are resistant to go forward,


 

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horses even that stop jumping,


 

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that have wanted to perform and jump,


 

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oftentimes prior to exhibiting unsoundness,


 

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will exhibit these behaviors and then push through it.


 

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hyperload certain limbs.


 

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And then we start seeing the soft tissue and the articular pain that is our classic objective pain with gait irregularities and lamenesses that we can block out.


 

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But there's a whole group of asymmetries in gait and irregularities in behavior and performance that come far before we're able to block out or isolate a lameness to a limb.


 

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To the degree that I think hoof growth is oftentimes correlated with the hyperloading.


 

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So you'll see one heel that tends to be very low,


 

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one leg that's very high.


 

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And that really,


 

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in my opinion,


 

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comes from spinal nerve compression and compensation and hyperloading of one side versus the other longterm.


 

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Because we see them as foals,


 

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as brand new day old foals,


 

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and they don't have a high low foot.


 

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But within a 60 day to 90 day period,


 

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you start to see growth patterns that are associated with that.


 

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And I actually think that comes from spinal nerve compression during the parturition process that they initially start to compensate for,


 

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which surprised me because as I was initially sorting this out,


 

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I was wondering what it was about our training techniques that was creating this issue.


 

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And so I went to palpate day old foals and palpated about 60 of them 'cause I was still doing reproductive practice at that time.


 

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And about nine out of 10 of those foals exhibited significant pain in similar areas as the adult horses that I was looking at for performance issues at that time.


 

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- There's something that's sort of been in the sort of the equine literature at the moment is the ridden horse pain ethogram,


 

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sort of driven by Sue Dyson.


 

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You'd like to comment on how that fits into what you see.


 

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- Yeah,


 

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I think it correlates very highly.


 

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Although Sue tends to look a little bit more and is coming more towards spinal pain,


 

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but still is more articular in her viewpoints.


 

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But the ethos is that their behavior most often is associated with pain or pain that is elicited when they respond to you asking them to do something.


 

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So even something as simple as you taking a hose to hose a horse off and it inverts and throws its head up in the air,


 

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if it has pain in that first region around the pole,


 

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it's like whiplashing it.


 

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And it will immediately start to correlate the hosing with that pain because it's eliciting it and you will start to develop a cycle of behavioral patterns that you have to retrain the behavioral patterns.


 

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But until you start taking the pain away,


 

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it's very difficult to retrain those behavioral patterns.


 

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- So you mentioned about taking the pain away.


 

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I mean,


 

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there's systemic medications,


 

00:10:48.600 - 00:10:51.919

there's probably some targeted local things that can be done.


 

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You mentioned acupuncture before.


 

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What's your approach to these horses that start to develop this aversion to exercise before they actually show overt lameness?


 

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- So unfortunately we're still lacking in significant neurodiagnostics of the body of the horse.


 

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And a lot of it goes back to clinical palpation and experience for me,


 

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which makes it hard to publish on and things like that.


 

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But it's pretty simple really to palpate a horse and identify where the pain is.


 

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They will tell you pretty well where it is.


 

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And I tend to go where that pain is and I will remove it utilizing primarily a local anesthetic along with a drug called Serapin that is a alkaloid that helps to block the C-fiber pain or diminish it by a bit for a period of time.


 

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And what surprises me is that doesn't last for two hours,


 

00:11:45.200 - 00:11:49.950

but it sort of allows that neuromuscular reset to occur and the relax,


 

00:11:49.950 - 00:11:50.919

but that's not the fix.


 

00:11:50.919 - 00:11:52.200

If you do that,


 

00:11:52.200 - 00:11:56.080

or if you do pulsating electromagnetic therapy or any of those,


 

00:11:56.080 - 00:11:58.480

you can eliminate a certain degree of pain.


 

00:11:58.480 - 00:11:59.320

And with this method,


 

00:11:59.320 - 00:12:02.000

I've been able to eliminate 100% of the pain,


 

00:12:02.000 - 00:12:07.960

whereas with acupuncture and PEM5 I was only able to eliminate about 20% of the pain.


 

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So really painful horses I couldn't make a big difference in.


 

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And the real change is you have to begin to work them in a manner that they change.


 

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They have to go to Pilates basically is what you have to do.


 

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Pilates and they have to change their core and because horses are quadrupeds,


 

00:12:26.759 - 00:12:29.919

they don't have to change a single area of our core like a human would.


 

00:12:29.919 - 00:12:31.240

As humans,


 

00:12:31.240 - 00:12:35.320

you go to Pilates and you work on a negative pelvic angle.


