My horse is on stall rest and he's becoming psychotic (cross posted)

[WalnutGroveEq]

I am at my wits end. I’m not sure what else to do.

I have a 5 year old OTTB with a suspensory injury. He has been on stall rest for a little over a month now and his mental state has been slowly deteriorating. Like to the point I absolutely dread handwalking him because I’ve been bitten, stepped on, kicked, and I’m legitimately concerned for my safety at this point.

In the barn he is still very sweet and generally quiet, but the second you try to walk him outside it’s like a switch gets flipped.

Hes been on zylkene for 20 days and it has done nothing that I can tell. My vet feels strongly that reserpine is not a good option because of the possibility of neurological effects after long term use. We’ve been doing IM ace once a day 20-30 mins before hand walking and it seems hit or miss. I tries oral ace today and I honestly thought he might kill himself or me.

I walk him with a lunge rope with a chain because without it he has bolted and gotten away. Even just walking in a straight line he frequently rears and bucks and leaps. Like far far beyond what I’ve ever had a horse do before.

He does get to wander the aisle of the barn for about 10-15?mins twice a day when his stall gets cleaned out and he really doesn’t do anything bad.

Last week we were trialing letting him out in a small pen outside (maybe 11x18 feet) and he did great for a few days and then came in with both front legs swollen…I’m not sure how he did it so hes back to the jail cell until the vet can ultrasound.

Please give me ideas. He has a jolly ball in his stall that he ignores. I wish I had a facility near by where I could swim him or something but that’s not an option as far as I know.

[goodmorning]

What’s he on for grain? I would cut it. Hay stretcher is fine. How much longer is he locked up for? Reserpine can be hit or miss but since he’s this naughty I would absolutely go there. Trampeled owner & loose horse is a bigger problem than your vets concerns IMO. Get vet on board or find a new vet.

I would give ace 45min to an hour. How much ace? 2ccs?

I was also going to suggest a medical paddock outside, even better if it’s off the stall. Where is he stalled in the barn? I would put him in a busy area.

Are you in a position to have the barn staff handle him for some waking? Twice a day may help, but honestly more/different drugs sound needed. Not all respond to ace, or resperpine.

[goodmorning]

Also hand walking him in the barn is fine, is there a reason you are walking him outside as well?

[Huntin_Pony]

I agree you need more pharmaceutical help. Maybe let your vet try to handwalk him and then see what (s)he suggests.

Beyond that, I do suggest walking him with his bridle rather than or in addition to his halter/chain.

[Equisis]

Just hand walk him up and down the barn aisle. Boring, but safer. He is not helping the ligament heal by leaping around, and your safety is more important. Also, ask your vet for better drugs.

[devvie_continued]

Is he in the barn alone (no other horses) for any length of time during an average day? Can he SEE other horses at all times? Does he get some contact with other horses, for example one in the stall next to him? Do you think he might walk better with a buddy very close by? Will he settle enough to graze? I agree with the “walk him in the aisle” suggestions, for sure safer. But I think that if he were happier in his stall rest situation overall he’d not be acting out so much in hand.

[EventerAJ]

Try a lip chain with your lunge line. Coming off the track, I can just about guarantee he’s worn one before and knows what it means (party’s over, human in control). If the chain is too harsh, you can wrap it with a little vetwrap for the section that goes over the gums. Keep consistent, light pressure on the chain. Some people pull the chain through the nose side ring to the end of the swivel, run the chain under lip, through the offside cheek ring and snap it back to itself to maintain tension; just beware if the horse has a panic attack you can’t quickly release the chain.

Similarly, you can use a small 6" bungee cord as a lip cord, hooked to the side halter rings. Then use your chain over the nose as usual. This has the advantage of a hands free lipchain, don’t have to worry about it slipping off the gums. Those little bungees are sold with the multipack sets in plastic jars, use the regular big ones to hang fans, etc.

Wear gloves, a helmet, and possibly a vest if you aren’t already. Handwalking a kite-beast is a royal PITA. If you have a safe horse to pony with, you could try that too… Sometimes being above the ground gives you more leverage (and safety).

[woodhillsmanhattan]

My guy was on stall rest when he was 5 as well…so I totally empathize with you! Ace is your friend! I would give 0.5-2cc as soon as I put him in the cross ties. Take ~10-20 minutes to groom him while it kicked in. And then go for our walk (~ 30 min). I would try to alternate which side of the neck or which pectoral muscle I injected.

The use of a chain will depend on your horse. Mine was worse with one (would go up…and since his injury was on his back leg that was no good!). I alway hand-walked with gloves, helmet, and a lunge line rather than a lead rope.

