Mare I recently bought after a long trial has been lame for a week on one of the front legs and everything points to an unlucky suspensory strain. I will ultrasound next week to confirm, but my money is on some sort of soft tissue injury.
I know the rehab is very extensive, and the prognosis on the front tends to be pretty good. Apart from two unfortunate lunging sessions on day 2 and 3 of injury due to misdiagnosis that ultimately allowed detecting the subtle lameness in trot (that grew very obvious over course of week), she has been on tiny paddock turnout/stall rest and I’ve put ice compresses on her leg for 6 out of 7 days 1x a day for 20-30min.
My question is not so much about the specifics of the rehab as that will probably be determined by the u.s. findings. What I am worried about is that there is no way I can manage icing or hand-walking her twice daily (it’s a 40min commute one way), because the job that pays the vet bills is pretty demanding and this week has been extremely exhausting (normally I go see her only 4x a week). The barn I board at is very nice, but a small facility so nobody dedicated to deal with these sorts of issues and other owners tend to live nearby so they do drive multiple times a day if necessary. If it was an acute problem I could have them help out but a dedicated multiple month rehab program will most definitely be a stretch.
I pay what feels like a pretty penny for her monthly care & training already (all in ~1.5k) and if this is not working for us going forward, I’m wondering what are my other options. I’m interested to hear what are other people’s experiences of rehabbing soft tissue injuries that take a lot of time and dedication to heal while having a job on the side. How did you manage the demands of time? Has anybody sent a horse to a lay-up facility for this type of issue? Would you recommend it?
I would send to a specialized rehab farm if I couldn’t get to the farm 2x a day, 7 days a week. Rehab work is a major commitment and time consuming. I love doing it, and it’s rewarding, but you can’t skip a single day for months.
Is the horse in full training or just board? If training, isn’t this included? Every training barn I’ve been at is full service including rehab.
If you give a roundabout of where your located maybe people can suggest rehab facilities.
As long as you have a stable barn situation with limited turnout, I’d say do the best that you can. I’ve rehabbed with a job and I was exceedingly obsessive about following protocols. I would go out once a day and I would usually skip the barn one day out of every 14 if the situation was basically under control. Sometimes I might have hand walked, then ridden another horse and hand walked or iced again. (I’ve also had injuries where I’ve gone out every day for months.) A lot may depend on if your horse can also mentally take the limited movement. I’ve been very lucky to that degree. Or maybe you can enlist someone to help you with rehab a day or two a week to limit the degree you will lose your mind:) If you know of a good lay up facility though, it might be worth it to let you focus on your job.
A lot will depend on the exact injury. Initially, mine have needed dedicated attention 2-3x/day for hand walking, icing, and wrapping, and vet appointments every two weeks for shockwave or follow-up ultrasounds.
In two cases, the horse was a very sane individual who was allowed to start using the tiny turnout/run off his stall by week 4. It sounds like you have one of these. That replaced afternoon handwalking and made care downright manageable. Remember that time is the primary catalyst for healing. Do the best you can with what you have available.
Sometimes it works best to leave the horse where he’s comfortable and pay a groom, fellow boarder, or lesson kid to do some shifts. This will depend a lot on how level-headed your horse stays while on stall rest.
On the other end of the spectrum, I rehabbed one years ago who needed drugs for everything by week 2 - including not killing you while changing standing wraps. That horse was simply too challenging and time consuming for even his full service barn - and he went to a rehab center.
If you consider going that route, there are two main options - normal boarding barns that specialize in rehab horses, and commercial rehab centers that have all the bells and whistles (treadmills, pools, lasers, on-site vets, etc.). Your local vet clinic will be a great source of finding the former. It’s not uncommon for a horse to be ready for discharge from the clinic, especially post surgery, but need more care than the owner can provide - so they typically know exactly where to point you.
The latter can be shockingly affordable compared to a normal training barn. I’m familiar with one in Ocala FL, one in NJ, and one in upstate NY - but I’m sure there are many. If your horse is the jerk, I highly recommend the latter - people used to handling 3 year stallions fresh off the race track are phased by little.
My experience with training barns and rehabs (unfortunately vast) is that they will do the wrapping, re-wrapping, hand walks, etc. as part of the training fee or even as a special layup training fee that is sometimes less. It sounds like the OP’s barn perhaps doesn’t do that.
I’d wait to see what the vet finds and then recommends WRT treatment and rehab protocol and then talk to the barn if it seems like you can make it work there. If not, you’re going to have to find a different situation that can handle it.