 

00:12:35.320 - 00:12:46.679

Michigan State's done a lot of research in runners showing that the negative pelvic angle improves long-term soundness in human runners as well as long-term performance.


 

00:12:46.679 - 00:12:48.759

But if you bring the top of your pelvis back,


 

00:12:48.759 - 00:12:57.039

you naturally curve your spine into a mild C similar to what you have when you are developing in your mother's uterus,


 

00:12:57.039 - 00:12:58.919

which every other mammal has.


 

00:12:58.960 - 00:13:05.279

And what I find is wherever the spine starts to dip towards the front excessively,


 

00:13:05.279 - 00:13:16.480

it begins to put pressure on those nerves and that pain cycle begins to start and then the body starts to guard and you can't begin to change the core musculature.


 

00:13:16.480 - 00:13:17.210

And again,


 

00:13:17.210 - 00:13:17.970

in horses,


 

00:13:17.970 - 00:13:19.840

the two cores versus the one,


 

00:13:19.840 - 00:13:28.679

we have to change both the shoulder or the shoulder sling musculature as a core and the abdominal musculature as a core.


 

00:13:28.700 - 00:13:31.279

So they have to be able to both lift their withers,


 

00:13:31.279 - 00:13:37.519

their entire back and tilt their pelvis while the head is being carried.


 

00:13:37.519 - 00:13:38.379

And the problem is,


 

00:13:38.379 - 00:13:42.679

is if you lift the head quickly with the withers being trapped down,


 

00:13:42.679 - 00:13:46.279

they will develop pain quickly.


 

00:13:46.279 - 00:14:05.279

It's very fast and you wanna modify that and they'll oftentimes then revert into this pain ethos where they start having behavioral problems and the first thing that typically happens is you check the saddle fit and you change the saddle fit and it improves them for a period of time because the pressure points are slightly adjusted.


 

00:14:05.279 - 00:14:10.039

And then you begin to blame the farrier.


 

00:14:10.039 - 00:14:13.159

That's usually the next individual that gets thrown under the bus.


 

00:14:13.159 - 00:14:15.879

And the farrier is generally saying,


 

00:14:15.879 - 00:14:16.289

"Well,


 

00:14:16.289 - 00:14:18.360

every time I go to pick this horse's legs up,


 

00:14:18.360 - 00:14:22.759

he's going into spasm and is hating it." And to me,


 

00:14:22.759 - 00:14:35.440

that is because you're engaging these neural pathways that are already in pain and the load in the foot is being affected by the compensatory load from the body pain.


 

00:14:35.440 - 00:14:38.360

And so they're reflecting it in growth patterns,


 

00:14:38.360 - 00:14:41.799

oftentimes shearing heels and things like that.


 

00:14:41.799 - 00:14:43.720

And so the farrier is trying to support that,


 

00:14:43.720 - 00:14:47.480

but they can only do it so much because if you're not changing load,


 

00:14:47.480 - 00:14:54.240

you're not really changing balance that much of the foot and it's not gonna change it.


 

00:14:54.269 - 00:14:55.200

So in my opinion,


 

00:14:55.200 - 00:14:59.679

you have to both help the foot as well as help the body simultaneously.


 

00:14:59.679 - 00:15:06.320

- So you mentioned a little bit about how the horse orientates itself under the influence of the rider.


 

00:15:06.320 - 00:15:10.720

So what particular positions can a rider put a horse in,


 

00:15:10.720 - 00:15:13.519

which will actually lead to the problems that you see,


 

00:15:13.519 - 00:15:15.039

bringing the head in,


 

00:15:15.039 - 00:15:16.029

bringing- - Well,


 

00:15:16.029 - 00:15:22.399

horses have three basic disobediences when it comes to handling them.


 

00:15:22.399 - 00:15:24.679

One is overpowering,


 

00:15:24.679 - 00:15:25.610

going forward,


 

00:15:25.610 - 00:15:26.120

backwards,


 

00:15:26.120 - 00:15:26.850

or sideways,


 

00:15:26.850 - 00:15:27.360

right?


 

00:15:27.360 - 00:15:28.559

They're gonna overpower,


 

00:15:28.559 - 00:15:29.279

run forward,


 

00:15:29.279 - 00:15:29.970

sideways,


 

00:15:29.970 - 00:15:30.960

or backwards.


 

00:15:30.960 - 00:15:35.399

Another significant inversion or misbehavior is inversion,


 

00:15:35.399 - 00:15:37.679

where the head comes up in the backdrops.


 

00:15:37.679 - 00:15:42.600

And the third primary disobedience is they will freeze in their front legs,


 

00:15:42.600 - 00:15:46.200

something that the French term is acumon,


 

00:15:46.200 - 00:15:49.129

or stillness of the hands,


 

00:15:49.129 - 00:15:49.919

and they won't move.


