My gelding has been on stall rest for almost 5 weeks currently and has 2 more to go. Xrays a few days ago showed the splint is not completely calcified but the vet said at the end of the added 2 weeks, it should be fully calcified.
What is the rehab schedule for a lay-up like this? I don’t want to underestimate what I should be doing because I really don’t want this splint becoming active again. I’d rather take more time building him up again than pushing him faster than he should be taking it
7 weeks of stall rest is significant, but not crazy. It’s also a bony injury, not soft tissue, so the rehab doesn’t need to be quite as slow. How much hand walking is he doing now? I’d want to build the hand walking up over a few weeks to at least 30 minutes twice a day. Then switch one of those to tack walking. Build up the tack walking time until you are doing a brisk walk for 45 minutes. Assuming no soft tissue involvement, you can also do gentle hills/terrain. About 4-6 weeks in, you should be able to add trotting. 5 minutes the first week, 10 minutes the second, etc.
Although it’s not a soft tissue injury, that is a lot of time in the stall for a non weight bearing structure. I assume it wasn’t displaced since no surgery? Was he very lame? Any walking happening yet? I’d build slowly up to 30 mins hand walk. Then tack walk. Then 5 mins trot, etc. One of the reasons we rehab slowly is not just for the injury but also everything is de-conditioned and more prone to injury after many weeks in a stall.
You may get some activity in the splint coming and going until it’s old and as gone as it’s going to be. But you should not get heat or lameness.
He’s been on strict stall rest. He walks to the wash stall to get cold hosed and starting 2 weeks ago, he gets around 30 minutes hand grazing a couple days a week.
In the beginning, his suspensory was irritated but he has been on bute which has helped and it’s no longer irritated.
My biggest concern with hand walking is that I don’t trust him enough to not flip out and want to run and I don’t have the knowledge and skill to give him ace or something and my trainers are not going to. He’s quite an angel under tack though. The other thing is, I don’t own him, I lease him from my trainers so I don’t know how they plan to introduce turnout.
It sounds like you need to sit down with the vet and the owner/trainer and come up with a group plan. Talk with the vet about your tranquilizer options for hand walking. There are many alternatives to injectables if you don’t feel comfortable - dorm gel goes under the tongue, ace pills can be fed in a cookie, etc.
Is he jogging sound for the vet off the bute? Ultrasound looks fine? You don’t want to take chances with suspensory irritation.
No the splint was not displaced. The splint is actually quite old, probably started around a year ago and it was small, no swelling or heat and was never lame but we had the vet look at it at that time and for cosmetic and pain management purposes, she injected the area with corticosteroids to make sure he was good to go for a championship event we had.( he ended up getting eliminated for not jumping and I’m wondering if that was the start where the splint started changing again and it became painful for him.) A couple weeks after that event, he was on stall rest for an abscess for a month and I guess that did nothing for it’s healing process. At the end of last year, it started growing and became sensitive with heat, no swelling. The suspensory became irritated and he was never lame. I’d say the splint went from less than an inch to close to 2 inches now.
He walks to the wash stall and he gets 30 minutes of hand grazing a couple days a week. In the beginning, walking was not advised. I guess I could start hand walking him now, but ace doesn’t look like an option, only for when he starts turnout and most of the times I am at the barn alone and I don’t trust him alone.
He just got off bute this past weekend. At the first vet visit, he was sound even with flexion tests. She has not seen him jog/ lunge since then. She is confident that the suspensory is no longer affected after palpating and did not decide to do an ultrasound. After these 2 weeks are up and he is deemed good to start up again, if he is still sensitive to palpation, I will contact her about making another appointment to check the suspensory.
I am the concerned rider for this horse and I am in charge of his daily care, but since I am not the owner, I don’t get to make decisions like this as I don’t pay for them.
Ok I see. So this is not a fresh splint but it has irritated the soft tissue. Do you know if the increase in size is bony or if it’s in the connective tissue? Was any shockwave done?
In any event, it sounds like a normal, slow rehab protocol is what you will need to follow, starting with short stints of hand walking. Perhaps the owner/trainer should be the one doing this at first. And teach you how to use a chain or something properly if drugs are not an option. You can start with just 5 minutes in the barn aisle. Doesn’t have to be a big walk out in the open.
Because he has been on strict rest and had soft tissue irritation, rehab it like a soft tissue injury. I’d probably put on some kind of protective boot for walking also just so he doesn’t knock the area.
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