In my experience, keeping a horse in training sometimes means that they will let you hack other horses–lesson horses who don’t have a lesson that day, horses belonging to people who are out of town (obviously with prior OK from owner), etc. But my horses have generally been pretty easy to deal with. If I had one that needed sedation for bandage changes it would probably leave and go to a rehab facility.
I’ve rehabbed multiple horses and multiple injuries on 1x daily trips to the barn after the acute stage.
I feel like during the stall rest period, it’s unfair to skip a day of hand walking as that’s the only time the horse gets out of the stall. But once they are in a pen outside, you can probably skip a day, or if the horse is a good patient, have a friend do the hand walking.
Once you start the real rehab after the injury is healed, I think consistency is key. I’ve had the best luck with daily rehab/riding. I’ve helped an older friend rehab her horse a few times - she’s not comfortable riding at the early stages, so she’d do in-hand walking and trotting on days I couldn’t ride for her.
This. I used to do this when I was a teenager/ student for boarders who couldn’t get to the barn. I know a lot of horse people are falling on hard times too so I would think you could find a local barn hand or mature barn rat to help you out and fill in gaps.
I’ve rehabbed multiple horses for ligament/tendon issues over the years and never had a vet who required multiple visits per day either. I did my own sedation and handwalking as needed. No a horse won’t die if you miss a very occasional day.
Also consider moving the horse to either a rehab facility if you don’t feel confident handling a crazed stall bound horse. Or to a cheaper, very local barn so you can save money and DIY it.
Rehab sucks - give yourself a break and make it easier as much as you can!
I’m not sure that this will be the problem you foresee.
My experience is that it is a rare soft tissue injury that needs multiple “touches” during the day past the acute phase. For the first 2-4 weeks, your vet may recommend some benefit from some combination of ice, poultice, or sweat applied to the leg. Since your mare has some turnout, the timing of this treatment may depend on her activity- if she is out overnight and in during the day, for instance, can you get there in the AM, ice, and bandage, and the farm take off the bandage for turnout? Or vice versa? If staff are unable to do this on the days that you can’t get out, is there another boarder you would trust to do this? (I would 100% ice and set a leg for any fellow boarder who asked me, and not expect payment; it would be a kind gesture to offer a couple dollars a day.)
She has a paddock. Does she need to be hand-walked? Are the facilities, and her brain, such that you could employ Dr. Green? Dr. Green is my favorite way to deal with a soft tissue injury- I think that provided the animal isn’t an absolute loon you get a happier horse, and better healing, if they can get out and graze and meander.
The way I did this with my horse was usually to go out in the morning before I went to work to ice and set up his leg, and the barn would take off his wraps. It meant early mornings, which was unpleasant in winter to say the least, but it was easier to get out before work than deal with the traffic after.
Continuing the discussion from Rehab options:
I’ve done it both ways. I’ve sent a horse to a facility the first time for a rehab. I was limited because my then farm where I boarded did not have the small paddocks with good footing for turnout. Where I sent him was perfect and had a lot of amenities-- eurociser, aquatread, small paddocks, and poly-surface track. They also broke 2 year olds for the track so there were exercise jockeys who didn’t think anything of my rehab horse’s antics. My most recent one, I rehabbed at home. COVID actually was a bit of a blessing because I paid a college student to do all the hand walking for me. I rented round pen panels and created a medical paddock. This farm also has amazing footing and grassy paddocks that only get small amounts of mud in just a few places even after lots of rain. The farm also had some smaller paddocks I was able to divide with the round pen panels and expand his turnout until he was cleared for full turnout.
For icing, I bought cryochaps and small car freezer I got off amazon that I kept in the tack room ($300 investment total with boots). That made icing really easy.
I went through a yearlong rehab last year, but luckily I’d moved to a barn that is 8 minutes from my house. Still, getting out there before and after work when that was necessary was a strain. Thankfully the BO would give me the occasional help by pulling a standing wrap, or hand walking a few days on a few occasions when I had to travel for work. One of the bodyworkers I use runs a rehab facility, and if I have to go through this again (knock wood I don’t), I would probably send the horse there. She has laser, PEMF, Theraplate and a horse pool, as well as the ability to follow more complicated rehab schedules. My board costs substantially less than yours; at what you’re paying, it probably wouldn’t make much difference money wise to send to a rehab facility and save your sanity.
Thank you all. Whatever the mare had and gave me such convincing symptoms (lame on the outside leg in trot, swelling behind knee) was resolved by the time our super busy vet could visit and do a thorough lameness exam. I insisted on ultrasound which came back clean too. I’m slowly and carefully bringing her back into work over the course of a few weeks and am so relieved that this looks like was just a mini crash course in rehabbing a lame horse. Hopefully we will never get to experience the extended version.