 

00:15:49.919 - 00:15:52.200

And that's probably the most dangerous,


 

00:15:52.200 - 00:15:55.279

the inversion and acumon lead to the rear.


 

00:15:55.279 - 00:16:03.200

And the rear behaviorally is the most dangerous misbehavior that a horse can do under saddle for a rider,


 

00:16:03.200 - 00:16:06.000

because the potential of them falling on them.


 

00:16:06.000 - 00:16:07.120

And I have,


 

00:16:07.120 - 00:16:11.600

I could count probably eight clients that I've had that have been killed by horses,


 

00:16:11.600 - 00:16:18.440

rearing and flipping over on them during my time working as a veterinarian,


 

00:16:18.440 - 00:16:21.519

and maybe a bit before as a rider also.


 

00:16:21.610 - 00:16:26.519

But those disobediences naturally lead to this freezing.


 

00:16:26.519 - 00:16:33.659

And oftentimes the inversion is used to help gain control because it's painful,


 

00:16:33.659 - 00:16:34.000

right?


 

00:16:34.000 - 00:16:38.240

And you can invert a horse in order to stop it if it's overpowering.


 

00:16:38.240 - 00:16:39.360

But the problem is,


 

00:16:39.360 - 00:16:44.240

is then they start to learn that behavior and you start changing the muscles.


 

00:16:44.240 - 00:16:45.519

And in my opinion,


 

00:16:45.519 - 00:16:51.480

we have to get the horse to go more into that fetal shape that they developed in,


 

00:16:51.490 - 00:16:54.080

not severely and not in a forceful way.


 

00:16:54.080 - 00:16:56.279

And that's why you have to take the pain away,


 

00:16:56.279 - 00:17:05.799

but in a manner that they start to develop those core muscles that lift the spine and put it back into that full mild C shape.


 

00:17:05.799 - 00:17:08.240

And then the horses will be free of pain.


 

00:17:08.240 - 00:17:09.319

For instance,


 

00:17:09.319 - 00:17:17.000

the horse that I'm trying to get to Kentucky this year was given to me five years ago because he was unrideable,


 

00:17:17.000 - 00:17:20.869

purchased for quite a bit in Europe and diagnosed with EPM,


 

00:17:20.869 - 00:17:23.640

diagnosed with cervical issues.


 

00:17:23.640 - 00:17:31.759

And over a period of time of removing pain and retraining and kind of going through the process of figuring it out,


 

00:17:31.759 - 00:17:32.759

he's gotten better and better.


 

00:17:32.759 - 00:17:38.680

And he hasn't had to be treated for quite a while because now he's strong and uses his body correctly,


 

00:17:38.680 - 00:17:43.079

Which is the whole concept of true physical therapy in humans,


 

00:17:43.079 - 00:17:43.720

right?


 

00:17:43.720 - 00:17:45.039

Our goal is to,


 

00:17:45.039 - 00:17:46.880

oftentimes our injuries occur.


 

00:17:46.910 - 00:17:48.480

If you're a pitcher,


 

00:17:48.480 - 00:17:59.359

your injuries occur to your arm typically because your technique is not correct or your musculature can't support the technique that you're using to throw certain styles of balls.


 

00:17:59.359 - 00:18:09.519

And there's tremendous research in young athletes showing that multi-sport athletes tend to have fewer career-ending injuries than single-sport athletes,


 

00:18:09.519 - 00:18:15.339

with baseball actually being the primary single-sport damaging athlete that there is.


 

00:18:15.339 - 00:18:16.400

And that's,


 

00:18:16.400 - 00:18:17.200

in my opinion,


 

00:18:17.200 - 00:18:26.119

because you are strengthening multiple muscles and you're never putting tremendous strain on a single group of muscles all the time.


 

00:18:26.119 - 00:18:29.640

And we get sometimes fixed.


 

00:18:29.640 - 00:18:35.640

And as we've moved further and further away from the cavalry in the world,


 

00:18:35.640 - 00:18:42.599

where these techniques were used to train horses and they were passed down by generations.


 

00:18:42.599 - 00:18:46.240

And the first people that taught me were generals and colonels,


 

00:18:46.240 - 00:18:49.759

General Burton and individuals like that,


 

00:18:49.759 - 00:18:51.519

but that's been lost.


 

00:18:51.519 - 00:18:58.599

And we've lost a lot of those older techniques and they've been passed on to quicker,


 

00:18:58.599 - 00:19:02.960

more efficient and better breeding techniques.