[OverandOnward]

Reserpine. (“reh-SIR-peen” but it doesn’t matter, even some vets can’t pronounce it)

It can be a miracle calmer, and it is not sedation. I’ve never known a vet to hesitate to prescribe it. One dose lasts a month.

A few horses have a reaction to it, but as I understand it is not fatal or even harmful. Just be careful on first administration.

Also, until he is more calm, wear a helmet and gloves when you mess with him. Maybe a safety vest, too. Carry a crop to push him away from you as needed (with the butt end).

Good luck. It takes a lot of love and patience, but you can do this. And you’ll have a wonderful horse when it is all over and he’s back on track (hopefully).

[vineyridge]

Would ground driving help in this situation? If he ground drives, at least you have a bit in his mouth and some distance between you and the horse, some control, and you’d be a good bit safer. And you could keep him at the walk. He might think he was working and behave better.

I have no idea if this would be a good thing, but it seemed worth suggesting.

[flyingchange]

If your vet won’t help you out with reserpine on this, find one who will. Give him at least one cc of ace 30 minutes before walking him.

[bornfreenowexpensive]

Send him to an experienced rehab farm. I send mine to one that has a big European style walker. The horses stay calmer in the routine of the rehab farm and I stay safer.

But in the ones I’ve rehabbed myself…resurpine. Yes…there is a small risk of the side effects…but there is a bigger risk of him hurting you or getting loose and getting hurt. I never did the one shot…but also did daily pills. I felt there was less risk without the time release aspect of the shot.

[TPF_Hunter]

Reserpine is a miracle worker, but PLEASE do your horse and yourself a favor and do NOT give the injectable reserpine that “lasts a month”. It has horrible gastric effects to it ( ask me how I know). Instead get the powdered form that you feed daily. It works better in my (unfortunately) very experienced opinion and you can increase or decrease your dosage as needed. The powdered form also does not have the negative gastric effects to it.

I rehabbed a stallion-like creature that was horrible in a stall, worst rehab patient in history. This guy was already a playful/opinionated/huge PITA while in full work (but we loved him). I’ll agree with the other posters here that you definitely need to not only up the ace, but you may want to try some Sedivet or Xylazine for hand walking as well. Those are stronger drugs that will help to keep his feet on the ground and you out of harms way. Here are my rehab go-to’s:

• Powdered Reserpine
• Small hole hay nets 24/7 - sometimes 2 in the stall at a time so he can have options.
• Having a buddy next to him or across from him at all times. If they can touch noses - even better.
• Confined turn out like you mentioned - but while Ace is on board. Have a hay net out there also. Handgrazing a buddy close by helps
• Lungeline w/ chain while walking for him, Helmet/ vest for you. Do not be afraid to use the chain on the gums.
• Handwalk in an arena if you have the option
• Minimum handwalking twice a day - the more the better. The longer the better. Walking will NOT hurt a suspensory.

If you’re at your wits end and just feel stressed/ your horse is stressed/ the barn staff is stressed, and you feel unsafe, take @bornfreenowexpensive 's advice and send him to a rehab farm. Most do have big Euro walkers that supplement hand walking and the horses love it. They are herd animals and love being around their friends. These facilities work great bc the rehabbers are all stalled together, cold touch noses, and have a routine. For my insane rehabber - this was our saving grace. He enjoyed his “group therapy” on the walker. Its not cheap, but in the long run its safer for everyone and your horse will benefit from it. Your horse will also be safer coming out of rehab and likely heal better.

Best of luck to you!!

[TPF_Hunter]

Also wanted to add… The powdered reserpine makes your ace work better! This way you can just shoot it in his mouth instead of giving a needle every day ( which can cause scar tissue, even if you alternate sides). 2cc oral ace. 30-45 minutes to set in.

[Trot_On]

Yep, powdered reserpine kept my OTTB and me from killing each other. He lasted about a month into stall rest without it and then flipped the switch. We both came out safe and sound on the other side. If you decide to use it be aware that they will still have days when they blow up, but it is usually containable. Without the added reserpine we were going through large doses of ace to keep most of his feet on the ground. I would start and keep him on some ulcer relief program.

Wear gloves and a helmet every time and always keep your eyes on him, the “tell” that they are going to blow when they are on sedation is not always as noticeable. My boy was more respectful with a correctly adjusted rope halter,the nose pressure points worked better for him then a chain over the nose. He could be sometimes distracted with changes of direction, halts with a treat reward (the sanity carrot) and changes of gait within the walk. Just say no to ground driving or long lining unless both of you are already experienced. Spooking, spinning and wrapping himself up like a present with the long lines, then bolting and falling over, is not conducive to suspensory healing. Once the grass comes up enough for hand grazing you will have another point in your favor.