 

00:19:02.960 - 00:19:04.839

So we breed for these super athletes,


 

00:19:04.839 - 00:19:07.000

which we're getting oftentimes,


 

00:19:07.000 - 00:19:22.519

but we aren't spending the time to develop them earlier in their lives such that they aren't affected by the time that they're eight or 10 with these pain behavior and then lameness consequences of it.


 

00:19:22.519 - 00:19:24.680

- You mentioned about palpating for your exam.


 

00:19:24.680 - 00:19:26.160

So if you're approaching a horse like this,


 

00:19:26.160 - 00:19:30.119

say one of these horses that was going rigid in front,


 

00:19:30.119 - 00:19:31.920

lifting the head back and trying to rear,


 

00:19:31.920 - 00:19:33.839

what would be your approach to that horse?


 

00:19:33.839 - 00:19:35.359

You say you palpate,


 

00:19:35.359 - 00:19:37.119

you're obviously gonna look at the horse.


 

00:19:37.119 - 00:19:39.319

How does Chris Newton assess those horses?


 

00:19:39.319 - 00:19:44.559

- The first thing I do is I watch the horses in motion and I'll either watch them on a lunge.


 

00:19:44.559 - 00:19:46.359

I tend to watch them all on a lunge,


 

00:19:46.359 - 00:19:54.920

not typically on a paved surface because I find paved surfaces to be quite slick with shoes and they really compensate in their gates for that.


 

00:19:54.920 - 00:19:55.799

So it's unfair.


 

00:19:55.799 - 00:19:58.559

And there are two things I'm looking for.


 

00:19:58.559 - 00:20:07.279

I wanna see if a horse independent of themselves or independent of a rider will go around and put their head all the way to the ground and lift their back.


 

00:20:07.279 - 00:20:08.599

And it is shocking to me,


 

00:20:08.599 - 00:20:11.660

the number of horses that you can put on a lunge and trot and canter,


 

00:20:11.660 - 00:20:12.559

the walk most will,


 

00:20:12.559 - 00:20:15.119

but the more you push a horse forward,


 

00:20:15.119 - 00:20:20.839

the more it engages the hind end and the horse's back muscles are interconnected with the gluteal muscles,


 

00:20:20.839 - 00:20:22.519

which is different than the human.


 

00:20:22.519 - 00:20:24.559

And thus as the hind end engages,


 

00:20:24.559 - 00:20:32.279

it forces the back to stretch and horses will refuse to go forward or they will refuse then to put the head down as they go forward,


 

00:20:32.279 - 00:20:34.039

because if they put the head down and stretch,


 

00:20:34.039 - 00:20:35.720

they have to lift the back.


 

00:20:35.720 - 00:20:48.440

And I would say seven out of 10 horses that I put on a lunge free of themselves would go around the circle for five hours and never put their pole below their withers.


 

00:20:48.440 - 00:20:50.559

Never stretch the pole below their withers.


 

00:20:50.559 - 00:20:52.960

Now they'll do it when they're grazing,


 

00:20:52.960 - 00:20:54.599

but when you watch them graze,


 

00:20:54.599 - 00:20:59.000

those ones that are really affected will split their front limbs severely.


 

00:20:59.000 - 00:21:02.559

They'll put one front limb out much further than the other.


 

00:21:02.759 - 00:21:07.759

And a horse that has less pain will stand much square in front.


 

00:21:07.759 - 00:21:12.039

And that's why the square halt of dressage,


 

00:21:12.039 - 00:21:16.400

which dressage was developed from military training techniques,


 

00:21:16.400 - 00:21:19.960

is what is evaluated at the halt,


 

00:21:19.960 - 00:21:22.960

that the horse stands up with all four legs there,


 

00:21:22.960 - 00:21:33.039

because a horse that stands unsquare is oftentimes unwilling to stand evenly on both legs because they have some degree of compensation.


 

00:21:33.039 - 00:21:35.039

So I'll watch them go free like that,


 

00:21:35.039 - 00:21:42.359

and then I'll flex their joints and see if their joints and soft tissue is a source of pain,


 

00:21:42.359 - 00:21:44.400

which if it is,


 

00:21:44.400 - 00:21:46.960

then I can't do the rehabilitation of the body.


 

00:21:46.960 - 00:21:51.039

We have to deal with the joint or the soft tissue injury.


 

00:21:51.039 - 00:21:52.480

We're not gonna take a horse,


 

00:21:52.480 - 00:21:53.319

for instance,


 

00:21:53.319 - 00:21:54.960

it's just torn a tendon,


 

00:21:54.960 - 00:21:58.559

and treat its body and put it into work immediately.


 

00:21:58.559 - 00:22:00.160

It's got to heal the tendon.


 

00:22:00.160 - 00:22:01.480

Then I say,


 

00:22:01.480 - 00:22:04.200

why did it injure the tendon?


 

00:22:04.200 - 00:22:06.799

Was it just a primary stepped in a hole?


 

00:22:06.799 - 00:22:08.559

Or is it an overload injury?


 

00:22:08.559 - 00:22:10.960

Which I think most often it is.


 

00:22:10.960 - 00:22:15.200

And most often I will correlate that with pain up high.


 

00:22:15.200 - 00:22:19.920

And then I'll do palpation all the way along the spine,


 

00:22:19.920 - 00:22:22.559

palpating for neuromuscular pain.


 

00:22:22.559 - 00:22:27.319

And it's pretty easy to elicit once you figure out where to palpate.


 

00:22:27.319 - 00:22:29.079

And it's shocking.


 

00:22:29.079 - 00:22:31.000

There are horses that I,


 

00:22:31.000 - 00:22:36.839

the reason I now palpate that last is because there are horses that when I hit those points,


 

00:22:36.839 - 00:22:39.920

they won't allow me near them again to touch them.


 

00:22:39.920 - 00:22:41.559

It's so painful.


 

00:22:41.559 - 00:22:44.440

And it shocked me when I first started to sort that out.


 

00:22:44.440 - 00:22:47.839

And now it doesn't shock me at all.


 

00:22:47.839 - 00:22:52.319

It makes sense because people are the same.


 

00:22:52.319 - 00:22:57.319

There are lots of people that you go up to and you go to hug them or something.


 

00:22:57.319 - 00:22:57.789

They say,


 

00:22:57.789 - 00:22:58.599

don't touch me.


 

00:22:58.599 - 00:22:59.220

And you say,


 

00:22:59.220 - 00:23:00.400

is your back painful?


 

00:23:00.400 - 00:23:01.880

And they'll say,


 

00:23:01.880 - 00:23:02.039

no,


 

00:23:02.039 - 00:23:03.000

my back's not painful,


 

00:23:03.000 - 00:23:06.920

but then they'll walk away and hunker and they can't pick anything up off the floor.


 

00:23:06.920 - 00:23:08.480

And natural,


 

00:23:08.480 - 00:23:10.640

our ability to survive,


 

00:23:10.640 - 00:23:17.839

we have natural abilities to reduce our pain thresholds and to fool ourselves into thinking we're not in pain,


 

00:23:17.839 - 00:23:21.319

but we are.


 

00:23:21.319 - 00:23:22.160

- Right.


 

00:23:22.160 - 00:23:24.440

So once you've actually identified that focus of the pain,


 

00:23:24.440 - 00:23:26.480

you mentioned some medications before.


 

00:23:26.480 - 00:23:28.240

What's your approach?


 

00:23:28.240 - 00:23:29.079

- I will,


 

00:23:29.079 - 00:23:30.119

if the joints are good,


 

00:23:30.119 - 00:23:35.799

then I will inject around where the nerves are coming out of the spine,


 

00:23:35.799 - 00:23:42.000

around the transverse process with the combination of carbocane and serapin and a little bit of prednisone.


 

00:23:42.000 - 00:23:44.200

It's not a primary steroid-based.


 

00:23:44.200 - 00:23:48.519

I use just a little bit that lasts for 12 hours to stop inflammation at the site.


 

00:23:48.519 - 00:23:51.200

And they begin working the next day.


 

00:23:51.200 - 00:23:54.200

And they begin the rehab process the next day.


 

00:23:54.200 - 00:23:56.359

If the horse is really inversive,


 

00:23:56.359 - 00:23:59.000

I begin to teach the clients the techniques.


 

00:23:59.000 - 00:24:00.640

And if they're capable of doing it,


 

00:24:00.640 - 00:24:01.119

they'll do it.


 

00:24:01.119 - 00:24:01.960

If they're not,


 

00:24:01.960 - 00:24:09.440

then I'll set up with a trainer or ourselves to help them do the rehab in the beginning.


 

00:24:09.440 - 00:24:14.319

And we begin to work the horse in hand without a rider on,


 

00:24:14.319 - 00:24:19.160

because typically the upper back is the area that's the most affected to the lower neck.


 

00:24:19.160 - 00:24:23.359

That's the most naturally downward bending region of the horse.


 

00:24:23.359 - 00:24:24.839

And we want to lift that.


 

00:24:24.839 - 00:24:27.559

And that's a very difficult area to get a horse to lift.