When we finally made it to the outdoor stall (with hay) and a buddy grazing near, we were over the hump. A close eye was needed and limited turnout time because he would still blow through the double sedation occasionally. This is a tough time, keeping them interested with food (nibble net) or interesting things going on around them can help.

Good luck, the horse that you have on stall rest is not the one you will have later, just like a toddler - the tantrums are not forever.

[evilc123]

I have been in this EXACT same situation and every day feels like an eternity of praying that he makes it through without killing himself or someone. I had my guy on reserpine, SmartCalm ultra, oral ace 2x/day, and robaxin. The two things that made a difference were: 1) I did a groundwork clinic with a natural horsemanship practitioner who helped me use my body language to keep him in check as I was walking him with minimal strain on his body, 2) I ultimately sent him to a rehab facility that was equipped to handle all types of horses at all stages of recovery–and I wish I had done it sooner. If this is an option for you, I would highly recommend it. They should also be able to do the walking and med administration for you. Just also keep in mind that recovery for a horse like this is all about risk/benefit. If you put his recovery at risk by catering to his need to be more active (e.g., giving him a bit more space in turnout), you may actually be enabling him to ultimately recover from something that he would otherwise not be mentally capable of.

Also…I saw someone recommend ground driving. I would be really careful with that. It COULD be a great solution, but it can also be super dangerous because if he spins/rears/bucks he has lots of opportunities to tangle himself in the lines which will literally make his brain explode (yes, that’s the medical terminology ;)).

Anyway, best of luck. I truly do not envy you.

[theresak]

FYI - reserpine can be compounded in several different ways and the injectable is not always a monthly dose.

I used it by dosing daily for 6 days to get to the desired level of sedation, then re-dosing every 5-6 days. I ended up changing my dosing to a smaller amount every other day at the end. By dosing gradually over several days, you can monitor the GI effects and get ahead of any dehydration from diarrhea. My horse had pretty loose poop for the first few days but not watery and then looser than normal for the rest of the time he was on the reserpine.

[Duramax]

My vet had me add xylazine to our ace for our hand walks and it saved me and my horse. I was in tears twice daily after our hand walks when he would violently spook and be so reactive. Once we added the xylazine I got my horse back. It got us through the Dec-March handwalks and now that it’s getting warmer he is actually fine with either just ace or totally sober. My guy is a 17.2 draft cross and he is a lot of animal when he blows up.

My vet was reluctant to do the reserpine or fluphenazine bc of the side effects.

I will second what someone suggested about having a trusty buddy tag along- that helped my guy big time. I also tried to be very clever about when I did the walks- tried to time them for the calmest weather and when there would be the least activity at the farm (not always easy to do, especially with walks twice daily).

Before the xylazine, I had gotten to the point where I would get sick to my stomach about halfway to the barn each day. Hang in there!

[MsM]

Another chemical possibility: My horse did not respond to oral reserpine. It just didnt work for him. Vet suggested trazadone which is mostly used for anxious dogs and cats, but did have some use reported in horses. This has been a lifesaver. Lasts about 6 hours for my horse so he gets handwalking and small paddock turnout. I did have to up the dose a bit as they do accomodate after a while, but I suspect that the warmer weather will help now.

Amazing how tall a horse looks when he is standing on his hind legs and you are holding the lead rope!

[runNjump86]

Oral reserpine powder was a life saver when my guy was on stall rest for three months. It took two packs a day, and it did give him some loose stool, but that was far preferred to the spinning, pacing, screaming mess he was prior to the drugs. He was on it long term and I firmly believe it messed with him mentally, but at the time it was the best option. When we graduated to hand walks he had to be in the Pessoa and only walked in the barn aisle. Tack walking could only be done using Xylazine and I had to time it right: empty or low traffic arena, and if it was too windy or raining too hard then forget it because the roof noise would set him off. If anyone came in to lunge I just got off and walked out.

Now we are coming off stall rest (again) and handwalking has been interesting. Thankfully he is MUCH calmer and quieter in his stall so is only getting 1 pack of Reserpine daily. For walking I’ve been successfully using a mouth or lip chain, but we always start with the chain over the nose and only progress if needed. The first couple of walks he was great, but now he’s feeling really good. I usually only go about ten minutes, any longer and he seems to work himself up. I haven’t needed to resort to any other drugs yet, and we’re down to the final week so I’m hoping they won’t be needed.