 

00:24:27.559 - 00:24:30.880

And with just a little bit of weight as a rider,


 

00:24:30.880 - 00:24:31.720

it affects it.


 

00:24:31.720 - 00:24:35.160

If I just put my hand on those horses when they're in pain,


 

00:24:35.160 - 00:24:42.480

most often they will rear or they will try and fall to the ground rather than lift their wither without a rider on them.


 

00:24:42.480 - 00:24:49.400

And so we keep the rider off until they learn how to go posturally correctly.


 

00:24:49.400 - 00:24:55.119

And we also work on balance so that they learn to carry their balance on the outside shoulder.


 

00:24:55.119 - 00:25:00.240

Because as a horse goes around a turn and they fall on their inside shoulder,


 

00:25:00.240 - 00:25:04.200

they have to engage the back muscles and hold them tightly.


 

00:25:04.200 - 00:25:06.599

And you'll see horses going around,


 

00:25:06.599 - 00:25:10.359

early on I would see horses that were lame on the right front.


 

00:25:10.359 - 00:25:14.920

I'd get horses that were non-responsive to everything for say a right front lameness.


 

00:25:14.920 - 00:25:21.519

And I'd put them on the lunge line and they would go around with their haunches into the circle at around a 40 degree angle,


 

00:25:21.519 - 00:25:23.079

bent to the outside,


 

00:25:23.079 - 00:25:25.839

severely hyper-loading their lame leg,


 

00:25:25.839 - 00:25:26.720

The leg that hurt them.


 

00:25:26.720 - 00:25:27.289

Well,


 

00:25:27.289 - 00:25:29.680

if a horse steps on my right foot,


 

00:25:29.680 - 00:25:31.359

I hyper-load my left.


 

00:25:31.359 - 00:25:33.240

I hobble around and don't put weight on that.


 

00:25:33.240 - 00:25:34.779

And I said,


 

00:25:34.779 - 00:25:53.319

that's why I walk down the pathway that I think oftentimes it is secondary to that compensation and is I oftentimes could just treat the body and change how they carried themselves and the lameness would dissipate and go away without even treating specifically that area in the heel.


 

00:25:53.319 - 00:25:55.759

Oftentimes it was sore and things along those lines,


 

00:25:55.759 - 00:25:56.920

which shocked me,


 

00:25:56.920 - 00:25:58.359

but it's a process.


 

00:25:58.359 - 00:25:58.950

It's not,


 

00:25:58.950 - 00:26:00.359

there's no magic to it.


 

00:26:00.359 - 00:26:01.210

It's,


 

00:26:01.210 - 00:26:12.910

if you want your back to get better and you go and get an epidural injection and you don't go and start doing physical therapy and Pilates,


 

00:26:12.910 - 00:26:14.519

you will never get better.


 

00:26:14.549 - 00:26:17.240

It will continue to be an issue.


 

00:26:17.240 - 00:26:22.119

If you begin to change your posture and you strengthen around your core,


 

00:26:22.119 - 00:26:23.359

you will begin to improve.


 

00:26:23.359 - 00:26:26.440

And the same thing can happen in horses.


 

00:26:26.440 - 00:26:27.240

The problem is,


 

00:26:27.240 - 00:26:32.619

is they're so big that you have to understand more effectively how to do it.


 

00:26:32.619 - 00:26:33.400

And,


 

00:26:33.400 - 00:26:34.759

you know,


 

00:26:34.759 - 00:26:38.319

we oftentimes just put them in swimming pools and things like that as rehab,


 

00:26:38.319 - 00:26:44.240

but I think it has to be a work-based learning self-carriage correctly process.


 

00:26:44.240 - 00:26:53.319

- And that is an uphill battle because we live in this 32nd TikTok world where people want you to inject something and be done with it and move on.


 

00:26:53.319 - 00:26:54.480

So it's,


 

00:26:54.480 - 00:26:56.240

so what you're describing is much more of a process.


 

00:26:56.240 - 00:26:57.359

It's learning,


 

00:26:57.359 - 00:27:01.960

there's a learning curve to it and an education that people need to go through.


 

00:27:01.960 - 00:27:02.460

- Yeah,


 

00:27:02.460 - 00:27:03.200

absolutely.


 

00:27:03.200 - 00:27:03.650

- Yeah,


 

00:27:03.650 - 00:27:05.359

there's no quick fixes here.


 

00:27:05.359 - 00:27:07.000

Give us an example of a case,


 

00:27:07.000 - 00:27:07.470

of course,


 

00:27:07.470 - 00:27:08.559

not naming names recently,


 

00:27:08.559 - 00:27:19.960

where you saw a particular behavior and you set in motion certain remedial activities and what the time course of that was.


 

00:27:19.960 - 00:27:25.599

- Let's say I had a horse that competed at the RRP that won this year,


 

00:27:25.599 - 00:27:38.559

who in May was rearing and had been diagnosed with severe kissing spine and a left hind high suspensory pain.


 

00:27:38.660 - 00:27:42.880

There was no ultrasonic graphic change to the suspensory ligament.


 

00:27:42.880 - 00:27:57.539

And they were told that the horse needed to likely be euthanized because kissing spine surgery probably had about 10 dorsal spinous processes that had enthesiophistic activity and some remodeling on them.


 

00:27:57.539 - 00:27:58.500

And they said,


 

00:27:58.500 - 00:28:05.720

probably it's gonna cost quite a bit of money for the surgery and the likelihood of a positive outcome isn't very high.


 

00:28:05.740 - 00:28:13.119

And they found me through another client and came and we began that process.


 

00:28:13.119 - 00:28:20.680

The left hind high suspensory pain was really a radiating sciatic nerve pain.


 

00:28:20.680 - 00:28:22.420

It was a left hind dominant horse,


 

00:28:22.420 - 00:28:24.920

which most horses are left hind dominant,


 

00:28:24.920 - 00:28:25.740

unlike humans,


 

00:28:25.740 - 00:28:27.240

which are right hand dominant.


 

00:28:27.240 - 00:28:47.000

And the horse tended to rear buck severely and had developed a splint on the inside of the right front where it also hyperloaded and it had gone through some stall rests and become basically angry at the world and was biting and being somewhat nasty and vicious.


 

00:28:47.000 - 00:28:55.759

And so we began this process with that horse and we trained it for a while because he was so difficult.


 

00:28:55.759 - 00:29:03.400

And then the owner took over and it went on to do quite well at the Retired Racehorse Project.


 

00:29:03.400 - 00:29:09.400

And she's since now down in Florida competing this winter with the horse and the horse has been sound.


 

00:29:09.400 - 00:29:11.710

And we still do the work,


 

00:29:11.759 - 00:29:13.160

Before she gets on him every day,


 

00:29:13.160 - 00:29:19.880

he goes on the line and has to carry himself correctly in self-carriage.


 

00:29:19.880 - 00:29:21.160

Because when we ride a horse,


 

00:29:21.160 - 00:29:29.019

we compensate for their imbalances and they have to learn to compensate for their imbalances themselves.


 

00:29:30.039 - 00:29:40.039

And that type of case has repeated itself over and over for me even with my own horses I was talking about.


 

00:29:40.039 - 00:29:44.680

- You mentioned earlier some of the difficulties because we don't have the right diagnostics.


 

00:29:44.680 - 00:29:49.359

Any hope on the horizon for new diagnostics that'll help you out?


 

00:29:49.359 - 00:29:50.299

- I asked Dr.


 

00:29:50.299 - 00:29:51.119

Garrett.


 

00:29:51.119 - 00:29:59.160

There is a new muscle device that measures pressures which is being used for high suspensors.


 

00:29:59.160 - 00:30:04.079

Ken Allen published a paper looking at high suspensory injuries using this.


 

00:30:04.079 - 00:30:08.839

But it is very correlative to my palpation techniques,


 

00:30:08.839 - 00:30:12.000

meaning I've messed with the people that are selling it,


 

00:30:12.000 - 00:30:20.039

but it wasn't able to give me significantly more than what I was garnering from palpation.


 

00:30:20.039 - 00:30:22.359

And for the price line that we went in,


 

00:30:22.359 - 00:30:24.759

I didn't think it was worth that.


 

00:30:24.759 - 00:30:26.240

But I hope so,


 

00:30:26.240 - 00:30:26.680

yeah.


 

00:30:26.680 - 00:30:27.339

And I talked to Dr.


 

00:30:27.339 - 00:30:35.839

Garrett because I wanted to do some studies looking at horses in different training positions and doing CT of the spine or x-rays of the spine.


 

00:30:35.839 - 00:30:36.710

And she said,


 

00:30:36.710 - 00:30:37.759

we just can't get those images.


 

00:30:37.759 - 00:30:39.089

And the problem is,


 

00:30:39.089 - 00:30:44.720

is we don't have humans that are large enough yet to drive the economy to get those there.


 

00:30:44.720 - 00:30:45.769

But hopefully,


 

00:30:45.769 - 00:30:46.369

I mean,


 

00:30:46.369 - 00:30:47.200

everybody,


 

00:30:47.200 - 00:31:01.279

I think as the industry recognizes more and more and from the point in time that I started looking at bodies and everybody else thought it was crazy to now it has shifted tremendously.


 

00:31:01.279 - 00:31:04.400

And my hope is that we do get more and more.


 

00:31:04.400 - 00:31:06.200

I get radiographs now.


 

00:31:06.200 - 00:31:09.059

We didn't,


 

00:31:09.059 - 00:31:11.359

before the advent of the digital x-ray machine,


 

00:31:11.359 - 00:31:13.440

we didn't diagnose kissing spine.


 

00:31:13.440 - 00:31:15.039

It was never heard of.


 

00:31:15.039 - 00:31:16.819

And in my opinion,


 

00:31:16.819 - 00:31:18.680

kissing spine is a symptom.


 

00:31:18.680 - 00:31:20.240

It's not a cause.


 

00:31:20.240 - 00:31:25.240

But as soon as we started having widespread diagnostic,


 

00:31:25.480 - 00:31:27.000

digital radiography,


 

00:31:27.000 - 00:31:30.960

all the horses had kissing spine and it's a big banter.


 

00:31:30.960 - 00:31:36.799

And now we're seeing that with the lower cervical vertebrae and the cervical vertebral malformation.


 

00:31:36.799 - 00:31:42.440

And I think that we have still a lot to learn.


 

00:31:42.440 - 00:31:46.519

We don't have a lot of pain relieving,


 

00:31:46.519 - 00:31:51.569

minimally invasive surgeries around the spine that humans have,


 

00:31:51.569 - 00:31:57.279

which I hope will begin to be developed like photo ablation therapy and things like that.


 

00:31:57.279 - 00:32:00.160

And it's just people,


 

00:32:00.160 - 00:32:07.880

I think the next generation will pursue it more because it is very relevant to performance.


 

00:32:07.880 - 00:32:17.720

And I think by two generations of veterinarians we'll begin to see significantly more intervention as well as diagnostics.


 

00:32:17.720 - 00:32:18.069

- Yeah,


 

00:32:18.069 - 00:32:22.880

and there's a lot of change on the horizon just we learn so much more all the time.


 

00:32:22.900 - 00:32:23.119

- Yes,


 

00:32:23.119 - 00:32:24.390

it's got a lot more complicated,


 

00:32:24.390 - 00:32:24.960

hasn't it?


 

00:32:24.960 - 00:32:25.759

- It has,


 

00:32:25.759 - 00:32:26.480

yeah.


 

00:32:26.480 - 00:32:27.109

- Yeah,


 

00:32:27.109 - 00:32:27.539

well,


 

00:32:27.539 - 00:32:28.759

that's great.


 

00:32:28.759 - 00:32:29.039

I mean,


 

00:32:29.039 - 00:32:29.339

Chris,


 

00:32:29.339 - 00:32:30.680

thanks for coming in and seeing us.


 

00:32:30.680 - 00:32:31.269

I mean,


 

00:32:31.269 - 00:32:34.259

this is a very holistic approach to the horse,


 

00:32:34.259 - 00:32:34.480

right?


 

00:32:34.480 - 00:32:37.640

It's not just a case of trying to localize something and block it out.


 

00:32:37.640 - 00:32:40.329

It's a case of sort of like looking at the horse as a whole and saying,


 

00:32:40.329 - 00:32:40.609

okay,


 

00:32:40.609 - 00:32:45.480

we temporarily relieve this pain and then we train you out of the pain,


 

00:32:45.480 - 00:32:50.720

Because you can only take so much medication for these things before you're not really solving the problem.


 

00:32:50.720 - 00:32:52.279

So this is a really fascinating approach.


 

00:32:52.279 - 00:32:52.690

- Yeah,


 

00:32:52.690 - 00:32:53.200

I agree.


 

00:32:53.200 - 00:32:54.880

Thanks for being with us.


 

00:32:54.880 - 00:32:55.720

That's interesting.


 

00:32:55.720 - 00:32:56.559

- Absolutely.


 

00:32:56.559 - 00:32:57.400

Thank you guys.


 

00:32:57.400 - 00:32:58.240

Wonderful.


 

00:32:58.240 - 00:32:58.529

- Yeah,


 

00:32:58.529 - 00:33:00.039

and that was "Stall Side" for this week.


 

00:33:00.039 - 00:33:01.450

We were talking to Dr.


 

00:33:01.450 - 00:33:05.599

Chris Newton regarding his approach to pain in horses,


 

00:33:05.599 - 00:33:06.839

the performance effects,


 

00:33:06.839 - 00:33:10.079

and how he holistically looks at the horse to deal with that.


 

00:33:10.079 - 00:33:11.000

See you next time.